TNCC Exam 8th edition study ACTUAL
QUESTIONS AND CORRECT ANSWERS
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - Correct
answers✔Hemoglobin does not readily release oxygen for use by the tissues A shift to the left
occurs in an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis),
increasing hemoglobin's affinity for oxygen.
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 it is appropriate to remove the cervical collar? - Correct answers✔After a
physical examination if the patient has no radiologic abnormalities on CT A CT is recommended
for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male 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 body surface area burned, how much IV fluid would be administered
in the first 8 hours? - Correct answers✔2280 mL Both upper arms = 8%, both lower arms =
6%, and both hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to 2280
mL. Superficial burns are not included in the TBSA calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to
a chest drainage system - Correct answers✔Fluctuation in the water seal chamber Fluctuation
in the water seal chamber indicates the tube is placed correctly in the pleural space.
.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? - Correct
answers✔Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs? - Correct answers✔Bradycardia and absent motor function
below the level of injury Patients with a complete spinal cord injury will have absent motor
, function below the level of the lesion. They become hypotensive and bradycardic due to loss of
autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - Correct answers✔A
52year-old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7%
TBSA burn with a preexisting medical history that could complicate management, prolong
recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - Correct
answers✔Placental abruption The findings of abdominal pain, elevated fundal height, dark
bloody show, and fetal distress are most consistent with placental abruption.
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? - Correct answers✔Straight catheter for urine sample Insertion of a
urinary catheter is contraindicated if urethral transection is suspected. Signs and symptoms of
urethral injury include blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a
highriding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - Correct
answers✔The aorta is torn at its attachment with the ligamentum arteriosum This occurs during
the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - Correct answers✔Defusings A defusing is part of critical incident stress
management but is not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage? - Correct answers✔MARCH The MARCH mnemonic
QUESTIONS AND CORRECT ANSWERS
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - Correct
answers✔Hemoglobin does not readily release oxygen for use by the tissues A shift to the left
occurs in an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis),
increasing hemoglobin's affinity for oxygen.
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 it is appropriate to remove the cervical collar? - Correct answers✔After a
physical examination if the patient has no radiologic abnormalities on CT A CT is recommended
for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male 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 body surface area burned, how much IV fluid would be administered
in the first 8 hours? - Correct answers✔2280 mL Both upper arms = 8%, both lower arms =
6%, and both hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to 2280
mL. Superficial burns are not included in the TBSA calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to
a chest drainage system - Correct answers✔Fluctuation in the water seal chamber Fluctuation
in the water seal chamber indicates the tube is placed correctly in the pleural space.
.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? - Correct
answers✔Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs? - Correct answers✔Bradycardia and absent motor function
below the level of injury Patients with a complete spinal cord injury will have absent motor
, function below the level of the lesion. They become hypotensive and bradycardic due to loss of
autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - Correct answers✔A
52year-old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7%
TBSA burn with a preexisting medical history that could complicate management, prolong
recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - Correct
answers✔Placental abruption The findings of abdominal pain, elevated fundal height, dark
bloody show, and fetal distress are most consistent with placental abruption.
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? - Correct answers✔Straight catheter for urine sample Insertion of a
urinary catheter is contraindicated if urethral transection is suspected. Signs and symptoms of
urethral injury include blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a
highriding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - Correct
answers✔The aorta is torn at its attachment with the ligamentum arteriosum This occurs during
the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - Correct answers✔Defusings A defusing is part of critical incident stress
management but is not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage? - Correct answers✔MARCH The MARCH mnemonic
