TRAUMA NURSING PROCESS - TNP - TNCC 9TH ED EXAM
ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS.
LATEST 2025 COMPLETE UPDATE.
An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the patient is only
responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to the face. What is the priority
intervention? - Correct Answer: - C. Use a jaw thrust to open the airway and look for signs of obstruction.
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph. The patient is awake and alert
and the right leg is shortened. Following initial resuscitation with fluids, the patient remains hypotensive. What would be
the priority intervention? - Correct Answer: - Apply a pelvic binder
A severely injured patient has been intubated and is being mechanically ventilated. The patient has received a balanced
resuscitation including multiple blood products. Under which circumstance will it be harder for the hemoglobin to release
oxygen to the tissues?
- Correct Answer: - Decreased body temperature
A patient is thrown against a car during a tornado and presents with obvious bilateral femur fractures. The patient is pale,
alert, disoriented, and has delayed capillary refill. Which of the following interventions would be most appropriate for this
patient based on the disaster triage principles?
- Correct Answer: - Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a
nonporous dressing over the chest wound and taped it on three sides. The patient is now showing signs of anxiety,
restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate immediate intervention? - Correct Answer: - Dressing removal
A driver involved in a high-speed motor vehicle collision arrives in the emergency department. The vehicle's air-bag failed
to deploy. The patient is drowsy but arousable and complaining of chest pain with ecchymosis noted to the chest. The
patient is tachycardia and hypotensive with no evidence of uncontrolled bleeding.
Cardiac monitor shows premature ventricular contractions. Which of the following is the most appropriate intervention for
this patient?
- Correct Answer: - C. Inotropic support
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is consistent with spinal shock?
- Correct Answer: - B. Loss of reflexes
A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66 kPa) and an intracranial
pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an indication of the body's response to these findings?
- Correct Answer: - Widening pulse pressure
An unconscious patient arrives following a motor vehicle collision. The patient is on a backboard with a cervical collar in
place and one intravenous line running. Respirations are shallow and there is active brisk bleeding from a large leg wound.
What is the priority intervention for this patient? - Correct Answer: - Control the bleeding
An obese trauma patient requires intubation. Assuming there are no contraindications, which position will provide the best
visualization for insertion of the endotracheal tube?
- Correct Answer: - Cramped
Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the scene but became responsive
with initial and subsequent Glasgow Coma Scale (GCS) scores of 13 (E-3, V-4, M-6). The patient has bilateral subdural
hematomas and is awaiting transfer to the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the
priority nursing intervention? - Correct Answer: - Notify the provider of the change
A patient arrives following prolonged exposure of their left hand to the cold. The patient is awake and alert and complains
of a tingling sensation to the fingers. Assessment reveals swelling and bright red skin to the left hand and a 1-inch round
clear blister to the dorsum of that hand. Which of the following nursing interventions is most appropriate for this patient? -
Correct Answer: - Gently rewarm over 15 to 30 minutes
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during a staffing crisis.
, The nurse expresses anger stating that the patients did not receive quality care and begins exhibiting aggression toward
colleagues. This is most consistent with which condition?
- Correct Answer: - Moral injury
What is the rationale for obtaining a serum lactate level during the initial assessment of a trauma patient? - Correct
Answer: - Gauges end-organ perfusion and tissue hypoxia
What is the most important consideration during the initial assessment when caring for an older adult who has sustained
serious injuries?
- Correct Answer: - Medical history including current medications
Following a gunshot wound, pre-hospital providers report diminished breath sounds bilaterally. Upon emergency
department arrival, the patient is unresponsive with shallow respirations and an O2 sat of 88%. What is the priority
intervention for this patient? - Correct Answer: - Assist ventilation with a bag-mask device
Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals
tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is
concerned about injury to which organ?
- Correct Answer: - C. Liver
A 5-year-old child presents to the emergency department with bruises to the upper arms 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 nursing intervention? - Correct Answer: -
A.Report your suspicion of maltreatment in accordance with local regulations
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding. Which intervention is most
appropriate for this patient? - Correct Answer: - Prepare the patient for surgery to remove the rod.
When should the definitive calculation for intravenous fluid resuscitation rate be performed for a patient with burns? -
Correct Answer: - B. During the secondary survey
Which of the following is true about use of the focused assessment sonography for trauma exam for a patient with
abdominal trauma? - Correct Answer: - B. It can be used in hypotensive patients too unstable for computed tomography
scan
What is the priority intervention for a child who has been diagnosed with an atlanto-occipital dislocation following a high-
speed motor vehicle collision? - Correct Answer: - Maintaining spinal motion restriction
What position optimizes ventilation in the obese patient with a lumbar fracture? - Correct Answer: - A. Reverse
Trendelenburg
During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which
priority nursing intervention should be performed next? - Correct Answer: - Insert an oropharyngeal airway if there is no
gag reflex
A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient
sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites,
the nose, and gums. What condition is most consistent with these findings? - Correct Answer: - Disseminated intravascular
coagulopathy
A patient is brought to the emergency department following a snowmobile crash with prolonged exposure time prior to
transport. The patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24 breaths/minute, T 34.6oC
(94.2oF) and an SpO2 of 90% on oxygen at 15L per non-rebreather mask. Other findings include ETCO2 24, serum lactate
of 6 mmol/L, and a pH of 6.8. Based on these findings, what is the most appropriate intervention?
- Correct Answer: - A. Initiate warming measures
Which of the following is a late sign of increased intracranial pressure? - Correct Answer: - Decreased respiratory effort
Based on fall mechanism, which patient warrants prehospital transfer to a trauma center? - Correct Answer: - B.A 2-year-
old lands on grass from a second-story balcony
The trauma nurse is caring for an unrestrained driver who struck their head on the windshield following a high- speed
MVC. The patient has been diagnosed with an anterior spinal cord injury at the level of C6. Which assessment finding
ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS.
LATEST 2025 COMPLETE UPDATE.
An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the patient is only
responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to the face. What is the priority
intervention? - Correct Answer: - C. Use a jaw thrust to open the airway and look for signs of obstruction.
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph. The patient is awake and alert
and the right leg is shortened. Following initial resuscitation with fluids, the patient remains hypotensive. What would be
the priority intervention? - Correct Answer: - Apply a pelvic binder
A severely injured patient has been intubated and is being mechanically ventilated. The patient has received a balanced
resuscitation including multiple blood products. Under which circumstance will it be harder for the hemoglobin to release
oxygen to the tissues?
- Correct Answer: - Decreased body temperature
A patient is thrown against a car during a tornado and presents with obvious bilateral femur fractures. The patient is pale,
alert, disoriented, and has delayed capillary refill. Which of the following interventions would be most appropriate for this
patient based on the disaster triage principles?
- Correct Answer: - Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a
nonporous dressing over the chest wound and taped it on three sides. The patient is now showing signs of anxiety,
restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate immediate intervention? - Correct Answer: - Dressing removal
A driver involved in a high-speed motor vehicle collision arrives in the emergency department. The vehicle's air-bag failed
to deploy. The patient is drowsy but arousable and complaining of chest pain with ecchymosis noted to the chest. The
patient is tachycardia and hypotensive with no evidence of uncontrolled bleeding.
Cardiac monitor shows premature ventricular contractions. Which of the following is the most appropriate intervention for
this patient?
- Correct Answer: - C. Inotropic support
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is consistent with spinal shock?
- Correct Answer: - B. Loss of reflexes
A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66 kPa) and an intracranial
pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an indication of the body's response to these findings?
- Correct Answer: - Widening pulse pressure
An unconscious patient arrives following a motor vehicle collision. The patient is on a backboard with a cervical collar in
place and one intravenous line running. Respirations are shallow and there is active brisk bleeding from a large leg wound.
What is the priority intervention for this patient? - Correct Answer: - Control the bleeding
An obese trauma patient requires intubation. Assuming there are no contraindications, which position will provide the best
visualization for insertion of the endotracheal tube?
- Correct Answer: - Cramped
Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the scene but became responsive
with initial and subsequent Glasgow Coma Scale (GCS) scores of 13 (E-3, V-4, M-6). The patient has bilateral subdural
hematomas and is awaiting transfer to the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the
priority nursing intervention? - Correct Answer: - Notify the provider of the change
A patient arrives following prolonged exposure of their left hand to the cold. The patient is awake and alert and complains
of a tingling sensation to the fingers. Assessment reveals swelling and bright red skin to the left hand and a 1-inch round
clear blister to the dorsum of that hand. Which of the following nursing interventions is most appropriate for this patient? -
Correct Answer: - Gently rewarm over 15 to 30 minutes
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during a staffing crisis.
, The nurse expresses anger stating that the patients did not receive quality care and begins exhibiting aggression toward
colleagues. This is most consistent with which condition?
- Correct Answer: - Moral injury
What is the rationale for obtaining a serum lactate level during the initial assessment of a trauma patient? - Correct
Answer: - Gauges end-organ perfusion and tissue hypoxia
What is the most important consideration during the initial assessment when caring for an older adult who has sustained
serious injuries?
- Correct Answer: - Medical history including current medications
Following a gunshot wound, pre-hospital providers report diminished breath sounds bilaterally. Upon emergency
department arrival, the patient is unresponsive with shallow respirations and an O2 sat of 88%. What is the priority
intervention for this patient? - Correct Answer: - Assist ventilation with a bag-mask device
Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals
tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is
concerned about injury to which organ?
- Correct Answer: - C. Liver
A 5-year-old child presents to the emergency department with bruises to the upper arms 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 nursing intervention? - Correct Answer: -
A.Report your suspicion of maltreatment in accordance with local regulations
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding. Which intervention is most
appropriate for this patient? - Correct Answer: - Prepare the patient for surgery to remove the rod.
When should the definitive calculation for intravenous fluid resuscitation rate be performed for a patient with burns? -
Correct Answer: - B. During the secondary survey
Which of the following is true about use of the focused assessment sonography for trauma exam for a patient with
abdominal trauma? - Correct Answer: - B. It can be used in hypotensive patients too unstable for computed tomography
scan
What is the priority intervention for a child who has been diagnosed with an atlanto-occipital dislocation following a high-
speed motor vehicle collision? - Correct Answer: - Maintaining spinal motion restriction
What position optimizes ventilation in the obese patient with a lumbar fracture? - Correct Answer: - A. Reverse
Trendelenburg
During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which
priority nursing intervention should be performed next? - Correct Answer: - Insert an oropharyngeal airway if there is no
gag reflex
A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient
sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites,
the nose, and gums. What condition is most consistent with these findings? - Correct Answer: - Disseminated intravascular
coagulopathy
A patient is brought to the emergency department following a snowmobile crash with prolonged exposure time prior to
transport. The patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24 breaths/minute, T 34.6oC
(94.2oF) and an SpO2 of 90% on oxygen at 15L per non-rebreather mask. Other findings include ETCO2 24, serum lactate
of 6 mmol/L, and a pH of 6.8. Based on these findings, what is the most appropriate intervention?
- Correct Answer: - A. Initiate warming measures
Which of the following is a late sign of increased intracranial pressure? - Correct Answer: - Decreased respiratory effort
Based on fall mechanism, which patient warrants prehospital transfer to a trauma center? - Correct Answer: - B.A 2-year-
old lands on grass from a second-story balcony
The trauma nurse is caring for an unrestrained driver who struck their head on the windshield following a high- speed
MVC. The patient has been diagnosed with an anterior spinal cord injury at the level of C6. Which assessment finding
