TNCC Core Content and Skills 2

Question 1

During the secondary survey of a trauma patient, the nurse notes tracheal deviation to the right. Which condition does this most likely indicate?

Accepted Answer

Left-sided tension pneumothorax

Answer

Right-sided tension pneumothorax

Answer

Right-sided hemothorax

Answer

Left-sided simple pneumothorax

Question 2

A patient arrives after a motor vehicle crash with a GCS of 14, BP 88/60, HR 126, and distended neck veins. Which injury is most suspected?

Accepted Answer

Cardiac tamponade

Answer

Massive hemothorax

Answer

Tension pneumothorax

Answer

Aortic dissection

Question 3

When assessing the 'E' component in the primary survey, what does the trauma nurse evaluate?

Accepted Answer

Expose and environment control

Answer

Extremity neurovascular status

Answer

Electrocardiogram rhythm

Answer

Edema and ecchymosis pattern

Question 4

Which mechanism best explains neurogenic shock in a cervical spinal cord injury patient?

Accepted Answer

Loss of sympathetic tone causing vasodilation and bradycardia

Answer

Massive blood loss from cord hemorrhage

Answer

Activation of the parasympathetic nervous system causing tachycardia

Answer

Systemic inflammatory response to cord edema

Question 5

A patient with an open book pelvic fracture is hemodynamically unstable. What is the FIRST priority intervention?

Accepted Answer

Application of a pelvic binder or sheet

Answer

CT scan of the pelvis

Answer

Emergency surgical exploration

Answer

Bilateral femoral angiography

Question 6

Which finding on the focused assessment with sonography in trauma (FAST) exam indicates significant intra-abdominal hemorrhage?

Accepted Answer

Free fluid in Morrison's pouch

Answer

Absence of lung sliding

Answer

Pericardial effusion only

Answer

Dilated inferior vena cava

Question 7

A trauma patient has a serum lactate of 6 mmol/L. What does this value most strongly indicate?

Accepted Answer

Significant tissue hypoperfusion and shock

Answer

Adequate tissue oxygenation

Answer

Mild dehydration only

Answer

Metabolic alkalosis from stress response