TNCC FULL SOLUTION PACK(ALL TNCC EXAMS AND STUDY QUESTIONS ARE HERE ,ALL ANSWERED CORRECTLY)

TNCC Physical Assessments
What is the Trauma Assessment Mnemonic? Correct answer- A = Airway with
simultaneous cervical spine stabilization/immobilization
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose patient/Environmental Control
F = Full set of VS/Focused Adjuncts/Facilitate Family Presence
G = Give comfort measures
H = History/Head-to-toe assessment
I = Inspect posterior surfaces
What is assessed in Airway while simultaneously protecting the cervical spine? Correct
answer- Assess:

Vocalization
Tongue obstructing airway
Loose teeth, foreign objects
Blood, vomitus, other secretions
Edema
Interventions:
Position pt
Jaw thrust/Chin lift
Remove foreign objects
Suction blood, vomitus, secretions
Insert oropharyngeal or nasopharyngeal airway
Needle or surgical cricothyrotomy
What is assessed in Breathing? Correct answer- Assess:
Spontaneous breathing
Rise and fall of chest
Rate and pattern of breathing
Use of accessory muscles/Diaphragmatic breathing
Skin color
Integrity of soft tissue and bony structures of chest wall
Bilateral breath sounds
Interventions:
Supplemental oxygen
Bag-Mask ventilation
Needle thoracentesis/Decompression
Chest tube
Nonporous dsg taped on 3 sides

What is assessed in Circulation? Correct answer- Assess:

Palpates central pulse for rate and quality
Skin color, temperature and moisture
External bleeding
Interventions:
Direct pressure over uncontrolled bleeding sites
Insert 2 large caliber IV’s with warmed isotonic crystalloid solution
Infuses fluid rapidly with blood tubing
Blood sampling for typing
Blood administration
Pericardiocentesis
Emergency thoracotomy
Surgery
Cardiopulmonary resuscitation and advanced life support measures
What is assessed in Disability? Correct answer- Assess:
AVPU (LOC)
Pupils (PERRL)
Interventions:
Perform further investigation
Hyperventilation, if indicated
What is assessed in Trauma Mnemonic under “E?” Correct answer- EXPOSE PATIENT
AND ENVIRONMENTAL CONTROL (remove clothing and keep patient warm)
Assess:
Obvious wounds/Deformities
Temperature Control
Interventions:
Remove clothing
Preserve clothing for evidence if indicated (don’t cut through bullet wounds, use paper
bags)
Cover with blankets
Warming lights
Increase ambient temperature
What is assessed in Trauma Mnemonic under “F?” Correct answer- FULL SET OF
VS/FOCUSED ADJUNCTS/FACILITATE FAMILY PRESENCE
Assess:
Obtain a complete set of vital signs
Consider the focused adjuncts
Cardiac Monitor
Pulse Oximeter
Urinary catheter if not contraindicated
Gastric tube
Laboratory studies
Facilitate family presence

TNCC test prepA, TNCC Notes for
Written Exam, TNCC Notes for Written
Exam, TNCC Prep, TNCC EXAM, TNCC
8th Edition
Expedite transfer to the closest trauma center Correct answer- 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 Correct answer- Which of the following considerations
is the most important when caring for a geriatric trauma pt?
Mitigation Correct answer- 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 Correct answer- 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 Correct answer- What is
the effect of hypothermia on the oxyhemoglobin dissociation curve?
acidosis Correct answer- Which of the following is a component of the trauma triad of
death?
Complete Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- When is the tertiary survey completed fora
trauma pt?
pressure Correct answer- 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 Correct answer- Which of the following is possible
complication of positive-pressure ventilation?
pelvic stability Correct answer- the most reassuring finding for a male pt with hip pain
after a fall is which of the following?
narrowed Correct answer- Which of the following pulse pressures indicate early
hypovolemic shock?
dysrhythmias Correct answer- Patients with a crush injury should be monitored for
which of the following conditions?
subdural hematoma Correct answer- Tearing of the bridging veins is most frequently
associated with which brain injury?
straight cath for urine sample Correct answer- 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 Correct answer- 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 Correct answer- Which of the
following is true about the log-roll?
defusings Correct answer- All of these are considered a critical communication point in
trauma care EXCEPT which of the following?
pulse oximetry and capnography Correct answer- 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 Correct answer- 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 Correct answer- Which of the following injuries is LEAST likely to be promptly
identified?
Initiate transfer to a trauma center Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- which
of the following occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations Correct
answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- What factor contributes most to the kinetic energy of a body in
motion?
subdural hematoma Correct answer- 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 Correct answer- 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 Correct answer- Which of the following is a late sign of increased
intracranial pressure?
serial FAST exams Correct answer- 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 Correct answer- Which of the following is NOT considered goaldirected therapy for cardiogenic shock?
endotracheal tube Correct answer- 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? Correct answer- which of the following assessment
findings differentiates a tension pneumothorax from a simple pneumothorax?
calcium Correct answer- 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 Correct answerWhich of the following is NOT considered a benefit of debriefings?

TNCC EXAM

Preparation and Triage
Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
Reevaluation (consideration of transfer)
Secondary Survey (HI) with reevaluation adjuncts
Reevaluation and post resuscitation care
Definitive care of transfer to an appropriate trauma nurseAns – Initial Assessment
A- airway and Alertness with simultaneous cervical spinal stabilization
B- breathing and Ventilation
circulation and control of hemorrhage
D – disability (neurologic status)
F – full set of vitals and Family presence
G – Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfacesAns – ABCDEFGHI
Before the arrival of the ptAns – When should PPE be placed:
Pt is at hospital in the right amount of time, right care, right trauma facility, right
resourcesAns – Safe Care:
Uncontrolled HemorrhageAns – Major cause of preventable death:
reorganize care to C-ABCAns – If uncontrolled hemorrhage ..
Used at the beginning of the initial assessment
A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is
clear.
V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation
to respond, an airway adjunct may be needed to keep the tongue from obstructing the
airway.
P responds to pain. If the pt. responds only to pain, he or she may not be able to
maintain his or her airway adjunct may need to be placed while further assessment is
made to determine the need for intubation.
U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct
someone to chk in the pt is pulseless while assessing if the cause of the problem is the
airway.Ans – Airway and AVPU:
ask pt to pen his or her mouthAns – While assessing airway the patient is alert and
responds to verbal stimuli you should..
jaw thrust maneuver to open airway and assess for obstruction. If pt has a suspected
csi, the jaw thrust procedure should be done by two providers. One provider can
maintain c-spine and the other can perform the jaw thrust maneuver.Ans – While
assessing airway pt is unable to open mouth, responds only to pain, or is unresponsive
you should..
The tongue obstructing the airway
loose or missing teeth
foreign objects
blood, vomit, or secretions’
edema
burns or evidence of inhalation injury
Auscultiate or listen for:
Obstructive airway sounds such as snoring or gurgling
Possible occlusive maxillofacial bony deformity
Subcutaneous emphysemaAns – Inspect the mouth for:
Check the presence of adequate rise and fall of the chest with assisted ventilation
Absence of gurgling on auscultation over the epigastrium
Bilateral breath sounds present on auscultation
Presence of carbon dioxide (CO2) verified by a CO2 device or monitorAns – If the pt
has a definitive airway in what should you do?
Suction the airway
2, Use care to avoid stimulating the gag reflex
If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate
methodAns – If Airway is not patent
Apnea
GCS 8 or less
Maxillary fractures
Evidence of inhalation injury (facial burns)
Laryngeal or tracheal injury or neck hematoma
High risk of aspiration and patients inability to protect the airway
Compromised or ineffective ventilationAns – Following conditions might require a
definitive airway

TNCC Written Exam 2022
What is the best measure of the adequacy of cellular perfusion and helps predict the
outcome of resuscitation? Correct answer- Base deficit used in conjunction with serum
lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral
vasculature? Correct answer- Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit? Correct answer- Metabolic
acidosis
What type of shock results in generalized vasodilation? Correct answer- Neurogenic
shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what?
Correct answer- Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? Correct
answer- Compartment Syndrome
What is a high risk of frostbite? Correct answer- Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury
along with rewarming? Correct answer- Tissue plasminogen activator or non steroidal
anti-inflammatory medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? Correct answerPeripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient?
Correct answer- Reverse Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries? Correct answer- Secondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? Correct answerQuaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting
walls, ground, or any hard object? Correct answer- Tertiary Phase

What phase of a blast results from impact of the over and under pressurization wave
with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal
hemorrhage, globe rupture, and mild traumatic brain injury? Correct answer- Primary
Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general
weakness or malaise, and elevated creatinine kinase levels? Correct answerRhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis,
cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein
distention, or hypotension? Correct answer- Pulmonary Embolus
Signs of what include headache, nausea and vomiting, amnesia, behavioral changes,
altered level of consciousness? Correct answer- Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse
pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort?
Correct answer- Late signs of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery? Correct
answer- Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness
and nausea. Correct answer- Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. Correct
answer- Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = – Correct answer- MAP – ICP
What is the range for CO2 to maximize perfusion? Correct answer- 35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? Correct
answer- Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? Correct answer- Constriction d/t low
CO2
Pupils with pressure on cranial nerve Correct answer- Fixed and dilated
Pupils with opiates vs stimulants Correct answer- small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine Correct
answer- large

TNCC 8th edition exam
The major cause of preventable death after injury Answer- Uncontrolled hemorrhage
The best measure of the adequacy of cellular perfusion and helps to predict the
outcome of resuscitation Answer- Base deficit
Examples of primary blast injuries Answer- Blast lung, ruptured tympanic membrane,
TBI, abdominal hemorrhage
Examples of secondary blast injuries Answer- Wounds from debris and bomb fragments
Examples of tertiary blast injuries Answer- Blunt or penetrating trauma from the body
being thrown by the blast
Examples of quaternary blast injuries Answer- Injuries or illness related to explosion:
burns, toxic injury from chemicals
Examples of quinary blast injuries Answer- Injuries associated with exposure to
hazardous materials from the components of the blast
Questions to ask for airway assessment (need 4) Answer- Is the tongue obstructing?
Are there any foreign objects?
Is there any edema?
Are there loose or missing teeth?
Is there snoring, gurgling, or stridor?
Is there bony deformity?
Is there blood, vomit, or secretions?
Questions to ask during breathing assessment. (Need 4) Answer- Is there symmetrical
chest rise?
Is there spontaneous breathing?
Is there tracheal deviation or JVD?
What is their skin color?
Are there open wounds or deformities in the chest?
What’s the depth, pattern, and rate of respirations?
Is there increased work of breathing?
Are breath sounds present and equal?
3 ways to assess ETT placement Answer- 1. Apply end tidal, assess CO2 after 5-6
breaths

Assess for symmetrical chest wall rise and fall
Auscultation over the epigastrium for gurgling and bilateral breath sounds.

globe rupture Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- When is the tertiary survey completed fora
trauma pt?
pressure Correct answer- 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 Correct answer- Which of the following is possible
complication of positive-pressure ventilation?
pelvic stability Correct answer- the most reassuring finding for a male pt with hip pain
after a fall is which of the following?
narrowed Correct answer- Which of the following pulse pressures indicate early
hypovolemic shock?
dysrhythmias Correct answer- Patients with a crush injury should be monitored for
which of the following conditions?
subdural hematoma Correct answer- Tearing of the bridging veins is most frequently
associated with which brain injury?
straight cath for urine sample Correct answer- 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 Correct answer- 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 Correct answer- Which of the
following is true about the log-roll?
defusings Correct answer- All of these are considered a critical communication point in
trauma care EXCEPT which of the following?
pulse oximetry and capnography Correct answer- 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 Correct answer- 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 Correct answer- Which of the following injuries is LEAST likely to be promptly
identified?
Initiate transfer to a trauma center Correct answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- which
of the following occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations Correct
answer- 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 Correct answer- 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 Correct answer- 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 Correct answer- What factor contributes most to the kinetic energy of a body in
motion?
subdural hematoma Correct answer- 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 Correct answer- 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 Correct answer- Which of the following is a late sign of increased
intracranial pressure?
serial FAST exams Correct answer- 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 Correct answer- Which of the following is NOT considered goaldirected therapy for cardiogenic shock?
endotracheal tube Correct answer- 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? Correct answer- which of the following assessment
findings differentiates a tension pneumothorax from a simple pneumothorax?
calcium Correct answer- 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 Correct answerWhich of the following is NOT considered a benefit of debriefings?

TNCC 8th Edition Questions and Answers(2022 edition)
What are the greatest risks for transport?Answer- Loss of airway patency, displaced
obstructive tubes lines or catheters, dislodge splinting devices, need to replace or
reinforce dressings, deterioration in patient status change in vital signs or level of
consciousness, injury to the patient and/or team members
According to newtons law which of these two force is greater: size or force?AnswerNeither. For each force there is an equal and opposite reaction.
What is the relationship between mass and velocity to kinetic energy?Answer- Kinetic
energy is equal to 1/2 the mass multiplied the square of its velocity therefore when
mass is doubled so is the net energy, however, when velocity is doubled energy is
quadrupled.
What is tension?Answer- stretching force by pulling at opposite ends
What is compression?Answer- Crushing by squeezing together
What is bending?Answer- Loading about an axis. Bending causes compression on the
side the person is bending toward intention to the opposite side
What is shearing?Answer- Damage by tearing or bending by exerting faucet different
parts in opposite directions at the same time.
What is torsion?Answer- Torsion forces twist ends in opposite directions.
What is combined loading?Answer- Any combination of tension compression torsion
bending and/or shear.
What are the four types of trauma related injuries?Answer- Blunt, penetrating, thermal,
or blast.
What are contributing factors to injuries related to blunt traumas?Answer- The point of
impact on the patient’s body, the type of surface that is hit, the tissues ability to resist
(bone versus soft tissue, air-filled versus solid organs), and the trajectory of force.
What are the seven patterns of pathway injuries related to motor vehicle accidents?
Answer- Up and over, down and under, lateral, rotational, rear, roll over, and ejection.
Differentiate between the three impacts of motor vehicle impact sequence.Answer- The
first impact occurs when the vehicle collided with another object. The second impact
occurs after the initial impact when the occupant continues to move in the original
direction of travel until they collide with the interior of the vehicle or meet resistance.
The third impact occurs when internal structures collide within the body cavity.

What are the three factors that contribute to the damage caused by penetrating
trauma’s?Answer- The point of impact, the velocity and speed of impact, and the
proximity to the object.
What causes the primary effects of blast traumas?Answer- The direct blast effects.
Types of injuries include last long, tympanic membrane rupture and middle ear damage,
abdominal hemorrhage and perforation, global rupture, mild Trumatic brain injury.
What causes the secondary effects of blast traumas?Answer- Projectiles propelled by
the explosion. Injuries include penetrating or blunt injuries or I penetration.
What causes the tertiary effects of blast traumas?Answer- Results from individuals
being thrown by the blast wind. Injuries include hole or partial body translocation from
being thrown against a hard service: blunt or penetrating trauma’s, fractures, traumatic
amputations.
What causes quarternary effects of blast traumas?Answer- All explosion related injuries,
illnesses, or diseases not due to the first three mechanisms. Injuries include external
and internal burns, crush injuries, closed and open brain injuries, asthmatic or breathing
problems from dust smoke or toxic fumes, angina, or hyper glycemia and hypertension.
What causes quinary effects of blasts traumas?Answer- Those associated with
exposure to hazardous materials from radioactive, biologic, or chemical components of
a blast. Injuries include a variety of health effects depending on agent.
What are the three processes that transfer oxygen from the air to the lungs and blood
streamAnswer- Ventilation: the active mechanical movement of air into and out of the
lungs; diffusion: the passive movement of gases from an area of higher concentration to
an area of lower concentration; and perfusion: the movement of blood to and from the
lungs as a delivery medium of oxygen to the entire body.
When would you use a nasopharyngeal airway versus an oral pharyngeal airway?
Answer- Nasopharyngeal airways is contraindicated in patients with facial trauma or a
suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive
patients unable to maintain their airway, without a gag reflex as a temporary measure to
facilitate ventilation with a bag mask device or spontaneous ventilation until the patient
can be intubated.
Describe the measurement of an NPAAnswer- Measure from the tip of the patient’s
nose to the tip of the patients earlobe.
Measurement of an OPAAnswer- Place the proximal end or flange of the airway adjunct
at the corner of the mouth to the tip of the mandibular angle.

TNCC final exam test 2022 open book
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
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
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) diffuse axonal injury
C) post-concussive syndrome
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 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 ***
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 ***
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 interventions?
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
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C – A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?
Answer: C – A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B – A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
Answer: D – A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
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 on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?

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