TNCC EXAM 9TH EDITION STUDY QUESTIONS
AND ANSWERS 2023 ( A+ GRADED 100%
VERIFIED)
1. What is the effect of hypothermia on the oxyhemoglobin
dissociation curve: Hemoglobin does not readily release oxygen for use by
the tissues A shift to the left occurs in an environment of low metabolic
demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
2. EMS arrives with the intoxicated driver of a car involved in a
motor vehicle crash. EMS reports significant damage to the driver's
side of the car. The patient is asking to have the cervical collar removed.
When it is appropriate to remove the cervical collar?: After a physical
examination if the patient has no radiologic abnormalities on CT A CT is
recommended for spinal clearance in an impaired patient.
3. The nurse is caring for a 120 kg male brought in after a
warehouse fire and is calculating the patient's fluid resuscitation needs.
He has painful red blistering to the entire surface of both upper
extremities and superficial burns to the anterior chest. Using the
modified Lund and Browder chart to calculate the total body surface
area burned, how much IV fluid would be administered in the first 8
hours?: 2280 mL Both upper arms = 8%, both lower arms = 6%, and both
hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to
2280 mL. Superficial burns are not included in the TBSA calculation for
fluid resuscitation.
4. Which of the following is an expected finding in a patient with a
tube thoracostomy connected to a chest drainage system: Fluctuation in
the water seal chamber Fluctuation in the water seal chamber indicates the
tube is placed correctly in the pleural space.
5. .A 35-year-old male presents with facial trauma after being struck
in the face with a baseball. A teardrop-shaped left pupil is noted on
exam. What type of injury is suspected?: Globe rupture A teardrop-
shaped pupil suggests a globe rupture.
6. .A patient with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?:
Bradycardia and absent motor function below the level of injury Patients
with a complete spinal cord injury will have absent motor function below
the level of the lesion. They become hypotensive and bradycardic due to
loss of autonomic nervous system function.
7. Which of the following patients warrants referral to a burn
center?: A 52-year-old diabetic male with a partial-thickness burn to the left
1/8
, lower leg This patient has a 7% TBSA burn with a preexisting medical
history that could complicate management, prolong recovery, or affect
mortality.
8. You are caring for a patient who was involved in a motor vehicle
crash and is 32 weeks pregnant. Findings of your secondary survey
include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cardiotocography.
These findings are most consistent with which of the following?:
Placental abruption The findings of abdominal pain, elevated fundal height,
dark bloody show, and fetal distress are most consistent with placental
abruption.
9. A 20-year-old male presents to the ED complaining of severe
lower abdominal pain after landing hard on the bicycle cross bars while
performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the
following orders would the nurse question?: Straight catheter for urine
sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include
blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a high-
riding or non-palpable prostate.
10. Which of the following occurs during the third impact of a motor
vehicle crash?: The aorta is torn at its attachment with the ligamentum
arteriosum This occurs during the third impact.
11. All of these are considered a critical communication point in
trauma care EXCEPT which of the following?: Defusings A defusing is
part of critical incident stress management but is not considered a critical
communication point in trauma care.
12. Which of the following mnemonics can help the nurse prioritize
care for a trauma patient with massive uncontrolled hemorrhage?:
MARCH The MARCH mnemonic stands for massive hemorrhage, airway,
respiration, circulation, and head injury/hypothermia. The MARCH
mnemonic recognizes uncontrolled hemorrhage as the major cause of
preventable death after injury.
13. You are treating a 27-year-old male in respiratory distress who
was involved in a house fire. Calculating total body surface area (TBSA)
burned is deferred due to the need for emergent intubation. At what
rate should you begin fluid resuscitation?: 500 mL/hour Prior to
calculating TBSA, this is the recommended starting point for fluid
resuscitation for patients 14 years of age and older
2/8
AND ANSWERS 2023 ( A+ GRADED 100%
VERIFIED)
1. What is the effect of hypothermia on the oxyhemoglobin
dissociation curve: Hemoglobin does not readily release oxygen for use by
the tissues A shift to the left occurs in an environment of low metabolic
demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
2. EMS arrives with the intoxicated driver of a car involved in a
motor vehicle crash. EMS reports significant damage to the driver's
side of the car. The patient is asking to have the cervical collar removed.
When it is appropriate to remove the cervical collar?: After a physical
examination if the patient has no radiologic abnormalities on CT A CT is
recommended for spinal clearance in an impaired patient.
3. The nurse is caring for a 120 kg male brought in after a
warehouse fire and is calculating the patient's fluid resuscitation needs.
He has painful red blistering to the entire surface of both upper
extremities and superficial burns to the anterior chest. Using the
modified Lund and Browder chart to calculate the total body surface
area burned, how much IV fluid would be administered in the first 8
hours?: 2280 mL Both upper arms = 8%, both lower arms = 6%, and both
hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to
2280 mL. Superficial burns are not included in the TBSA calculation for
fluid resuscitation.
4. Which of the following is an expected finding in a patient with a
tube thoracostomy connected to a chest drainage system: Fluctuation in
the water seal chamber Fluctuation in the water seal chamber indicates the
tube is placed correctly in the pleural space.
5. .A 35-year-old male presents with facial trauma after being struck
in the face with a baseball. A teardrop-shaped left pupil is noted on
exam. What type of injury is suspected?: Globe rupture A teardrop-
shaped pupil suggests a globe rupture.
6. .A patient with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?:
Bradycardia and absent motor function below the level of injury Patients
with a complete spinal cord injury will have absent motor function below
the level of the lesion. They become hypotensive and bradycardic due to
loss of autonomic nervous system function.
7. Which of the following patients warrants referral to a burn
center?: A 52-year-old diabetic male with a partial-thickness burn to the left
1/8
, lower leg This patient has a 7% TBSA burn with a preexisting medical
history that could complicate management, prolong recovery, or affect
mortality.
8. You are caring for a patient who was involved in a motor vehicle
crash and is 32 weeks pregnant. Findings of your secondary survey
include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cardiotocography.
These findings are most consistent with which of the following?:
Placental abruption The findings of abdominal pain, elevated fundal height,
dark bloody show, and fetal distress are most consistent with placental
abruption.
9. A 20-year-old male presents to the ED complaining of severe
lower abdominal pain after landing hard on the bicycle cross bars while
performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the
following orders would the nurse question?: Straight catheter for urine
sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include
blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a high-
riding or non-palpable prostate.
10. Which of the following occurs during the third impact of a motor
vehicle crash?: The aorta is torn at its attachment with the ligamentum
arteriosum This occurs during the third impact.
11. All of these are considered a critical communication point in
trauma care EXCEPT which of the following?: Defusings A defusing is
part of critical incident stress management but is not considered a critical
communication point in trauma care.
12. Which of the following mnemonics can help the nurse prioritize
care for a trauma patient with massive uncontrolled hemorrhage?:
MARCH The MARCH mnemonic stands for massive hemorrhage, airway,
respiration, circulation, and head injury/hypothermia. The MARCH
mnemonic recognizes uncontrolled hemorrhage as the major cause of
preventable death after injury.
13. You are treating a 27-year-old male in respiratory distress who
was involved in a house fire. Calculating total body surface area (TBSA)
burned is deferred due to the need for emergent intubation. At what
rate should you begin fluid resuscitation?: 500 mL/hour Prior to
calculating TBSA, this is the recommended starting point for fluid
resuscitation for patients 14 years of age and older
2/8
