TNCC 8 EDITIONS & Final Exam Test 2024/25 Open Book BUNDLED WITH COMPLETE SOLUTIONS 100%, Exams of Nursing

Download TNCC 8 EDITIONS & Final Exam Test 2024/25 Open Book BUNDLED WITH COMPLETE SOLUTIONS 100% and more Exams Nursing in PDF only on Docsity! TNCC 8th Edition (A GRADED AND REVIEWED 2024/2025)Questions And Answers The trauma nurse knows that placing a bariatric patient in a "ramped position" provides better visualization during the insertion of which device? - Correct answerendotracheal tube Tearing of the bridging veins is most frequently associated with which brain injury? - Correct answersubdural hematoma A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is expected with a musculoskeletal complication associated with this presentation? - Correct answerElevated creatine kinase A patient is brought to the emergency department of a rural hospital following a high- speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority intervention? - Correct answerInitiate transfer to a trauma center Which of the following injuries is LEAST likely to be promptly identified? - Correct answerbowel Which of the following patients warrants referral to a burn center? - Correct answerA 52-year-old diabetic male with a partial-thickness burn to the left lower leg A patient has been in the emergency department 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 complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and symptoms most commonly associated with which of the follow conditions? - Correct answerfat embolism A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? - Correct answerApply a splint and elevate the extremity ABOVE the level of the heart A 56-year-old male patient involved in a motor vehicle crash is brought to the emergency department of a rural critical assess facility. He complaints of neck pain, shortness of breath, and diffuse abdominal pain. His Glasgow Coma Score is 15. His vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the follow is the priority intervention for this patient? - Correct answerExpedite transfer to the closest trauma center Which of the following values indicates the need for alcohol withdrawal interventions? - Correct answerCIWA-Ar of 36 A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma team's communication? - Correct answerhuddle A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? - Correct answerBradycardia and absent motor function below the level of injury Which of the following is true about the log-roll maneuver? - Correct answerIt can worsen cord damage from a unstable spinal injury What factor contributes most to the kinetic energy of a body in motion? - Correct answervelocity A 5-year-old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? - Correct answerReport your suspicion of maltreatment in accordance with local regulations A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question? - Correct answerStraight catheter for urine sample You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal margin, and some dark bloody show. Varying accelerations and decelerations are note don cardiotocography. These findings are most consistent with which of the following? - Correct answerplacental abruption Which of the following occurs during the third impact of a motor vehicle crash? - Correct answerThe aorta is torn at its attachment with the ligmentum arteriosum Which pulse pressure description is an indication of early hypovolemic shock? - Correct answernarrowed Which of the following is NOT considered goal-directed therapy for cardiogenic shock? - Correct answerpericardiocentesis A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now showing signs of anxiety, restlessness, severe respiratory distressed, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention? - Correct answerdressing removal Which of the following is an expected finding in a patient with a tube thoracotomy connected to a chest drainage system? - Correct answerFluctuation in the water seal chamber Which of the following considerations is most important when caring for geriatric trauma patient? - Correct answermedical history Which of the following is a late sign of increased intracranial pressure? - Correct answerDecreased respiratory effort Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? - Correct answerMARCH Caregivers carry a 2-year-old into the emergency department who fell out of a second- 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? - Correct answerPadding the upper back while stabilizing the cervical spine You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating total body surface area (TBSA) burned is deferred due to the need for emergent intubation. A what rate should you begin fluid resusitation? - Correct answer500 ml/hour Which of the following is a component of the trauma triad of death? - Correct answeracidosis Patients with a crush injury should be monitored for which of the following conditions? - Correct answerdysrhythmias What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? - Correct answerPulse oximetry and capnography The most reassuring finding for a male patient with hip pain after a fall is which of the following? - Correct answerPelvic stability TNCC 8th Edition A GRADED AND REVIEWED 2024/2025)52Questions 100% Correct Answers>.. What are the greatest risks for transport? - Correct answerLoss of airway patency, displaced obstructive tubes lines or catheters, dislodge splinting devices, need to replace or reinforce dressings, deterioration in patient status change in vital signs or level of consciousness, injury to the patient and/or team members According to newtons law which of these two force is greater: size or force? - Correct answerNeither. For each force there is an equal and opposite reaction. What is the relationship between mass and velocity to kinetic energy? - Correct answerKinetic energy is equal to 1/2 the mass multiplied the square of its velocity therefore when mass is doubled so is the net energy, however, when velocity is doubled energy is quadrupled. What is tension? - Correct answerstretching force by pulling at opposite ends What is compression? - Correct answerCrushing by squeezing together What is bending? - Correct answerLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is shearing? - Correct answerDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is torsion? - Correct answerTorsion forces twist ends in opposite directions. What is combined loading? - Correct answerAny combination of tension compression torsion bending and/or shear. What are the four types of trauma related injuries? - Correct answerBlunt, penetrating, thermal, or blast. What are contributing factors to injuries related to blunt traumas? - Correct answerThe point of impact on the patient's body, the type of surface that is hit, the tissues ability to resist (bone versus soft tissue, air-filled versus solid organs), and the trajectory of force. What are the seven patterns of pathway injuries related to motor vehicle accidents? - Correct answerUp and over, down and under, lateral, rotational, rear, roll over, and ejection. Differentiate between the three impacts of motor vehicle impact sequence. - Correct answerThe first impact occurs when the vehicle collided with another object. The second impact occurs after the initial impact when the occupant continues to move in the original direction of travel until they collide with the interior of the vehicle or meet resistance. The third impact occurs when internal structures collide within the body cavity. What are the three factors that contribute to the damage caused by penetrating trauma's? - Correct answerThe point of impact, the velocity and speed of impact, and the proximity to the object. What causes the primary effects of blast traumas? - Correct answerThe direct blast effects. Types of injuries include last long, tympanic membrane rupture and middle ear damage, abdominal hemorrhage and perforation, global rupture, mild Trumatic brain injury. What causes the secondary effects of blast traumas? - Correct answerProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - Correct answerResults from individuals being thrown by the blast wind. Injuries include hole or partial body translocation from being thrown against a hard service: blunt or penetrating trauma's, fractures, traumatic amputations. What causes quarternary effects of blast traumas? - Correct answerAll explosion related injuries, illnesses, or diseases not due to the first three mechanisms. Injuries include external and internal burns, crush injuries, closed and open brain injuries, asthmatic or breathing problems from dust smoke or toxic fumes, angina, or hyper glycemia and hypertension. What causes quinary effects of blasts traumas? - Correct answerThose associated with exposure to hazardous materials from radioactive, biologic, or chemical components of a blast. Injuries include a variety of health effects depending on agent. What are the three processes that transfer oxygen from the air to the lungs and blood stream - Correct answerVentilation: the active mechanical movement of air into and out of the lungs; diffusion: the passive movement of gases from an area of higher concentration to an area of lower concentration; and perfusion: the movement of blood to and from the lungs as a delivery medium of oxygen to the entire body. What is the minimum permissive hypertension and a trauma patient? - Correct answerA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - Correct answerGreater than or equal to 94% What is Cullen's sign and its significance? - Correct answerCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding Define Cushing's triad - Correct answerBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort What are the early signs of increased Intracranial pressure - Correct answerheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the late signs of Increased intracranial pressure - Correct answerdilated, non-reactive pupil(s); abnormal motor posturing (flexion, extension, flaccidity); Cushing's triad, Unresponsive to per verbal and painful stimuli, bradycardia and decreased respiratory effort What are the symptoms of a subdural hematoma? - Correct answerDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What is a trademark symptom of an epidural hematoma - Correct answerLoss of consciousness then awake and alert then loss of consciousness Define the characteristics of neurogenic shock - Correct answerDistributive shock with a T6 or higher injury results and vasodilation, bradycardia, flushed warm dry skin. Risk for temperature instability. Nursing interventions include maintaining warmth and spinal stabilization. Define the characteristics of spinal shock - Correct answerTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe the four types of spinal cord injury - Correct answerCentral cord injury results in greater weakness distally, anterior injury includes motor loss or weakness below the cord level of injury yet sensory is intact, Brown-Sequard (hemicord) is weak on one side with sensory deficit on opposite side, posterior cord syndrome although rare is when the patient is unable to use sense vibration in proprioception Describe one fat embolism syndrome is most likely to occur in its characteristics - Correct answerWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. What is the Munro-Kellie doctrine? - Correct answerWithin the skull 80% his brain, 10% is blood, and 10% is CSF. Any increase of any of the products results in increased intracranial pressure. What are the treatment goals for a TBI? - Correct answerO2 saturation > or equal to 95%, systolic blood pressure > or equal to 100 MMHG, ICP < 15 MMHG, CPP > or equal to 60 MMHG, normal glycemia, hemoglobin > or equal to 7 g/DL, sodium 135- 145, osmotic diuretics, anti-emetics, sedatives, anticonvulsants, head of bed at 30°, and neck at midline TNCC Final Exam Test 2024/25 Open Book Questions and 100% Correct Answers You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation? A) 1000 mL/hr B) 500 mL/hr C) 250 mL/hr D) 125 mL/hr - Correct answerB) 500 mL/hr 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 confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with which of the following conditions? A) acute lung injury B) fat embolism C) PTX D) pulmonary contusion - Correct answerB) fat embolism Which pulse pressure description is an indication of early hypovolemic shock? A) widened B) narrowed C) bounding D) weak - Correct answerB) narrowed Which of the following considerations is most important when caring for a geriatric trauma patient? A) head to to exam B) medical history C) incontinence D) falls - Correct answerB) medical history Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? A) increased work of breathing B) unilaterally diminished breath sounds C) pleuritic chest pain D) hypotension that worsens with inspiration - Correct answerD) hypotension that worsens with inspiration. Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis. 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 hours? A) 2280 mL B) 3840 mL C) 4560 mL D) 7680 mL - Correct answerA) 2280 mL (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 Which of the following is a component of the trauma triad of death? A) Acidosis B) hyperthermia C) hemorrhage D) sepsis - Correct answerA) Acidosis D) intact reflexes distal to the injury - Correct answerB) Priapism A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? A) Bradycardia and ipsilateral absences of motor function B) Tachycardia and respiratory depression C) Tachycardia and absent motor function below the level of injury D) Bradycardia and absent motor function below the level of the injury - Correct answerD) Bradycardia and absent motor function below the level of the injury A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? A) report your suspicion of the maltreatment in accordance with local regulations B) apply ice to the bruises and consult wound care C) engage in therapeutic communication to determine the MOI D) provide the family with injury prevention recourses - Correct answerA) report your suspicion of the maltreatment in accordance with local regulations A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? A) apply a sling and elevate the extremity to the level of the heart. B) apply a splint and elevate above the level of the heart C) Apply a sling and elevate the extremity above the level of the heart D) apply a splint and elevate the extremity to the level of the heart. - Correct answerB) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A) elevating the extremity above the level of the heart B) repositioning and apply ice C) Elevating the extremity to the level of the heart D) Preparing the patient for ultrasound - Correct answerC) Elevating the extremity to the level of the heart Which of the following is a late sign of increased intracranial pressure? A) Restlessness or drowsiness B) Nausea and vomiting C) Decreased respiratory effort D) Amnesia and anxiety - Correct answerC) Decreased respiratory effort A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principle? A) initiate two large bore intravenous lines for Ringers lactate solution administration B) Administer Dilaudid for pain control and provide comfort care C) Place the patient in an observation area for care within the next few hours D) Contact the command center for the personnel to notify next of kin. - Correct answerA) initiate two large bore intravenous lines for Ringers lactate solution administration Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? A) ABC B) MARCH C) AVPU D) VIPP - Correct answerB) MARCH A patient arrives with a large open chest wound after being assaulted with a machete, Prehospital providers placed a nonporous 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? A) needle decompression B) tube thoracostomy C) dressing removal D) surgical repair - Correct answerC) dressing removal 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? A) elevated creatine kinase B) decreased potassium level C) decreased WBC D) elevated GFR - Correct answerA) elevated creatine kinase 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? 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 - Correct answerA) padding the upper back while stabilizing the cervical spine A 35-year old male presents with facial trauma after bring struck in the face with a baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is suspected? A) oculomotor nerve palsy B) globe rupture *** C) Uncal herniation D) retinal detachment - Correct answerB) globe rupture Which of the following is true about the log roll maneuver? A) it causes less spinal motion than the lift and slide maneuver B) it is recommended for patients with unstable pelvic fractures C) it can worsen cord damage from an unstable spinal injury *** D) it does not increases the risk of life threatening hemorrhage from unstable injuries - Correct answerC) it can worsen cord damage from an unstable spinal injury EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The patient is asking to have the cervical color removed. when is it appropriate to remove the cervical collar? A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan *** B) after physician evaluation if the patient has not neurologic abnormalities on exam C) after palpation of the spine if the patient has no point tenderness the the vertebral column D) after physical examination if the patient has not neck pain with movement - Correct answerA) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? A) potassium B) magnesium C) sodium D) calcium - Correct answerD) calcium Tearing of the bridging veins is most frequently associated with which brain injury? D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. - Correct answerC) a 52-year old diabetic male with partial thickness burn to the left lower leg Which is the effect of hypothermia on the oxyhemoglobin dissociation curve? 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 - Correct answerA) Hemoglobin does not readily release oxygen for use by the tissues A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycle cross bars which performing an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurse questions? A) Fast exam B) CT scan C) straight cath for urine sample D) ice and elevation of the scrotum - Correct answerC) straight cath for urine sample Which of the following is possible complication of positive-pressure ventilation? A) worsening pneumothorax B) worsening flail chest C) reabsorption of pleural air D) negative intrapleural pressure - Correct answerA) worsening pneumothorax Which of the following is NOT considered goal-directed therapy of cardiogenic shock? A) controlled fluid boluses B) antidysrhythmic administration C) pericardiocentesis D) cardiac cath - Correct answerC) pericardiocentesis What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? A) pulse oximetry and capnogaphy ** B) respiratory rate and capnography C) pulse oximetry and respiratory rate D) capnography and capnometry - Correct answerA) pulse oximetry and capnogaphy Which of the following values indicates the need for alcohol withdrawal interventions? A) CIWA-Ar of 36 *** B) GCS 13 C) ETCo2 of 48 mm Hg D) heart rate of 45 beats/min - Correct answerA) CIWA-Ar of 36 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 assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? A) Ventilate with a BVM B) Prepare for cricothyroidotomy C) administer reversal medications D) contact anesthesia for assistance - Correct answerA) Ventilate with a BVM The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? A) Intraosseous line B) orogastric tube C) ET tube *** D) urinary catheter - Correct answerC) ET tube 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? A) placental abruption B) preterm labor C) uterine rupture D) fetal demise - Correct answerA) placental abruption