TNCC FINAL EXAM SCRIPT OPEN BOOK 2026
QUESTIONS WITH FULL SOLUTIONS
◉ 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. Answer: B) fat embolism
◉ Which pulse pressure description is an indication of early
hypovolemic shock?
A) widened
B) narrowed
C) bounding
,D) weak. Answer: 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. Answer: 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. Answer: 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. Answer: 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?
QUESTIONS WITH FULL SOLUTIONS
◉ 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. Answer: B) fat embolism
◉ Which pulse pressure description is an indication of early
hypovolemic shock?
A) widened
B) narrowed
C) bounding
,D) weak. Answer: 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. Answer: 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. Answer: 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. Answer: 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?
