TNCC STUDY GUIDE EXAM PREP
COMPLETE QUESTIONS AND ANSWERS
2026
◉ What are the three signs of Cushing's triad and why is it ominous
when these three signs are present?
Answer: -widening pulse pressure
-reflex bradycardia
irregular, decreased respiratory effort
◉ What focal brain injury is typically caused by arterial bleeding
versus Venus bleeding?
Answer: arterial: epidural hematoma
venous: subdural hematoma
◉ What mechanism of injury is associated with major injuries to the
thorax?
Answer: blunt traumas such as MVCs, fall from heights, sports
related injuries
,◉ What injuries are associated with fractures the thorax? What is
significance of a flail chest and what interventions should be
anticipated?
Answer: typically pneumothorax, pulmonary contusion, lacerated
organs, and/or flail chest. Flail chest is significant because is causes
parodoxical chest movement, leading to severe respiratory
compromise. Interventions include supplemental O2, prep for
intubation, possible surgery
◉ What are the three signs of Beck's triad? What are the limitations
when assessing these sign signs when a patient is hypovolemic?
Answer: Beck's triad includes: hypotension, distended neck veins,
muffled heart sounds. Hypovolemia may prevent distention of neck
veins and the often loud trauma bay may disallow identifying
muffled heart sounds
◉ What is the most important intervention for a patient in acute
respiratory distress with tachycardia, hypotension, jugular vein,
distention, and unilateral absent breath sounds?
Answer: needle decompression of a tension pneumothorax
◉ What are the differences between a simple (closed)
pneumothorax and a complex or communicating open
pneumothorax? What causes progression to a tension
pneumothorax?
,Answer: A simple (closed) pneumothorax occurs when air leaks
from the lung into the pleural space without a chest wall injury,
while a complex or communicating open pneumothorax happens
when a wound in the chest wall allows air from the outside to
directly enter the pleural space, creating a communication between
the outside atmosphere and the chest cavity. Tension pneumo is
caused by the air entering the pleural space but cannot escape on
expiration
◉ What interventions should the nurse anticipate for a patient with
a massive hemothorax?
Answer: -prep for a chest tube
- 2 large bore IVs
-initiate massive transfusion protocol
- prep for the OR
◉ What are the indications for resuscitative thoracotomy?
Answer: -penetrating chest trauma with cardiac arrest
-cardiac tamponade
- pulseless and receiving CPR within 15 min of trauma
- refractory shock and systolic is less than 65
◉ What injuries are common with blunt abdominal trauma?
Answer: MVCs, assaults, falls
, ◉ What are some examples of hollow abdominal organs? Solid
abdominal organs?
Answer: Hollow: gallbladder, stomach, small bowel, and large bowel.
Solid: liver, spleen, kidneys, and pancreas
◉ List concurrent injuries that may occur with abdominal and/or
pelvic injuries. Describe why trauma to the abdomen and/or pelvis
may result in significant hemorrhage.
Answer: Abdominal: liver or spleen injuries, renal injuries
Pelvic: bladder, urethral, rectal, and vaginal injuries
◉ What equipment or intervention may be used to stabilize a
suspected or known pelvic fracture?
Answer: need a pelvic binder, longitudinal skeletal traction
◉ Does your facility have pelvic binders available? Where are they
located?
Answer: honestly no f***ing clue
◉ What assessment finding is a contraindication to inserting
indwelling catheter?
Answer: urethral trauma, bleeding from the meatus of the penis or
vaginal area
COMPLETE QUESTIONS AND ANSWERS
2026
◉ What are the three signs of Cushing's triad and why is it ominous
when these three signs are present?
Answer: -widening pulse pressure
-reflex bradycardia
irregular, decreased respiratory effort
◉ What focal brain injury is typically caused by arterial bleeding
versus Venus bleeding?
Answer: arterial: epidural hematoma
venous: subdural hematoma
◉ What mechanism of injury is associated with major injuries to the
thorax?
Answer: blunt traumas such as MVCs, fall from heights, sports
related injuries
,◉ What injuries are associated with fractures the thorax? What is
significance of a flail chest and what interventions should be
anticipated?
Answer: typically pneumothorax, pulmonary contusion, lacerated
organs, and/or flail chest. Flail chest is significant because is causes
parodoxical chest movement, leading to severe respiratory
compromise. Interventions include supplemental O2, prep for
intubation, possible surgery
◉ What are the three signs of Beck's triad? What are the limitations
when assessing these sign signs when a patient is hypovolemic?
Answer: Beck's triad includes: hypotension, distended neck veins,
muffled heart sounds. Hypovolemia may prevent distention of neck
veins and the often loud trauma bay may disallow identifying
muffled heart sounds
◉ What is the most important intervention for a patient in acute
respiratory distress with tachycardia, hypotension, jugular vein,
distention, and unilateral absent breath sounds?
Answer: needle decompression of a tension pneumothorax
◉ What are the differences between a simple (closed)
pneumothorax and a complex or communicating open
pneumothorax? What causes progression to a tension
pneumothorax?
,Answer: A simple (closed) pneumothorax occurs when air leaks
from the lung into the pleural space without a chest wall injury,
while a complex or communicating open pneumothorax happens
when a wound in the chest wall allows air from the outside to
directly enter the pleural space, creating a communication between
the outside atmosphere and the chest cavity. Tension pneumo is
caused by the air entering the pleural space but cannot escape on
expiration
◉ What interventions should the nurse anticipate for a patient with
a massive hemothorax?
Answer: -prep for a chest tube
- 2 large bore IVs
-initiate massive transfusion protocol
- prep for the OR
◉ What are the indications for resuscitative thoracotomy?
Answer: -penetrating chest trauma with cardiac arrest
-cardiac tamponade
- pulseless and receiving CPR within 15 min of trauma
- refractory shock and systolic is less than 65
◉ What injuries are common with blunt abdominal trauma?
Answer: MVCs, assaults, falls
, ◉ What are some examples of hollow abdominal organs? Solid
abdominal organs?
Answer: Hollow: gallbladder, stomach, small bowel, and large bowel.
Solid: liver, spleen, kidneys, and pancreas
◉ List concurrent injuries that may occur with abdominal and/or
pelvic injuries. Describe why trauma to the abdomen and/or pelvis
may result in significant hemorrhage.
Answer: Abdominal: liver or spleen injuries, renal injuries
Pelvic: bladder, urethral, rectal, and vaginal injuries
◉ What equipment or intervention may be used to stabilize a
suspected or known pelvic fracture?
Answer: need a pelvic binder, longitudinal skeletal traction
◉ Does your facility have pelvic binders available? Where are they
located?
Answer: honestly no f***ing clue
◉ What assessment finding is a contraindication to inserting
indwelling catheter?
Answer: urethral trauma, bleeding from the meatus of the penis or
vaginal area
