TNCC 8th Edition Provider Exam Flashcards
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? - ansStraight catheter for urine
sample
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? - ansGlobe rupture
A 36-year-old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
- ansApply a splint and elevate the extremity above the level of the heart
A 49-year-old restrained driver involved in a motor vehicle collision presents to the
trauma center complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital
signs are stable. The nurse can anticipate all of these after a negative FAST exam
EXCEPT which of the following? - ansDiagnostic peritoneal lavage
A 5-year-old child presents to the ED 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? - ansReport your suspicion of
maltreatment in accordance with local regulations
A 56-year-old male patient involved in a motor vehicle crash is brought to the
emergency department of a rural critical access facility. He complains of neck pain,
shortness of breath, and diffuse abdominal pain. His Glasgow Coma Score is 15. His
vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR 26
breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the
following is the priority intervention for this patient? - ansExpedite transfer to the closest
trauma center
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. He 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? - ansDressing removal
,A patient has been in the emergency department for several hours 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 patient is restless, with
respiratory distress and petechiae to his neck. The patient is exhibiting signs and
symptoms most commonly associated with which of the following conditions? - ansFat
embolism
A patient is brought to the emergency department of a rural hospital following a high-
speed motor vehicle collision. When significant abdominal and pelvic injuries are noted
in the primary survey, which of the following is the priority intervention? - ansInitiate
transfer to a trauma center
A patient is found lying on the floor after falling 13 hours ago. Which of the following
laboratory values is expected with a musculoskeletal complication associated with this
presentation? - ansElevated creatine kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral 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? - ansInitiate two large-caliber intravenous lines for
Ringer's lactate solution administration.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - ansBradycardia and absent motor function
below the level of injury
A patient with a lower extremity fracture complains of severe pain and tightness in his
calf, minimally relieved by pain medications. Which of the following is the priority nursing
intervention? - ansElevating the extremity to the level of the heart
A trauma patient is en route to a rural emergency department. Radiology notifies the
charge nurse that the computed tomography (CT) scanner will be out of service for
several hours. The team gathers to plan accordingly. Which of the following terms best
describes this trauma team's communication? - ansHuddle
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon
arrival were BP 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her
skin is cool and dry. Current vital signs are BP 104/84 mm Hg, HR 108 beats/minute,
and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which
stage of shock? - ansCompensated
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. What is the most likely cause of her
symptoms? - ansSubdural hematoma
, An intubated trauma patient is being transferred to a tertiary care center. After moving
the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which
of the following is the priority intervention? - ansConfirm endotracheal tube placement
An unresponsive trauma patient has an oropharyngeal 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? - ansVentilate with a bag-mask device
Caregivers carry a 2-year-old into the emergency department who fell out of a second-
story window. The patient is awake and crying with increased work of breathing and
pale skin. Which of the following interventions has the highest priority? - ansPadding the
upper back while stabilizing the cervical spine
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? - ansInsert an oropharyngeal airway if there is no gag reflex
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 is it appropriate to remove the cervical collar? -
ansAfter a physical examination if the patient has no radiologic abnormalities on a
computed tomography scan
EMS brings a patient who fell while 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? - ansAlert with no neurological
deficits
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? - ansMitigation
If a patient has received multiple transfusions of banked blood preserved with citrate,
which electrolyte is most likely to drop and require supplementation? - ansCalcium
Patients with a crush injury should be monitored for which of the following conditions? -
ansDysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? -
ansSubdural hematoma
The most reassuring finding for a male patient with hip pain after a fall is which of the
following? - ansPelvic stability
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? - ansStraight catheter for urine
sample
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? - ansGlobe rupture
A 36-year-old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
- ansApply a splint and elevate the extremity above the level of the heart
A 49-year-old restrained driver involved in a motor vehicle collision presents to the
trauma center complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital
signs are stable. The nurse can anticipate all of these after a negative FAST exam
EXCEPT which of the following? - ansDiagnostic peritoneal lavage
A 5-year-old child presents to the ED 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? - ansReport your suspicion of
maltreatment in accordance with local regulations
A 56-year-old male patient involved in a motor vehicle crash is brought to the
emergency department of a rural critical access facility. He complains of neck pain,
shortness of breath, and diffuse abdominal pain. His Glasgow Coma Score is 15. His
vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR 26
breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the
following is the priority intervention for this patient? - ansExpedite transfer to the closest
trauma center
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. He 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? - ansDressing removal
,A patient has been in the emergency department for several hours 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 patient is restless, with
respiratory distress and petechiae to his neck. The patient is exhibiting signs and
symptoms most commonly associated with which of the following conditions? - ansFat
embolism
A patient is brought to the emergency department of a rural hospital following a high-
speed motor vehicle collision. When significant abdominal and pelvic injuries are noted
in the primary survey, which of the following is the priority intervention? - ansInitiate
transfer to a trauma center
A patient is found lying on the floor after falling 13 hours ago. Which of the following
laboratory values is expected with a musculoskeletal complication associated with this
presentation? - ansElevated creatine kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral 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? - ansInitiate two large-caliber intravenous lines for
Ringer's lactate solution administration.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - ansBradycardia and absent motor function
below the level of injury
A patient with a lower extremity fracture complains of severe pain and tightness in his
calf, minimally relieved by pain medications. Which of the following is the priority nursing
intervention? - ansElevating the extremity to the level of the heart
A trauma patient is en route to a rural emergency department. Radiology notifies the
charge nurse that the computed tomography (CT) scanner will be out of service for
several hours. The team gathers to plan accordingly. Which of the following terms best
describes this trauma team's communication? - ansHuddle
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon
arrival were BP 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her
skin is cool and dry. Current vital signs are BP 104/84 mm Hg, HR 108 beats/minute,
and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which
stage of shock? - ansCompensated
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. What is the most likely cause of her
symptoms? - ansSubdural hematoma
, An intubated trauma patient is being transferred to a tertiary care center. After moving
the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which
of the following is the priority intervention? - ansConfirm endotracheal tube placement
An unresponsive trauma patient has an oropharyngeal 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? - ansVentilate with a bag-mask device
Caregivers carry a 2-year-old into the emergency department who fell out of a second-
story window. The patient is awake and crying with increased work of breathing and
pale skin. Which of the following interventions has the highest priority? - ansPadding the
upper back while stabilizing the cervical spine
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? - ansInsert an oropharyngeal airway if there is no gag reflex
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 is it appropriate to remove the cervical collar? -
ansAfter a physical examination if the patient has no radiologic abnormalities on a
computed tomography scan
EMS brings a patient who fell while 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? - ansAlert with no neurological
deficits
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? - ansMitigation
If a patient has received multiple transfusions of banked blood preserved with citrate,
which electrolyte is most likely to drop and require supplementation? - ansCalcium
Patients with a crush injury should be monitored for which of the following conditions? -
ansDysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? -
ansSubdural hematoma
The most reassuring finding for a male patient with hip pain after a fall is which of the
following? - ansPelvic stability
