TNCC 9th Edition TNP ACTUAL
QUESTIONS AND CORRECT ANSWERS
—What does the J stand for at the end of the secondary survery? - Correct answers✔just keep
evaluating - vipp
—What does VIPP stand for? - Correct answers✔vital signs, injuries/interventions, primary
survey, pain
—During the head-to-toe, where would you find Grey-Turner's sign? - Correct answers✔flank
—During the head-to-toe, where would you find Cullen's sign? - Correct answers✔umbilicus
-What is sometimes deferred at the end of the head-to-toe? - Correct answers✔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? - Correct answers✔AFTER head-to-toe, BEFORE J (VIPP)
-What three items are obtained during the pertinent history assessment? - Correct
answers✔Medical records, prehospital report, SAMPLE
-What are examples of nonpharmacologic measures? (must identify at least one during testing) -
Correct answers✔Distraction, family presence, padding bony prominences, repositioning,
splinting, verbal reassurance
-For whom is capnography highly recommended? - Correct answers✔all patients
,-In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? - Correct
answers✔EKG
-In Step 16 of "Exposure and Environment", you must name at least one of these interventions: -
Correct answers✔blankets, room temp increase, warmed fluids, warming lights
-To assess circulation, you must do these two main tasks: - Correct answers✔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? -
Correct answers✔intervene as appropriate and reassess
-What three assessments must be done if the patient is intubated? - Correct answers✔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: - Correct answers✔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? - Correct answers✔cardiac monitor
-When should 2 IV sites be established? - Correct answers✔During "Circulation" assessment -
If the patient is intubated and you've already assessed ETT placement, what else needs to be
,done with the ETT? (step 10) - Correct answers✔assess ETT position by noting the number at
teeth/gums AND secure ETT
-What should you verbalize after completing all ETT assessments? - Correct answers✔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? - Correct answers✔"Breathing
and Ventilation"
-Four of these must be identified to assess patency and protection of the airway: - Correct
answers✔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? - Correct
answers✔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? - Correct answers✔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 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow? - Correct answers✔A.Decrease the rate of
manual ventilation.
, An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - Correct answers✔post-concussive syndrome
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - Correct answers✔C.Elevating the leg to the
level of the heart
A patient involved in a high-speed rollover is complaining of increased difficulty breathing.
There is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which
finding is most consistent with an injury to the diaphragm? - Correct answers✔Bowel sounds
heard in the left lower chest
A ruptured diaphragm is a potentially life-threatening injury. The patient will most likely have
decreased breath sounds on the affected side along with pain, which may radiate to the left
shoulder. However, these signs do not specifically implicate an injury to the diaphragm.
QUESTIONS AND CORRECT ANSWERS
—What does the J stand for at the end of the secondary survery? - Correct answers✔just keep
evaluating - vipp
—What does VIPP stand for? - Correct answers✔vital signs, injuries/interventions, primary
survey, pain
—During the head-to-toe, where would you find Grey-Turner's sign? - Correct answers✔flank
—During the head-to-toe, where would you find Cullen's sign? - Correct answers✔umbilicus
-What is sometimes deferred at the end of the head-to-toe? - Correct answers✔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? - Correct answers✔AFTER head-to-toe, BEFORE J (VIPP)
-What three items are obtained during the pertinent history assessment? - Correct
answers✔Medical records, prehospital report, SAMPLE
-What are examples of nonpharmacologic measures? (must identify at least one during testing) -
Correct answers✔Distraction, family presence, padding bony prominences, repositioning,
splinting, verbal reassurance
-For whom is capnography highly recommended? - Correct answers✔all patients
,-In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? - Correct
answers✔EKG
-In Step 16 of "Exposure and Environment", you must name at least one of these interventions: -
Correct answers✔blankets, room temp increase, warmed fluids, warming lights
-To assess circulation, you must do these two main tasks: - Correct answers✔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? -
Correct answers✔intervene as appropriate and reassess
-What three assessments must be done if the patient is intubated? - Correct answers✔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: - Correct answers✔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? - Correct answers✔cardiac monitor
-When should 2 IV sites be established? - Correct answers✔During "Circulation" assessment -
If the patient is intubated and you've already assessed ETT placement, what else needs to be
,done with the ETT? (step 10) - Correct answers✔assess ETT position by noting the number at
teeth/gums AND secure ETT
-What should you verbalize after completing all ETT assessments? - Correct answers✔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? - Correct answers✔"Breathing
and Ventilation"
-Four of these must be identified to assess patency and protection of the airway: - Correct
answers✔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? - Correct
answers✔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? - Correct answers✔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 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow? - Correct answers✔A.Decrease the rate of
manual ventilation.
, An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - Correct answers✔post-concussive syndrome
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - Correct answers✔C.Elevating the leg to the
level of the heart
A patient involved in a high-speed rollover is complaining of increased difficulty breathing.
There is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which
finding is most consistent with an injury to the diaphragm? - Correct answers✔Bowel sounds
heard in the left lower chest
A ruptured diaphragm is a potentially life-threatening injury. The patient will most likely have
decreased breath sounds on the affected side along with pain, which may radiate to the left
shoulder. However, these signs do not specifically implicate an injury to the diaphragm.
