TNCC test A, TNCC Notes for Written
Exam, TNCC Notes for Written Exam,
TNCC Prep, TNCC EXAM, TNCC 8th
Edition
Expedite transfer to the closest trauma center - A 56 y/o M pt involved in a motor vehicle crash
is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and
diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2
via NRB mask. Which of the following is the priority intervention for this patient?
a pertinent medical hx is crucial - Which of the following considerations is the most important
when caring for a geriatric trauma pt?
Mitigation - Following a review of recent drills and a real disaster event, a hospital has identified
deficiencies and is taking steps to minimize the impact of a future disaster . Which phase of the
disaster life cycle does this describe?
Multiple requests for water - EMS brings a pt who fell while riding his bicycle. Using the
American College of Surgeobs screening guidelines, which assessment finding would prompt the
RN to prepare the pt for a radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - What is the effect of hypothermia
on the oxyhemoglobin dissociation curve?
acidosis - Which of the following is a component of the trauma triad of death?
Complete - EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The
pt exhibits urinary incontinence and priapism. These assessment findings are most consistent
with which of the following types of spinal cord injury?
flucuation in the water seal chamber - Which of the following is an expected finding in a pt with
a tube thoracstomy connected to a chest drainage system?
insert an oropharyngeal airway if there is no gag reflex - During the primary survey of an
unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority
nursing interventions should be preformed next?
globe rupture - A 35 y/o M 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?
,compensated - A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP
110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The
pt is demonstrating s/sx of which stage of shock?
ventilate with a bag mask device - An unresponsive trauma pt has an oropharygeal airway in
place, shallow and labored respirations, and dusky skin. The trauma team has administered
medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is
the most appropriate immediate next step?
within 24 hrs of trauma - When is the tertiary survey completed fora trauma pt?
pressure - An intubated and sedated pt in the ED has multiple extremity injuries with the
potential for causing compartment syndrome. What is the most reliable indication of
compartment syndrome in a patient who is unconscious?
worsening pneumothorax - Which of the following is possible complication of positive-pressure
ventilation?
pelvic stability - the most reassuring finding for a male pt with hip pain after a fall is which of
the following?
narrowed - Which of the following pulse pressures indicate early hypovolemic shock?
dysrhythmias - Patients with a crush injury should be monitored for which of the following
conditions?
subdural hematoma - Tearing of the bridging veins is most frequently associated with which
brain injury?
straight cath for urine sample - A 20 y/o M presents to the ED complaining of severe lower abd
pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver.
Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the RN question?
placental abruption - You are caring for a pt who was involved in a MVC and is 32 weeks
pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cariocgraphy. These findings are most consistent with which of the following?
it can worsen cord damage from an unstable spinal injury - Which of the following is true about
the log-roll?
defusings - All of these are considered a critical communication point in trauma care EXCEPT
which of the following?
,pulse oximetry and capnography - What bedside monitoring parameters are used to assess for
adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - Caregivers carry in a 2 y/o into the
ED who fell out of a second-story window. The pt is awake and crying with increased work of
breathing and pale skin. Which of the following interventions has the highest priority?
bowel - Which of the following injuries is LEAST likely to be promptly identified?
Initiate transfer to a trauma center - A pt is brought to the ED of a rural hospital following a
high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey,
which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury - A pt with a complete spinal
cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs?
apply splint and elevate above the level of the heart - a 37 y/o F has a deformity of the L wrist
after a fall. She is reluctant to move her hand due to pain. Which of the following is the most
appropriate intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - which of the following occurs
during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - a 5 y/o child
presents to the ED with bruises to the upper arm and buttocks in various stages of healing and
multiple small, clean, round burns to the back. There are no abnormalities found based on the
pediatric assessment triangle or primary survey. Which of the following is the priority survey.
Which of the following is the priority nursing intervention?
to guage end-organ perfusion and tissue hypoxia - Why is a measure of serum lactate obtained in
the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - A pt with a lower extremity fracture complains
of severe pain and tightness in his calf, minimally by pain medications. Which of the following is
the priority nursing intervention?
velocity - What factor contributes most to the kinetic energy of a body in motion?
subdural hematoma - An elderly patient with a history of anticoagulant use presents after a fall at
home today. She denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms?
fat embolism - a pt has been in the ED for several hrs waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining
of leg pain. His wife reported that he suddenly became anxious and confused. Upon
, reassessment, the pt is restless with respiratory distress and petechiae to his neck. The pt is
exhibiting s/sx most commonly associated with which of the following conditions?
nausea and vomiting - Which of the following is a late sign of increased intracranial pressure?
serial FAST exams - a 49 y/o restrained driver involved in a MVC presents to the trauma center
complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can
anticipate all of these after a negative FAST exam EXCEPT which of the following?
pericardiocentesis - Which of the following is NOT considered goal-directed therapy for
cardiogenic shock?
endotracheal tube - The trauma nurse knows that placing a bariatric patient in a ramped position
providers better visualization during the insertion of which device?
increased work of breathing? - which of the following assessment findings differentiates a
tension pneumothorax from a simple pneumothorax?
calcium - if a pt has received multiple transfusions of banked blood preserved with citrate, which
electrolyte is most likely to drop and require supplementation?
identifying individuals who made mistakes during the traumatic event - Which of the following
is NOT considered a benefit of debriefings?
500 mL/hr - You are treating a 27 y/o M in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate
should you begin fluid resuscitation?
advanced age - Which of the following is most likely to contribute to inadequate oxygenation
and ventilation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - Which of the following
patients warrants referral to a burn center?
dressing removal - A patient arrives with a large open chest wound after being assaulted with a
machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on
three sides. he is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis
and decreasing blood pressure. Which of the following is the MOST appropriate immediate
intervention?
after a physical examination if the pt has no radiologic abnormalities on CT - EMS arrives with
the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers
side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to
remove the cervical collar?
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