TCRN Exam Questions and Answers, Exams of Nursing

Download TCRN Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! TCRN EXAM QUESTIONS AND ANSWERS List three effects of inflammatory mediators - Answers -Diaphoresis, glycogeonolysis, bronchodilation, increased: HR, contractility, automasticity, RR Describe the technique for inserting IO into distal femur - Answers -Anterior midline above the external epicondyles, 1 - 3cm above the femoral plateau; the knee slightly flexed and the hip externally rotated and flexed Describe the technique for inserting IO into distal tibia - Answers -just proximal to the medial malleolus Describe the technique for inserting IO into humerus - Answers -Directly above the greater tuberosity Describe the technique for inserting IO into proximal tibia - Answers -2cm distal and slightly medial to the tibial tuberosity Recognize adequate fluid resuscitation using four end points to resuscitation - Answers -Traditional - Vital signs, urinary output (>0.5mg/kg/hr), Mental status Treatment goals for patients with PTSD - Answers -Restore sense of control Diminish power of the traumatic event Reduce chronic hyperarousal Reduce feelings of guilt/self-blame Restore sense of equilibrium List three patient dispositions allowed by COBA/EMTALA legislation - Answers - Admission to the facility Stabilizing care, followed by transfer to qualified facility Treated and discharged What is the performance improvement loop? - Answers -Identify the outcomes Determine plan Measure progress Describe quantitative research - Answers -A deductive process that utilizes numeric findings examples: randomized controlled trials, cohort studies Describe qualitative research - Answers -an inductive process where words are used to give meaning to data, involves interactions between researcher and the subject. examples: data collected by observation, questionnaires, or interviews, data is reported using words as opposed to numbers Five ethical principals utilized in trauma care - Answers -Autonomy Beneficence Non-malficence Veracity (honesty) Justice List three complications associated with a contusion and/or hematoma - Answers - Compartment syndrome Risk for infection Risk of hypovolemia The four interventions used to control hemorrhage in amputations - Answers -Direct pressure Pressure point Elevation Tourniquet Describe primary wound closure - Answers -Immediate wound closure Describe secondary wound closure - Answers -Allowed to close on own over time (for clean wounds with significant tissue loss) Describe tertiary wound closure - Answers -Closure is delayed for a period of time (wounds with significant bacterial contamination) The Rule of Nines - adult - Answers -Head 9% Chest 9% Abdomen 9% upper back 9% lower back 9% Arm 9% upper leg 9% lower leg and foot 9% Genitals 1% Rule of Nines - pediatric - Answers -Head 18% Chest 9% Abdomen 9% upper back 9% lower back 9% arm 9% upper leg 7% lower leg and foot 7% Invasive hemodynamic monitoring - Central Venous Pressure (normal 2-6mmHg), Pulmonary wedge pressure (8-10mmHg), Cardiac Index (2.5 - 4.0L/minute/m^2), Delivery of oxygen (DO2) (500-600mL O2/min/m^2) WBC ↑ Define primary injury prevention - Answers -designed to prevent occurrence of injury Define secondary injury prevention - Answers -designed to reduce the severity of the injury Define tertiary injury prevention - Answers -improvement in outcomes related to traumatic injuries Advantages of ground transport - Answers -Larger payloads Readily available Advantages of helicopter transport - Answers -Rapid point to point transfer Can reach areas of difficult terrain Usually has advanced care crew Advantages of fixed wing transport - Answers -Can travel long distances rapidly Cabin is pressurized and roomy Can transport multiple patients Not limited by weather Disadvantages of ground transport - Answers -Slow Affected by weather Disadvantages of helicopter transport - Answers -Expensive Limited by: - weight - distance - weather Loud Cabin not pressurized Disadvantages of fixed wing transport - Answers -Expensive Limited accessibility due to landing strip Usually requires ground support to complete transport Four factors that increase risks of falls - Answers -Muscle weakness Drugs which increase sleepiness Use of cane or walker Need to use bathroom frequently Members of rehab team - Answers -Patient and family Nurse Physical therapist Respiratory therapist Occupational Therapist Speech pathologist Physiatrist Conditions of brain death - Answers -Irreversible Body temp > 35C Fixed pupils Apnea in presence of hypercarbia (PaCO2 > 60) No reflex activity: oculocephalic, oculovestibular, cough, gag, and corneal Describe corneal reflex - Answers -Brush a wisp of cotton against the cornea, or apply a small drop of saline; normal response is rapid closing of eyelid Gag reflex - Answers -Stimulate back of pharynx, normal response is to gag Swallow reflex - Answers -Stimulate uvula, normal response is elevation of uvula What is oculocephalic reflex - Answers -Dolls eyes; if eyes move opposite direction of head movement, it is abnormal finding What is oculovestibular reflex - Answers -Water is instilled in ear canal. Warm water - eyes deviate towards tested side; Cold water - eyes deviate towards opposite side; Lack of eye movement is consistent with brain death. Indications for ICP monitoring - Answers -Salvageable patients with severe injury GCS of 3 to 8 after resuscitation Abnormal CT findings Unconscious Contraindications for ICP monitoring - Answers -Awake patients Coagulopathies Pupillary response in brain injured patients - Answers -Irregular or oval shaped pupils Anisocoria (unequal pupil size) Slow or unequal or lack of pupillary response List five nursing activities that reduce cerebral metabolism - Answers -Maintain dark and quiet room Limit visitors Speak softly Cluster nursing activities Limit dialogue Regular sedation/analgesia List symptoms associated with diffuse axonal injury - Answers -Coma Increased ICP Posturing Hypertension Increased temperature Hyperhydrosis from nipple line up No pupillary signs Describe deficits associated with anterior cord injuries - Answers -Loss of motor function, pain & temperature perception, crude touch and pressure Intact - fine touch, fine pressure, and vibration Describe deficits associated with posterior cord injuries - Answers -Loss of proprioception, vibration, fine touvhm fine pressure Intact - motor function, pain, temperature, crude touch, crude pressure Treatment for an avulsed tooth - Answers -Handle by crown Do not clean, rub, scrape, or disinfect Store in Hank's solution ( or milk or normal saline) Define penetrating globe injury - Answers -Entrance without an exit Define perforating globe injury - Answers -complete disruption of the sclera and cornea, through and through