TNCC Final Exam Test 2025 – Open Book Trauma Nursing Core
Course Review & Answer Key | Verified Q&A with Updated
Guidelines | Trauma Scenarios, Evidence-Based Interventions &
Rationales | Current TNCC Testing Version
You are treating a 27-year-old male in respiratory distress who was involved in a house fire. Calculating TBSA
burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr
B) 500 mL/hr
A patient has been in the ED 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 c/o leg pain. His wife reported suddenly becoming
anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his
neck. the patient is exhibiting signs of symptoms commonly associated with which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion
B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak
B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls
B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration
D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart
and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased
intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is 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 BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL
A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis
A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck
pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
Course Review & Answer Key | Verified Q&A with Updated
Guidelines | Trauma Scenarios, Evidence-Based Interventions &
Rationales | Current TNCC Testing Version
You are treating a 27-year-old male in respiratory distress who was involved in a house fire. Calculating TBSA
burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr
B) 500 mL/hr
A patient has been in the ED 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 c/o leg pain. His wife reported suddenly becoming
anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his
neck. the patient is exhibiting signs of symptoms commonly associated with which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion
B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak
B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls
B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration
D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart
and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased
intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is 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 BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL
A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis
A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck
pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
