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

Tracheal deviation shifts away from the affected side; deviation to the right indicates a left-sided tension pneumothorax pushing mediastinal structures rightward.

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

Beck's triad (hypotension, distended neck veins, muffled heart sounds) is classic for cardiac tamponade, which impairs ventricular filling.

Question 3

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

Accepted Answer

Expose and environment control

Answer

The 'E' in the ABCDE primary survey stands for Expose/Environment — fully exposing the patient while preventing hypothermia.

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

Cervical cord injuries disrupt descending sympathetic pathways, causing peripheral vasodilation and unopposed vagal bradycardia.

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

A pelvic binder reduces pelvic volume, tamponades venous bleeding, and is the first step in stabilizing an unstable pelvic fracture.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Core Content and Skills 2