TNCC 9 TH EDITION FINAL ACTUAL EXAM
2026/2027 QUESTIONS AND CORRECT ANSWERS
GRADED A+
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?
A. Decrease the rate of manual ventilation.
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered.
A. Decrease the rate of manual ventilation.
An adult patient is brought to the emergency department following a vehicle "roll-
over" with prolonged extrication. Assessment reveals swelling and bruising to the
right proximal thigh and a weak pedal pulse. Skin is pale, cool, and moist. What is
the most appropriate initial intervention?
A. Application of a tourniquet to the affected extremity
B. Application of a pelvic binder
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa)
,B. Application of a pelvic binder
Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as
amputation of a limb, paralysis, or loss of sight.
What is the most important consideration during the initial assessment when caring
for an older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
,B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
You are caring for a patient who was thrown from a bike and was not wearing a
helmet. While performing the head-to-toe assessment, you note clear drainage
from the right ear. Which of the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
, When should the definitive calculation for intravenous fluid resuscitation rate be
performed for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage
of total body surface area which requires a good skin assessment and is calculated
after clothing is removed.
6. In a motor vehicle collision, which injury pathway is most likely to increase the
patient's morbidity and mortality?
A. Rotational
B. Ejection
2026/2027 QUESTIONS AND CORRECT ANSWERS
GRADED A+
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?
A. Decrease the rate of manual ventilation.
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered.
A. Decrease the rate of manual ventilation.
An adult patient is brought to the emergency department following a vehicle "roll-
over" with prolonged extrication. Assessment reveals swelling and bruising to the
right proximal thigh and a weak pedal pulse. Skin is pale, cool, and moist. What is
the most appropriate initial intervention?
A. Application of a tourniquet to the affected extremity
B. Application of a pelvic binder
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa)
,B. Application of a pelvic binder
Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as
amputation of a limb, paralysis, or loss of sight.
What is the most important consideration during the initial assessment when caring
for an older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
,B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
You are caring for a patient who was thrown from a bike and was not wearing a
helmet. While performing the head-to-toe assessment, you note clear drainage
from the right ear. Which of the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
, When should the definitive calculation for intravenous fluid resuscitation rate be
performed for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage
of total body surface area which requires a good skin assessment and is calculated
after clothing is removed.
6. In a motor vehicle collision, which injury pathway is most likely to increase the
patient's morbidity and mortality?
A. Rotational
B. Ejection
