TNCC 9th EDITION FINAL TEST NEWEST VERSION 2024-
2025 ACTUAL 80 QUESTION AND CORRECT DETAILED
ANSWERS WITH RATIONALES.
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. ✔✔CORRECT ANSWER✔✔C. Notify
the physician
A patient is brought to the emergency department of a rural hospital
following a high-speed motor vehicle collision. When significant abdominal
and pelvic injuries are noted in the primary survey, what is the priority
intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter ✔✔CORRECT ANSWER✔✔A. Initiate
transfer to a trauma center
,An adult who fell from a second story roof is brought to the emergency
department by private vehicle. The patient is confused with unlabored
respirations and has strong, palpable radial pulses. There is an open wound
in proximity to an obvious deformity of the left lower extremity. What is the
priority intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen.
D. Log roll the patient onto a spine board ✔✔CORRECT ANSWER✔✔A.
Initiate cervical spine stabilization
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. ✔✔CORRECT ANSWER✔✔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)
✔✔CORRECT ANSWER✔✔B. Application of a pelvic binder
A patient involved in an MVC has sustained a fracture to the second rib of
the anterior left chest. Which concurrent injury is most commonly associated
with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax ✔✔CORRECT ANSWER✔✔b. first and second rib fractures
are commonly associated with great vessel, head and spinal cord and
brachial plexus injuries.
a. blunt cardiac injury-sternal fractures;
c. pneumothorax is most commonly associated with sternal fractures,
multiple rib fractures, flail chest
d. Hemothorax is most commonly associated with flail chest of multiple rib
fractures
, Understanding the kinematic concepts associated with the mechanism of
injury and energy transfer can initially assist the trauma care provider in
which of the following?
a. anticipating the types of injuries that may be present
b. deciding whether law enforcement should be notified
c. determining the need for lab tests
d. predicting the need for a surgical procedure ✔✔CORRECT ANSWER✔✔a.
anticipating the types of injuries that may be present
mechanism of injury and energy transfer can assist the provider in
anticipating the types of injuries that may be present and their severity
In a patient with severe traumatic brain injury, hypocapnia causes which
condition?
a. respiratory acidosis
b. metabolic acidosis
c. neurogenic shock
d. cerebral vasoconstriction ✔✔CORRECT ANSWER✔✔***d. hypocapnia,
cause vasoconstriction especially in the cerebral vasculature
a. hypercapnia from inadequate ventilation causes respiratory acidosis, not
hypocapnia
b. metabolic acidosis results from tissue hypoperfusion and oxygen deficit,
not hypocapnia
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