LATEST UPDATED TNCC TRAUMA NURSING
CORE COURSE EXAM 1, 2 AND 3 |
COMPREHENSIVE QUESTION BANK WITH
ANSWERS AND RATIONALES.
1. Why is a measure of serum lactate obtained in the
initial assessment of the trauma patient?
A. to measure oxygenation and ventilation
B. to quantify the base deficit for the adequacy of
cellular perfusion
C. to gauge end-organ perfusion and tissue hypoxia
D. to determine the underlying cause of shock
**Correct Answer:** C
**Rationale:** Serum lactate gauges end-organ
perfusion and tissue hypoxia.
2. A trauma patient is restless and repeatedly asking
"where am I?" Vital signs upon arrival were BP
100/60 mm Hg, HR 96 beats/min, and RR 24
breaths/min. Her skin is cool and dry. Current vital
signs are BP 104/84 mm Hg, HR 108, RR 28
breaths/min. The patient is demonstrating signs and
symptoms of which stage of shock?
A. compensated
,B. progressive
C. irreversible
D. decompensated
**Correct Answer:** A
**Rationale:** Narrowed pulse pressure, tachycardia,
and restlessness indicate compensated shock.
3. An elderly patient with a history of anticoagulant
use presents after a fall at home that day. She denies
any loss of consciousness. She has a hematoma to
her forehead and complains of headache, dizziness,
and nausea. Which is a most likely cause of her
symptoms?
A. epidural hematoma
B. diffuse axonal injury
C. post-concussive syndrome
D. subdural hematoma
**Correct Answer:** D
**Rationale:** Anticoagulant use and fall history with
delayed symptoms suggest subdural hematoma.
4. EMS brings a patient who fell riding his bicycle.
Using the American College of Surgeons screening
,guidelines, which assessment finding would prompt
the nurse to prepare the patient for radiologic spine
clearance?
A. Alert with no neurologic deficits
B. Multiple abrasions to the extremities
C. Multiple requests of water
D. Smell of alcohol on breath
**Correct Answer:** D
**Rationale:** Alcohol intoxication is a high-risk
criterion requiring spine imaging.
5. Which of the following occurs during the third
impact of a motor vehicle crash?
A. The driver of the vehicle collides with the steering
wheel
B. the vehicle collides with a tree
C. the aorta is torn at its attachment with the
ligamentum arteriosum
D. the airbag deploys and strikes the front seat
passenger
**Correct Answer:** C
**Rationale:** The third impact involves internal
organs colliding within the body cavity.
, 6. A passenger is brought to the emergency
department of a rural hospital following a high-speed
MVC. When significant abdominal and pelvic injuries
are noted in the primary survey, which of the
following is the priority intervention?
A. initiate transfer to a trauma center
B. provide report to the operating room nurse
C. obtained imaging studies
D. place a gastric tube
**Correct Answer:** A
**Rationale:** Significant injuries at a rural facility
require immediate transfer to a trauma center.
7. Which of the following injuries is LEAST likely to be
promptly identified?
A. spleen
B. lung
C. bowel
D. brain
**Correct Answer:** C
**Rationale:** Bowel injuries are often missed initially
due to subtle early symptoms.
CORE COURSE EXAM 1, 2 AND 3 |
COMPREHENSIVE QUESTION BANK WITH
ANSWERS AND RATIONALES.
1. Why is a measure of serum lactate obtained in the
initial assessment of the trauma patient?
A. to measure oxygenation and ventilation
B. to quantify the base deficit for the adequacy of
cellular perfusion
C. to gauge end-organ perfusion and tissue hypoxia
D. to determine the underlying cause of shock
**Correct Answer:** C
**Rationale:** Serum lactate gauges end-organ
perfusion and tissue hypoxia.
2. A trauma patient is restless and repeatedly asking
"where am I?" Vital signs upon arrival were BP
100/60 mm Hg, HR 96 beats/min, and RR 24
breaths/min. Her skin is cool and dry. Current vital
signs are BP 104/84 mm Hg, HR 108, RR 28
breaths/min. The patient is demonstrating signs and
symptoms of which stage of shock?
A. compensated
,B. progressive
C. irreversible
D. decompensated
**Correct Answer:** A
**Rationale:** Narrowed pulse pressure, tachycardia,
and restlessness indicate compensated shock.
3. An elderly patient with a history of anticoagulant
use presents after a fall at home that day. She denies
any loss of consciousness. She has a hematoma to
her forehead and complains of headache, dizziness,
and nausea. Which is a most likely cause of her
symptoms?
A. epidural hematoma
B. diffuse axonal injury
C. post-concussive syndrome
D. subdural hematoma
**Correct Answer:** D
**Rationale:** Anticoagulant use and fall history with
delayed symptoms suggest subdural hematoma.
4. EMS brings a patient who fell riding his bicycle.
Using the American College of Surgeons screening
,guidelines, which assessment finding would prompt
the nurse to prepare the patient for radiologic spine
clearance?
A. Alert with no neurologic deficits
B. Multiple abrasions to the extremities
C. Multiple requests of water
D. Smell of alcohol on breath
**Correct Answer:** D
**Rationale:** Alcohol intoxication is a high-risk
criterion requiring spine imaging.
5. Which of the following occurs during the third
impact of a motor vehicle crash?
A. The driver of the vehicle collides with the steering
wheel
B. the vehicle collides with a tree
C. the aorta is torn at its attachment with the
ligamentum arteriosum
D. the airbag deploys and strikes the front seat
passenger
**Correct Answer:** C
**Rationale:** The third impact involves internal
organs colliding within the body cavity.
, 6. A passenger is brought to the emergency
department of a rural hospital following a high-speed
MVC. When significant abdominal and pelvic injuries
are noted in the primary survey, which of the
following is the priority intervention?
A. initiate transfer to a trauma center
B. provide report to the operating room nurse
C. obtained imaging studies
D. place a gastric tube
**Correct Answer:** A
**Rationale:** Significant injuries at a rural facility
require immediate transfer to a trauma center.
7. Which of the following injuries is LEAST likely to be
promptly identified?
A. spleen
B. lung
C. bowel
D. brain
**Correct Answer:** C
**Rationale:** Bowel injuries are often missed initially
due to subtle early symptoms.
