Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

TNCC 8th Edition Exam 2: 200 Questions and Answers with Rationales, Exams of Nursing

A comprehensive set of 200 questions and answers with rationales covering various aspects of trauma care, including shock, spinal cord injuries, blast traumas, and intracranial pressure. It is designed to help students prepare for the tncc 8th edition exam 2. Detailed explanations for each answer, making it a valuable resource for understanding the concepts and principles of trauma care.

Typology: Exams

2024/2025

Available from 11/04/2024

kinuthia-mbiukia
kinuthia-mbiukia 🇬🇧

3

(2)

176 documents

1 / 377

Toggle sidebar

Related documents


Partial preview of the text

Download TNCC 8th Edition Exam 2: 200 Questions and Answers with Rationales and more Exams Nursing in PDF only on Docsity! TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ sensory deficit on opposite side, posterior cord syndrome although rare is when the patient is unable to use sense vibration in proprioception Describe the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe first impact occurs when the vehicle collided with another object. The second impact TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Define the characteristics of spinal shock - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. Describe the characteristics of obstructive shock - ANSObstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: the active mechanical movement of air into and out of the TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the four types of spinal cord injury - ANSCentral 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 the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss of airway patency, displaced obstructive tubes lines or catheters, dislodge splinting devices, need to replace or TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ reinforce dressings, deterioration in patient status change in vital signs or level of consciousness, injury to the patient and/or team members What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 saturation > or equal to 95%, systolic blood pressure > or equal to 100 MMHG, ICP < 15 MMHG, CPP > or equal to 60 TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Describe the measurement of an NPA - ANSMeasure from the tip of the patient's nose to the tip of the patients earlobe. Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe 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. Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What causes quinary effects of blasts traumas? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin the skull 80% his brain, 10% is blood, and 10% is CSF. Any increase of any of the products results in increased intracranial pressure. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What causes the secondary effects of blast traumas? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of these? One should consider the potential need for a definitive airway. What are contributing factors to injuries related to blunt traumas? - ANSThe 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 early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the early signs of increased Intracranial pressure - ANSheadache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, & Distributive What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or blast. What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the greatest risks for transport? - ANSLoss 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 What are the late signs of Increased intracranial pressure - ANSdilated, 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 seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the seven patterns of pathway injuries related to motor vehicle accidents? - ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection. What are the signs and symptoms of decompensated shock? - ANSDecreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll explosion related injuries, illnesses, or diseases not due to the first three mechanisms. Injuries include external TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults 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 is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea vomiting headache and ipsilateral pupillary changes What are the three factors that contribute to the damage caused by penetrating trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity to the object. What are the three processes that transfer oxygen from the air to the lungs and blood stream - ANSVentilation: 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 are the three stages of shock - ANSCompensated, decompensated or progressive, and irreversible. What are the treatment goals for a TBI? - ANSO2 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 What causes quarternary effects of blast traumas? - ANSAll 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? - ANSThose 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 causes the primary effects of blast traumas? - ANSThe 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? - ANSProjectiles propelled by the explosion. Injuries include penetrating or blunt injuries or I penetration. What causes the tertiary effects of blast traumas? - ANSResults from individuals being thrown by the blast wind. Injuries include hole or partial body translocation from being TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ thrown against a hard service: blunt or penetrating trauma's, fractures, traumatic amputations. What is a trademark symptom of an epidural hematoma - ANSLoss of consciousness then awake and alert then loss of consciousness What is bending? - ANSLoading about an axis. Bending causes compression on the side the person is bending toward intention to the opposite side What is combined loading? - ANSAny combination of tension compression torsion bending and/or shear. What is compression? - ANSCrushing by squeezing together What is Cullen's sign and its significance? - ANSCullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding What is shearing? - ANSDamage by tearing or bending by exerting faucet different parts in opposite directions at the same time. What is tension? - ANSstretching force by pulling at opposite ends What is the minimum permissive hypertension and a trauma patient? - ANSA systolic of greater than or equal to 90 MMHG What is the minimum permissive oxygenation level of a trauma patient? - ANSGreater than or equal to 94% What is the Munro-Kellie doctrine? - ANSWithin 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 is the recommended fluid bolus for a trauma? - ANS500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the relationship between mass and velocity to kinetic energy? - ANSKinetic 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 the trauma triad of death? - ANShypothermia, acidosis, coagulopathy What is torsion? - ANSTorsion forces twist ends in opposite directions. TNCC 8TH EDITION EXAM 2 LATEST VERSIONS (VERSION A & B) 2023-2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSIncreasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSDecreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. When would you use a nasopharyngeal airway versus an oral pharyngeal airway? - ANSNasopharyngeal airways is contraindicated in patients with facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive patients unable to maintain their airway, without a gag reflex as a temporary measure to facilitate ventilation with a bag mask device or spontaneous ventilation until the patient can be intubated. According to newtons law which of these two force is greater: size or force? - ANSNeither. For each force there is an equal and opposite reaction. Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort Define the characteristics of neurogenic shock - ANSDistributive 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 - ANSTransient loss of function can include loss of reflexes and muscle tone below the level of industry with possible vascular response. Describe one fat embolism syndrome is most likely to occur in its characteristics - ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash. Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature.