TCRN Exam Questions with 100% Correct Answers, Exams of Advanced Education

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TCRN Exam Questions with 100% Correct Answers | Verified | Latest Version List three effects of inflammatory mediators - Correct Answer- Diaphoresis, glycogeonolysis, bronchodilation, increased: HR, contractility, automasticity, RR Describe the technique for inserting IO into distal femur - Correct Answer-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 - Correct Answer-just proximal to the medial malleolus Describe the technique for inserting IO into humerus - Correct Answer-Directly above the greater tuberosity Describe the technique for inserting IO into proximal tibia - Correct Answer-2cm distal and slightly medial to the tibial tuberosity Recognize adequate fluid resuscitation using four end points to resuscitation - Correct Answer-Traditional - Vital signs, urinary output (>0.5mg/kg/hr), Mental status 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) Metabolic parameters - Lactate (>4 is severe), Base Deficit (>6mmol/L indicates severe injury) Treatment for neurogenic shock - Correct Answer-1 -2 L bolus (often insufficient and may cause pulmonary edema) Vasopressors (Epi, Norepi, dopamine, phenylephrine, or vasopressin) MAP 85-90mmHg Atropine respiratory support as needed List 6 effects that a state of crisis may have on a trauma patient - Correct Answer-Disruption of family Depression Failure to return to pre-event life Economic problems Elevation Tourniquet Describe primary wound closure - Correct Answer-Immediate wound closure Describe secondary wound closure - Correct Answer-Allowed to close on own over time (for clean wounds with significant tissue loss) Describe tertiary wound closure - Correct Answer-Closure is delayed for a period of time (wounds with significant bacterial contamination) The Rule of Nines - adult - Correct Answer-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 - Correct Answer-Head 18% Chest 9% Abdomen 9% upper back 9% lower back 9% arm 9% upper leg 7% lower leg and foot 7% Four treatment strategies for electrical burns - Correct Answer-Fluid replacement using Modified Parkland Formula Consider starting with 20ml/kg bolus and adjust to maintain 1ml/kg/hr Continuous cardiac monitoring Osmotic diuretics Sodium bicarb (to alkalinize urine) Monitor for compartment syndrome Two complications associated with exposure to hydrocarbons - Correct Answer-Respiratory failure Hepatic injury (delayed) Describe Volkmann's contracture - Correct Answer-muscle contraction distal to nerve impingement injury List injuries commonly associated with blunt cardiac injury - Correct Answer-Pericardial tamponade Cardiac contusion - Electrical disturbances - Chest pain - Heart failure, primarily right sided HF Great vessel injuries Care for pulmonary contusion - Correct Answer-Pain management Maintain respiratory rate, ventilation Adequate gas exchange - ETCO2, SaO2 Mobilize and clear blood and secretions Define Acute Respiratory Distress Syndrome (ARDS) - Correct Answer- Non-cardiogenic pulmonary edema Describe components of ABD assessment on a traumatically injured patient - Correct Answer-FAST - Focused Abdominal Sonography Assessment DPA - Diagnostic Peritoneal Lavage Define secondary injury prevention - Correct Answer-designed to reduce the severity of the injury Define tertiary injury prevention - Correct Answer-improvement in outcomes related to traumatic injuries Advantages of ground transport - Correct Answer-Larger payloads Readily available Advantages of helicopter transport - Correct Answer-Rapid point to point transfer Can reach areas of difficult terrain Usually has advanced care crew Advantages of fixed wing transport - Correct Answer-Can travel long distances rapidly Cabin is pressurized and roomy Can transport multiple patients Not limited by weather Disadvantages of ground transport - Correct Answer-Slow Affected by weather Disadvantages of helicopter transport - Correct Answer-Expensive Limited by: - weight - distance - weather Loud Cabin not pressurized Disadvantages of fixed wing transport - Correct Answer-Expensive Limited accessibility due to landing strip Usually requires ground support to complete transport Four factors that increase risks of falls - Correct Answer-Muscle weakness Drugs which increase sleepiness Use of cane or walker Need to use bathroom frequently Members of rehab team - Correct Answer-Patient and family Nurse Physical therapist Respiratory therapist Occupational Therapist Speech pathologist Physiatrist Conditions of brain death - Correct Answer-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 - Correct Answer-Brush a wisp of cotton against the cornea, or apply a small drop of saline; normal response is rapid closing of eyelid Gag reflex - Correct Answer-Stimulate back of pharynx, normal response is to gag Swallow reflex - Correct Answer-Stimulate uvula, normal response is elevation of uvula What is oculocephalic reflex - Correct Answer-Dolls eyes; if eyes move opposite direction of head movement, it is abnormal finding