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Trauma Nursing Process - TNP - TNCC 9th Ed Exam Actual
Questions and Correct Answers Expert Updated 2024/2025
What does the J stand for at the end of the secondary survery? - ANSWER just keep
evaluating - vipp
What does VIPP stand for? - ANSWER vital signs, injuries/interventions, primary
survey, pain
During the head-to-toe, where would you find Grey-Turner's sign? - ANSWER flank
During the head-to-toe, where would you find Cullen's sign? - ANSWER umbilicus What
is sometimes deferred at the end of the head-to-toe? - ANSWER inspecting posterior
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting,
psychosocial support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT? - ANSWER AFTER head-to-toe,
BEFORE J (VIPP)
What three items are obtained during the pertinent history assessment? - ANSWER
Medical records, prehospital report, SAMPLE
What are examples of nonpharmacologic measures? (must identify at least one during
testing) - ANSWER Distraction, family presence, padding bony prominences,
repositioning, splinting, verbal reassurance
For whom is capnography highly recommended? - ANSWER all patients
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? -
, 2
ANSWER EKG
In Step 16 of "Exposure and Environment", you must name at least one of these
interventions: - ANSWER blankets, room temp increase, warmed fluids, warming lights
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? -
ANSWER In Step 15 of "Exposure and Environment"
In Step 13 of "Disability", what is assessed if pt is altered? - ANSWER glucose To
assess circulation, you must do these two main tasks: - ANSWER 1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
What do you do when alterations are identified in any of the steps in the primary
survery? - ANSWER intervene as appropriate and reassess
What three assessments must be done if the patient is intubated? - ANSWER 1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs
for bilateral breath sounds
Four of these must be identified to assess breathing effectiveness: - ANSWER Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which
credit is given in the LMNOP section? - ANSWER cardiac monitor
When should 2 IV sites be established? - ANSWER During "Circulation" assessment
, 3
If the patient is intubated and you've already assessed ETT placement, what else needs
to be done with the ETT? (step 10) - ANSWER assess ETT position by noting the
number at teeth/gums AND secure ETT
What should you verbalize after completing all ETT assessments? - ANSWER moving
patient from assisted ventilation to mechanical
During which part of the primary survey would you anticipate the need for a chest tube,
intubation, decompression of pneumothorax, oxygen, or BVMs? - ANSWER "Breathing
and Ventilation"
Four of these must be identified to assess patency and protection of the airway: -
ANSWER bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization
During which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? -
ANSWER Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - ANSWER the need
for a second person to provide manual c-spine stabilization
An adult patient who sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient
has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is
1
Trauma Nursing Process - TNP - TNCC 9th Ed Exam Actual
Questions and Correct Answers Expert Updated 2024/2025
What does the J stand for at the end of the secondary survery? - ANSWER just keep
evaluating - vipp
What does VIPP stand for? - ANSWER vital signs, injuries/interventions, primary
survey, pain
During the head-to-toe, where would you find Grey-Turner's sign? - ANSWER flank
During the head-to-toe, where would you find Cullen's sign? - ANSWER umbilicus What
is sometimes deferred at the end of the head-to-toe? - ANSWER inspecting posterior
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting,
psychosocial support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT? - ANSWER AFTER head-to-toe,
BEFORE J (VIPP)
What three items are obtained during the pertinent history assessment? - ANSWER
Medical records, prehospital report, SAMPLE
What are examples of nonpharmacologic measures? (must identify at least one during
testing) - ANSWER Distraction, family presence, padding bony prominences,
repositioning, splinting, verbal reassurance
For whom is capnography highly recommended? - ANSWER all patients
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? -
, 2
ANSWER EKG
In Step 16 of "Exposure and Environment", you must name at least one of these
interventions: - ANSWER blankets, room temp increase, warmed fluids, warming lights
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? -
ANSWER In Step 15 of "Exposure and Environment"
In Step 13 of "Disability", what is assessed if pt is altered? - ANSWER glucose To
assess circulation, you must do these two main tasks: - ANSWER 1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
What do you do when alterations are identified in any of the steps in the primary
survery? - ANSWER intervene as appropriate and reassess
What three assessments must be done if the patient is intubated? - ANSWER 1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs
for bilateral breath sounds
Four of these must be identified to assess breathing effectiveness: - ANSWER Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which
credit is given in the LMNOP section? - ANSWER cardiac monitor
When should 2 IV sites be established? - ANSWER During "Circulation" assessment
, 3
If the patient is intubated and you've already assessed ETT placement, what else needs
to be done with the ETT? (step 10) - ANSWER assess ETT position by noting the
number at teeth/gums AND secure ETT
What should you verbalize after completing all ETT assessments? - ANSWER moving
patient from assisted ventilation to mechanical
During which part of the primary survey would you anticipate the need for a chest tube,
intubation, decompression of pneumothorax, oxygen, or BVMs? - ANSWER "Breathing
and Ventilation"
Four of these must be identified to assess patency and protection of the airway: -
ANSWER bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization
During which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? -
ANSWER Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - ANSWER the need
for a second person to provide manual c-spine stabilization
An adult patient who sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient
has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is
