FREE TNCC Trauma Care Questions and Answers

Question 1

Why is a serum lactate measurement used during the trauma patient's initial evaluation?

Accepted Answer

to measure tissue hypoxia and end-organ perfusion

Answer

Serum lactate is a crucial indicator in trauma because it reflects the body's metabolic response to inadequate oxygen delivery. Elevated lactate levels signify tissue hypoxia and anaerobic metabolism, directly indicating poor end-organ perfusion and the severity of shock. Monitoring lactate helps guide resuscitation efforts to restore adequate oxygenation and perfusion.

Question 2

The trauma patient's vital signs were 100/60 mm Hg, 96 beats per minute, and 24 breaths per minute when they arrived. The patient is agitated and asks "where am I?" frequently. She has dry, cold skin. The patient's vital signs are 104/84 mm Hg, 108 bpm, and 28 breaths per minute. Which stage of shock is the patient exhibiting symptoms and signs of?

Accepted Answer

compensated

Answer

The patient's initial vital signs show a narrow pulse pressure, increased heart rate, and increased respiratory rate, which worsen over time. Agitation and dry, cold skin are also classic signs of sympathetic nervous system activation. These indicate that the body's compensatory mechanisms, such as vasoconstriction and increased heart rate, are actively working to maintain blood pressure and vital organ perfusion despite ongoing hypoperfusion, characteristic of compensated shock.

Question 3

That day, an elderly patient who has used anticoagulants in the past comes in after falling at home. She disputes that she ever lost consciousness. In addition to complaining of headache, nausea, and dizziness, she has a hematoma on her forehead. Which of the following best describes her symptoms?

Accepted Answer

subdural hematoma

Answer

An elderly patient on anticoagulants who falls is at high risk for intracranial bleeding. A subdural hematoma, which involves bleeding between the dura mater and arachnoid mater, often presents with a delayed onset of symptoms like headache, nausea, and dizziness, even without immediate loss of consciousness. The use of anticoagulants significantly increases the risk of such bleeding following trauma.

Question 4

A patient who fell off his bicycle is brought in by EMS. Which evaluation result, according to the American College of Surgeons screening recommendations, would lead the nurse to get the patient ready for radiologic spine clearance?

Accepted Answer

alcohol odor on breath

Answer

According to American College of Surgeons screening recommendations (like NEXUS or Canadian C-Spine Rule), patients must be alert, oriented, and free from distracting injuries or altered mental status to undergo clinical spine clearance. An alcohol odor on breath suggests intoxication, which impairs the patient's ability to reliably report pain or neurological deficits. Therefore, radiological imaging is required to rule out spinal injury in such cases.

Question 5

After a high-speed MVC, a passenger is taken to the emergency room of a rural hospital. Which of the following procedures should be prioritized if the main survey reveals substantial damage to the abdomen and pelvis?

Accepted Answer

start the trauma center transfer process

Answer

A rural hospital may lack the specialized resources, such as immediate access to trauma surgeons, advanced imaging, and operating room capabilities, required for definitive management of severe multi-system trauma. Prioritizing transfer to a higher-level trauma center ensures the patient receives timely, comprehensive care from a specialized trauma team. This critical step significantly improves outcomes for patients with substantial abdominal and pelvic injuries.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

FREE TNCC Trauma Care Questions and Answers