TNCC Initial Assessment 2 — Questions and Answers
Question 1: During the primary survey, which component of the 'E' step in the ABCDE mnemonic is assessed?
- Electrolytes and labs
- Exposure and environmental control (Correct answer)
- Extremity neurovascular status
- Edema and fluid balance
Correct answer: Exposure and environmental control
The 'E' in the primary survey stands for Exposure and Environmental Control — removing clothing to expose injuries while preventing hypothermia.
Question 2: A trauma patient's GCS is assessed as: eyes open to pain (2), confused verbal response (4), withdraws to pain (4). What is the total GCS score?
- 8
- 9
- 10 (Correct answer)
- 11
Correct answer: 10
GCS = Eye (2) + Verbal (4) + Motor (4) = 10, indicating moderate traumatic brain injury.
Question 3: Which intervention is the priority when a tension pneumothorax is identified during the primary survey?
- Chest X-ray confirmation
- Needle decompression at the 2nd intercostal space, midclavicular line (Correct answer)
- Immediate chest tube insertion
- Positive pressure ventilation
Correct answer: Needle decompression at the 2nd intercostal space, midclavicular line
Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression without waiting for imaging.
Question 4: The 'D' in the ABCDE primary survey specifically refers to:
- Disability: neurological status (Correct answer)
- Drugs and allergies
- Dressings and wound care
- Drainage from injuries
Correct answer: Disability: neurological status
Disability in the primary survey refers to a rapid neurological assessment including GCS, pupils, and gross motor function.
Question 5: During secondary survey, a trauma patient reports pain rated 8/10. Which action is most appropriate for the trauma nurse?
- Delay analgesia until the full secondary survey is complete
- Administer pain medication per protocol while continuing the assessment (Correct answer)
- Document and reassess in 30 minutes
- Notify the physician before administering any analgesia
Correct answer: Administer pain medication per protocol while continuing the assessment
Pain management should not be withheld during assessment; analgesics can be given per protocol while the secondary survey continues.
Question 6: A FAST exam (Focused Assessment with Sonography in Trauma) is primarily used to detect:
- Pneumothorax location
- Free fluid (blood) in the peritoneal and pericardial spaces (Correct answer)
- Bowel injury and perforation
- Retroperitoneal hematoma
Correct answer: Free fluid (blood) in the peritoneal and pericardial spaces
FAST is a bedside ultrasound exam used to rapidly identify free fluid (hemorrhage) in the abdomen and around the heart.
Question 7: Which finding during the initial assessment most strongly suggests cardiac tamponade?
- Tachycardia, hypotension, and absent breath sounds
- Hypotension, distended neck veins, and muffled heart sounds (Beck's triad) (Correct answer)
- Tachycardia, widened pulse pressure, and unequal pupils
- Bradycardia, hypertension, and irregular respirations
Correct answer: Hypotension, distended neck veins, and muffled heart sounds (Beck's triad)
Beck's triad — hypotension, jugular venous distension, and muffled heart sounds — is the classic presentation of cardiac tamponade.
TNCC Initial Assessment 2
During the primary survey, which component of the 'E' step in the ABCDE mnemonic is assessed?