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TNCC Exam Practice Questions: Trauma Nursing Review, Exams of Nursing

Multiple-choice questions and answers for trauma nursing, focusing on the TNCC final exam. Topics include fluid resuscitation, pneumothorax assessment, geriatric trauma, and hypothermia's impact on oxygen delivery. Correct answers are provided, aiding nurses preparing for the TNCC exam or enhancing trauma care knowledge. It covers disaster preparedness, shock management, and scenarios like burns, pelvic injuries, and pregnancy-related trauma. Designed to test understanding of key concepts and best practices, ensuring optimal trauma patient care. The open-book format suggests review and self-assessment, making it a valuable tool for evaluating comprehension and identifying areas for improvement.

Typology: Exams

2024/2025

Available from 05/15/2025

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TNCC final exam test 2024-2025 open
book
If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most
likely to drop and require supplementation?
Answer: D correct answerA) potassium
B) magnesium
C) sodium
D) calcium ***
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT scanner will be out of
service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this
trauma teams communication?
Answer: D correct answerA) Brief
B) loop
C) debrief
D) huddle ***
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient's fluid
resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial
burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total BSA burned, how
much IV fluids would be administered in the first 8 hours?
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book

If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyteis most likely to drop and require supplementation? Answer: D correct answerA) potassium

B) magnesium

C) sodium

D) calcium ***

A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT scanner will beout of service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma teams communication? Answer: D correct answerA) Brief

B) loop

C) debrief

D) huddle ***

The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient'sfluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate thetotal BSA burned, how much IV fluids would be administered in the first 8 hours?

book

(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA. 120 kg x (2 mL) x (19% TBSA) = 4560 mL 4560 / 2 (half of fluids given in first 8 hours) = 2280 mL Answer: A correct answerA) 2280 mL ***

B) 3840 mL

C) 4560 mL

D) 7680 mL

Which of the following assessment findings differentiates a tension PTX from a simple PTX? answer: D Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, andcyanosis. correct answerA) increased work of breathing

B) unilaterally diminished breath sounds

C) pleuritic chest pain

D) hypotension that worsens with inspiration ***

Which of the following considerations is most important when caring for a geriatric trauma patient?

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C) assist respirations using a BVM

D) insert an oropharyngeal airway if there is no gag reflex ***

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 future disaster. Which phase of the disaster life cycle does this describe? Answer: A correct answerA) mitigation ***

B) preparedness

C) response

D) recovery

Which pulse pressure description is an indication of early hypovolemic shock? Answer: B correct answerA) widened

B) narrowed ***

C) bounding

D) weak

The most reassuring finding for a male patient with hop pain after a fall is which of the following? Answer: D correct answerA) a normal prostate exam

B) absence of abdominal distension

C) a normal fast exam

D) pelvic stability ***

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A 49 - year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic, and billower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative fast exam except which of the following? Answer: A The FAST exam is done at the bedside to identify pathological fluid in the abdominal and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be repeated if clinical changes or hemodynamic changes occur. A negative FAST study does not rule out injury and may warrant a follow-up computed tomography scan. Serial FAST exams can identify increasing abdominal fluid collections from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is performed by the surgical team to rapidly identify the presence of hemorrhage in patients who are hemodynamically unstable after trauma. correct answerA) diagnostic peritoneal lavage ***

B) serial fast exams

C) abdominal and pelvic CT scans

D) serial abdominal assessments

Which of the following is an expected finding in a patient with a thoracostomy connected to a chestdrainage system? Answer: D correct answerA) output of 200 mL/hr

B) tubing clamp closed for transport

C) dependent loops in the tubing to promote drainage

D) fluctuations in the water serial chamber ***

Which of the following patients warrants referral to a burn center?

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B) CT scan

C) straight cath for urine sample ***

D) ice and elevation of the scrotum

You are treating a 27 - year old male in respiratory distress who was involved in a house fire. CalculatingTBSA burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation? Answer: B correct answerA) 1000 mL/hr B) 500 mL/hr ***

C) 250 mL/hr

D) 125 mL/hr

Which of the following is possible complication of positive-pressure ventilation? Answer: A correct answerA) worsening pneumothorax

B) worsening flail chest

C) reabsorption of pleural air

D) negative intrapleural pressure

Which of the following is NOT considered goal-directed therapy of cardiogenic shock? Answer: C correct answerA) controlled fluid boluses

B) antidysrhythmic administration

C) pericardiocentesis ***

D) cardiac cath

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What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectivenessof ventilation? Answer: A correct answerA) pulse oximetry and capnogaphy **

B) respiratory rate and capnography

C) pulse oximetry and respiratory rate

D) capnography and capnometry

Which if the following values indicates the need for alcohol withdrawal interventions? Answer: A correct answerA) CIWA-Ar of 36 ***

B) GCS 13

C) ETCo2 of 48 mm Hg

D) heart rate of 45 beats/min

An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respiratory,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? Answer: A correct answerA) Ventilate with a BVM ***

B) Prepare for cricothyroidotomy

C) administer reversal medications

D) contact anesthesia for assistance

The trauma nurse knows that placing a bariatric patients in a "ramped position" provides bettervisualization during the insertion of which device?

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Answer: A correct answerA) compensated **

B) Progressive

C) irreversible

D) decompensated

An elderly patient with a history of anticoagulant use presents after a fall at home that day. she deniesany 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 correct answerA) epidural hematoma

B) diffuse axonal injury

C) post-concussive syndrome

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D) subdural hematoma ***

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 spineclearance? Answer: D correct answerA) Alert with no neurologic deficits

B) Multiple abrasions to the extremities

C) Multiple requests of water

D) Smell of alcohol on breath ***

Which of the following occurs during the third impact of a motor vehicle crash? Answer: C correct answerA) 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 ***

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 isthe priority interventions? Answer: A correct answerA) initiate transfer to a trauma center **

B) provide report to the operating room nurse

C) Obtained imaging studies

D) Place a gastric tube

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C) Tachycardia and absent motor function below the level of injury

D) Bradycardia and absent motor function below the level of the injury ***

A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based onthe pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? Answer: A correct answerA) report your suspicion of the maltreatment in accordance with localregulations ***

B) apply ice to the bruises and consult wound care

C) engage in therapeutic communication to determine the MOI

D) provide the family with injury prevention resourse

A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimallyrelieved by pain medications. Which of the following is the priority nursing intervention? Answer: C correct answerA) elevating the extremity above the level of the heart

B) repositioning and apply ice

C) Elevating the extremity to the level of the heart ***

D) Preparing the patient for ultrasound

A 36 - year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand dueto pain. Which of the following is the most appropriate intervention? Answer: B correct answerA) apply a sling and elevate the extremity to the level of the heart.

B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***

C) Apply a sling and elevate the extremity above the level of the heart

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D) apply a splint and elevate the extremity to the level of the heart.

Which of the following is a late sign of increased intracranial pressure? Answer: C Cushing Response Widening pulse pressure Reflex bradycardia Decreased RR correct answerA) Restlessness or drowsiness

B) Nausea and vomiting

C) Decreased respiratory effort**

D) amnesia and anxiety

Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massiveuncontrolled hemorrhage? Answer: B correct answerA) ABC

B) MARCH***

C) AVPU

D) VIPP

A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures.The patient is pale, alert, disoriented, and has delayed cap refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principle?

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RR 26 breaths/min SpO2 94% on high flow O2 via NRB mask which of the following is the priority intervention for this patient? Answer: C correct answerA) Expedite transport to the CT scanner

B) prepare the patient for spinal radiographs

C) expedite transfer to the closest trauma center ***

D) notify the patients family

Caregivers carry a 2 - year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? Answer: A correct answerA) padding the upper back while stabilizing the cervical spine ***

B) applying a tight-fitting NRB mask with an attached resevior

C) establishing intravenous access and administering a 20mL/kg bolus

D) preparing for drug assisted intubation

Which of the following is a component of the trauma triad of death? Answer: A hypothermia, metabolic acidosis, coagulopathy correct answerA) Acidosis **

B) hyperthermia

C) hemorrhage

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D) sepsis

A 35 - year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-dropshaped left pupil is noted on exam. What type of injury is suspected? Answer: B correct answerA) oculomotor nerve palsy

B) globe rupture ***

C) uncal herniation

D) retinal detachment

Which of the following is true about the log roll maneuver? Answer: C correct answerA) it causes less spinal motion than the lift and slide manuever

B) it is recommended for patients with unstable pelvic fractures

C) it can worsen cord damage from an unstable spinal injury ***

D) it does not increases the risk of life threatening hemorrhage from unstable injuries

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 patient is asking to have the cervical color removed. when is it appropriate to remove the cervical collar? Answer: A correct answerA) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan ***

B) after physician evaluation if the patient has not neurologic abnormalities on exam

C) after palpation of the spine if the patient has no point tenderness the the vertebral column

D) after physical examination if the patient has not neck pain with movement