TNCC FINAL EXAM QUESTIONS AND
ANSWERS
1. Why is a measure of serum lactate obtained in the initial
assessment of the trauma patient?
Answer: c: a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
2. A trauma patient is restless and repeatedly asking "where am I?"
vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min,
and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are
BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is
demonstrating signs and symptoms of which stage of shock?
Answer: A: A) compensated **
B) Progressive
C) irreversible
D) decompensated
3. An elderly patient with a history of anticoagulant use presents
after a fall at home that day. she denies any loss of consciousness.
,She has a hematoma to her forehead and complains of headache,
dizziness, and nausea. Which is a most likely cause of her
symptoms?
Answer: D: A) epidural hematoma
B) dittuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
4. EMS brings a patient who fell riding his bicycle. Using the
American College of Surgeons screening guidelines, which
assessment finding would prompt the nurse to prepare the patient
for radiologic spine clearance?
Answer: D: A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
5. Which of the following occurs during the third impact of a
motor vehicle crash?
Answer: C: A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
, D) the airbag deploys and strikes the front seat passenger ***
6. A passenger is brought to the emergency department of a
rural hospital following a high-speed MVC. When significant
abdominal and pelvic injuries are noted in the primary survey,
which of the following is the priority interven- tions?
Answer: A: A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
7. Which of the following injuries is LEAST likely to be promptly
identified?
Answer: C: A) spleen
B) lung
C) bowel ***
D) brain
8. Patients with a crush injury should be monitored for which of the
following conditions?
Answer: C: A) Hypernatremia
ANSWERS
1. Why is a measure of serum lactate obtained in the initial
assessment of the trauma patient?
Answer: c: a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
2. A trauma patient is restless and repeatedly asking "where am I?"
vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min,
and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are
BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is
demonstrating signs and symptoms of which stage of shock?
Answer: A: A) compensated **
B) Progressive
C) irreversible
D) decompensated
3. An elderly patient with a history of anticoagulant use presents
after a fall at home that day. she denies any loss of consciousness.
,She has a hematoma to her forehead and complains of headache,
dizziness, and nausea. Which is a most likely cause of her
symptoms?
Answer: D: A) epidural hematoma
B) dittuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
4. EMS brings a patient who fell riding his bicycle. Using the
American College of Surgeons screening guidelines, which
assessment finding would prompt the nurse to prepare the patient
for radiologic spine clearance?
Answer: D: A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
5. Which of the following occurs during the third impact of a
motor vehicle crash?
Answer: C: A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
, D) the airbag deploys and strikes the front seat passenger ***
6. A passenger is brought to the emergency department of a
rural hospital following a high-speed MVC. When significant
abdominal and pelvic injuries are noted in the primary survey,
which of the following is the priority interven- tions?
Answer: A: A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
7. Which of the following injuries is LEAST likely to be promptly
identified?
Answer: C: A) spleen
B) lung
C) bowel ***
D) brain
8. Patients with a crush injury should be monitored for which of the
following conditions?
Answer: C: A) Hypernatremia
