CPEG208 TNCC final exam test 2022 open book GRADED A+, Exercises of Nursing

Download CPEG208 TNCC final exam test 2022 open book GRADED A+ and more Exercises Nursing in PDF only on Docsity! CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ 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 CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ 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 CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ Response Widening pulse pressure Reflex bradycardia Decreased RR A)Restlessness or drowsiness B)Nausea and vomiting C) Decreased respiratory effort** D) amnesia and anxiety CPEG208 TNCC final exam test LATEST UPDATE 2022/2023 n book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Answer: B A)ABC B)MARCH*** C) AVPU D) VIPP 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? CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ Answer: D A)Bradycardia and ipsilateral absences of motor function B)Tachycardia and respiratory depression CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ RR 26 breaths/min SpO2 94% on high flow O2 via NRB mask Which of the following patients warrants referral to a burn center? Answer: C A)a 21- year old female with a partial thickness burn to the right forearm B)a 40-year old hypertensive male with a superficial burn to the back C) a 52-year old diabetic male with partial thickness burn to the left lower leg *** D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife reported suddenly becoming anxious and CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ commonly associated with which of the following conditions? Answer: B A)acute lung injury B) fat embolism *** C) PTX D) pulmonary contusion Which is the effect of hypothermia on the oxyhemoglobin dissociation curve? Answer: A A)Hemoglobin does not readily release oxygen for use by the tissues *** B)The amount of oxygen available to the tissues increases C) Tissue oxygenation (PaO2) increases D) Hemoglobin molecule saturation (SaO2) decreases A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ Answer: C A)controlled fluid boluses B)antidysrhythmic administration C) pericardiocentesis *** D) cardiac cath Which of the following considerations is most important when caring for a geriatric trauma patient? Answer: B A)head to to exam B)medical history ** C) incontinence D) falls An intubated trauma patient is being transferred to a tertiary care center. After moving the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is the priority interventions? CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ Answer: D A)call for a portable CXR stat B)chest to make sure the ventilator is plugged in CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ C) suction the ET tube D) confirm ET tube placement What factor contributes most the kinetic energy of a body in motion? answer: C A)acceleration B)mass C) velocity *** D) inertia During the primary survey of an unconscious patient with multi- system trauma, the nurse notes snoring respirations. Which priority nursing interventions should be performed next? Answer: D A)open the airway with the head-tilt/chin lift maneuver B)auscultate bilateral breath sounds to assess ventilatory status C) assist respirations using a BVM D) insert an oropharyngeal airway if there is no gag CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative fast exam except which of the following? Answer: A The FAST exam is done at the bedside to identify pathological fluid in the abdominal and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be repeated if clinical changes or hemodynamic changes occur. A negative FAST study does not rule out injury and may warrant a follow-up computed tomography scan. Serial FAST exams can identify increasing abdominal fluid collections from hemorrhage. Diagnostic CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ peritoneal lavage/diagnostic peritoneal aspiration is performed by the surgical team to rapidly identify the presence of hemorrhage in patients who are hemodynamically unstable after trauma. A)diagnostic peritoneal lavage *** B)serial fast exams C) abdominal and pelvic CT scans D) serial abdominal assessments Which of the following is an expected finding in a patient with a thoracostomy connected to a chest drainage system? Answer: D A)output of 200 mL/hr B) tubing clamp closed for transport C) dependent loops in the tubing to promote drainage D) fluctuations in the water serial chamber *** What bedside monitoring parameters are used CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ to assess for adequacy of oxygenation and effectiveness of ventilation? Answer: A A)pulse oximetry and capnogaphy ** B)respiratory rate and capnography C) pulse oximetry and respiratory rate D) capnography and capnometry Which if the following values indicates the need for alcohol withdrawal interventions? Answer: A A)CIWA-Ar of 36 *** B)GCS 13 C) ETCo2 of 48 mm Hg D) heart rate of 45 beats/min An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respiratory, and dusky skin. the trauma team has administered medications for drug CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are most consistent with which of the following? Answer: A A) placental abruption *** B) preterm labor C) uterine rupture D) fetal demise which of the following is the priority intervention for this patient? Answer: C A)Expedite transport to the CT scanner B)prepare the patient for spinal radiographs C) expedite transfer to the closest trauma center *** D) notify the patients family CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? Answer: A A)padding the upper back while stabilizing the cervical spine *** B)applying a tight-fitting NRB mask with an attached resevior C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation Which of the following is a component of the trauma triad of death? Answer: A hypothermia, metabolic acidosis, coagulopathy A)Acidosis ** CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ B)hyperthermia C) hemorrhage D) sepsis A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is suspected? Answer: B A)oculomotor nerve palsy B)globe rupture *** C) uncal herniation D) retinal detachment Which of the following is true about the log roll maneuver? Answer: C A) it causes less spinal motion than the lift and slide manuever B) it is recommended for patients with unstable pelvic fractures CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ dressing over the chest wound and tapes it on 3 sides. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST appropriate interventions? Answer: C A)needle decompression B) tube thoracostomy C) dressing removal ** D) surgical repair A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values is expected with a musculoskeletal complication associated with this presentation? Answer: A A)elevated creatine kinase *** B)decreased potassium level C) decreased WBC CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ D) elevated GFR Which of the following occurs during the third impact of a motor vehicle crash? CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ 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 CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ D) intracerebral hematoma If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? Answer: D A)potassium B)magnesium C) sodium D) calcium *** A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT scanner will be out of service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma teams communication? Answer: D A)Brief B) loop CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ C) debrief D) huddle *** The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total BSA burned, how much IV fluids would be administered in the first 8 CPEG208 TNCC final exam test 2022 open book GRADED A+ CPEG208 TNCC final exam test 2022 open book GRADED A+ hours? (upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA. 120 kg x (2 mL) x (19% TBSA) = 4560 mL 4560 / 2 (half of fluids given in first 8 hours) = 2280 mL Answer: A A) 2280 mL *** B)3840 mL C) 4560 mL D) 7680 mL Which of the following assessment findings differentiates a tension PTX from a simple PTX? answer: D Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and CPEG208 TNCC final exam test 2022 open book GRADED A+