TNCC final exam test 2022 open book
OE COMPLETE QUESTIONS AND
ANSWERS (VERIFIED)
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access
facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71,
HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority
intervention for this patient? - ANSWER>>Expedite transfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma
pt? - ANSWER>>a pertinent medical hx is crucial
Following a review of recent drills and a real disaster event, a hospital has identified
deficiencies and is taking steps to minimize the impact of a future disaster . Which phase of the
disaster life cycle does this describe? - ANSWER>>Mitigation
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeons
screening guidelines, which assessment finding would prompt the RN to prepare the pt for a
radiologic spine clearance? - ANSWER>>Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of any
substances, and without neurologic abnormalities
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? -
ANSWER>>hemoglobin does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER>>acidosis
EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits
urinary incontinence and priapism. These assessment findings are most consistent with which
of the following types of spinal cord injury? - ANSWER>>Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a
chest drainage system? - ANSWER>>flucuation in the water seal chamber
,During the primary survey of an unconscious pt with multi-system trauma, the nurse notes
snoring respirations. What priority nursing interventions should be preformed next? -
ANSWER>>insert an oropharyngeal airway if there is no gag reflex
A 35 y/o M 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? -
ANSWER>>globe rupture
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96,
RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock? - ANSWER>>compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored
respirations, and dusky skin. The trauma team has administered medications for drug-assisted
intubation and attempted intubation but was unsuccessful. What is the most appropriate
immediate next step? - ANSWER>>ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER>>within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for
causing compartment syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious? - ANSWER>>pressure
Which of the following is possible complication of positive-pressure ventilation? -
ANSWER>>worsening pneumothorax
the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER>>pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? -
ANSWER>>narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER>>dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? -
ANSWER>>subdural hematoma
,A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the
bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals
lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN
question? - ANSWER>>straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark
bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These
findings are most consistent with which of the following? - ANSWER>>placental abruption
Which of the following is true about the log-roll? - ANSWER>>it can worsen cord damage from
an unstable spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ANSWER>>defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness
of ventilation? - ANSWER>>pulse oximetry and capnography
Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake
and crying with increased work of breathing and pale skin. Which of the following interventions
has the highest priority? - ANSWER>>padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER>>bowel
A pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd
and pelvic injuries are noted in the primary survey, which of the following is the priority
interventions? - ANSWER>>Initiate transfer to a trauma center
A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ANSWER>>bardycardia and absent motor function below the level
of injury
a 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to
pain. Which of the following is the most appropriate intervention? - ANSWER>>apply splint and
elevate above the level of the heart
, which of the following occurs during the third impact of a motor vehicle crash? - ANSWER>>the
aorta is torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of
healing and multiple small, clean, round burns to the back. There are no abnormalities found
based on the pediatric assessment triangle or primary survey. Which of the following is the
priority survey. Which of the following is the priority nursing intervention? - ANSWER>>Report
your suspicion of maltreatment in accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? -
ANSWER>>to guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf,
minimally by pain medications. Which of the following is the priority nursing intervention? -
ANSWER>>elevating the extremity to the level of the heart
What factor contributes most to the kinetic energy of a body in motion? - ANSWER>>velocity
An elderly patient with a history of anticoagulant use presents after a fall at home today. She
denies any loss of consciousness. She has a hematoma to her forehead and complains of
headache, dizziness, and nausea. What is the most likely cause of her symptoms? -
ANSWER>>subdural hematoma
a pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib
fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg
pain. His wife reported that he suddenly became anxious and confused. Upon reassessment,
the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx
most commonly associated with which of the following conditions? - ANSWER>>fat embolism
Which of the following is a late sign of increased intracranial pressure? - ANSWER>>Late signs
of increased intracranial pressure include: dilated nonreactive pupils, unresponsive to verbal or
painful stimuli, abnormal motor posturing, and Cushing response (widening pulse pressure,
reflex bradycardia, decreased respiratory effort)
a 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd,
pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these
after a negative FAST exam EXCEPT which of the following? - ANSWER>>serial FAST exams
OE COMPLETE QUESTIONS AND
ANSWERS (VERIFIED)
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access
facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71,
HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority
intervention for this patient? - ANSWER>>Expedite transfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma
pt? - ANSWER>>a pertinent medical hx is crucial
Following a review of recent drills and a real disaster event, a hospital has identified
deficiencies and is taking steps to minimize the impact of a future disaster . Which phase of the
disaster life cycle does this describe? - ANSWER>>Mitigation
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeons
screening guidelines, which assessment finding would prompt the RN to prepare the pt for a
radiologic spine clearance? - ANSWER>>Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of any
substances, and without neurologic abnormalities
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? -
ANSWER>>hemoglobin does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER>>acidosis
EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits
urinary incontinence and priapism. These assessment findings are most consistent with which
of the following types of spinal cord injury? - ANSWER>>Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a
chest drainage system? - ANSWER>>flucuation in the water seal chamber
,During the primary survey of an unconscious pt with multi-system trauma, the nurse notes
snoring respirations. What priority nursing interventions should be preformed next? -
ANSWER>>insert an oropharyngeal airway if there is no gag reflex
A 35 y/o M 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? -
ANSWER>>globe rupture
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96,
RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock? - ANSWER>>compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored
respirations, and dusky skin. The trauma team has administered medications for drug-assisted
intubation and attempted intubation but was unsuccessful. What is the most appropriate
immediate next step? - ANSWER>>ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER>>within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for
causing compartment syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious? - ANSWER>>pressure
Which of the following is possible complication of positive-pressure ventilation? -
ANSWER>>worsening pneumothorax
the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER>>pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? -
ANSWER>>narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER>>dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? -
ANSWER>>subdural hematoma
,A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the
bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals
lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN
question? - ANSWER>>straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal ht at the costal margin, and some dark
bloody show. Varying accelerations and decelerations are noted on cariocgraphy. These
findings are most consistent with which of the following? - ANSWER>>placental abruption
Which of the following is true about the log-roll? - ANSWER>>it can worsen cord damage from
an unstable spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ANSWER>>defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness
of ventilation? - ANSWER>>pulse oximetry and capnography
Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake
and crying with increased work of breathing and pale skin. Which of the following interventions
has the highest priority? - ANSWER>>padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER>>bowel
A pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd
and pelvic injuries are noted in the primary survey, which of the following is the priority
interventions? - ANSWER>>Initiate transfer to a trauma center
A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ANSWER>>bardycardia and absent motor function below the level
of injury
a 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to
pain. Which of the following is the most appropriate intervention? - ANSWER>>apply splint and
elevate above the level of the heart
, which of the following occurs during the third impact of a motor vehicle crash? - ANSWER>>the
aorta is torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm and buttocks in various stages of
healing and multiple small, clean, round burns to the back. There are no abnormalities found
based on the pediatric assessment triangle or primary survey. Which of the following is the
priority survey. Which of the following is the priority nursing intervention? - ANSWER>>Report
your suspicion of maltreatment in accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? -
ANSWER>>to guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf,
minimally by pain medications. Which of the following is the priority nursing intervention? -
ANSWER>>elevating the extremity to the level of the heart
What factor contributes most to the kinetic energy of a body in motion? - ANSWER>>velocity
An elderly patient with a history of anticoagulant use presents after a fall at home today. She
denies any loss of consciousness. She has a hematoma to her forehead and complains of
headache, dizziness, and nausea. What is the most likely cause of her symptoms? -
ANSWER>>subdural hematoma
a pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib
fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg
pain. His wife reported that he suddenly became anxious and confused. Upon reassessment,
the pt is restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx
most commonly associated with which of the following conditions? - ANSWER>>fat embolism
Which of the following is a late sign of increased intracranial pressure? - ANSWER>>Late signs
of increased intracranial pressure include: dilated nonreactive pupils, unresponsive to verbal or
painful stimuli, abnormal motor posturing, and Cushing response (widening pulse pressure,
reflex bradycardia, decreased respiratory effort)
a 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd,
pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these
after a negative FAST exam EXCEPT which of the following? - ANSWER>>serial FAST exams
