TNCC 8th Edition Examination Questions and Answers, Exams of Nursing

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TNCC 8th edition Examination with

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Questions to ask for airway assessment (need 4) - Correct Ans: ✔✔  Is the tongue obstructing?  Are there any foreign objects?  Is there any edema?  Are there loose or missing teeth?  Is there snoring, gurgling, or stridor?  Is there bony deformity?  Is there blood, vomit, or secretions? Questions to ask during breathing assessment. (Need 4) - Correct Ans: ✔✔  Is there symmetrical chest rise?  Is there spontaneous breathing?  Is there tracheal deviation or JVD?  What is their skin color?  Are there open wounds or deformities in the chest?  What's the depth, pattern, and rate of respirations?  Is there increased work of breathing?  Are breath sounds present and equal? 3 ways to assess ETT placement - Correct Ans: ✔✔

1. Apply end tidal, assess CO2 after 5-6 breaths
2. Assess for symmetrical chest wall rise and fall
3. Auscultation over the epigastrium for gurgling and bilateral breath sounds. What do you document after placing an ETT? - Correct Ans: ✔✔ETT placement at teeth or gums Situations that require a definitive airway - Correct Ans: ✔✔  GCS 8 or less  Apnea  Inhalation injury  Increased risk of aspiration  Anticipate decreased neuro status  Severe maxo fractures  Laryngeal/tracheal injury Where do you listen for breath sounds? - Correct Ans: ✔✔  2nd intercostal space at midclavicular line and  5th intercostal space at anterior axillary line King airway - Correct Ans: ✔✔A multidimensional esophageal airway that traps the glottis opening between an esophageal cuff and an oropharyngeal cuff

3 things to assess for circulation - Correct Ans: ✔✔  Palpate central pulse  Assess (again) for external hemorrhage  Inspect and palpate skin for color, temp, and moisture. When do you establish IV access? - Correct Ans: ✔✔Right after the circulatory assessment At what point to you evaluate need for transfer or definitive care? - Correct Ans: ✔✔After the primary survey How do you palpate the iliac crests? - Correct Ans: ✔✔Downward and medially The 3 components of the pediatric assessment triangle - Correct Ans: ✔✔Skin circulation, work of breathing, general appearance What type of fluids should you give kids with normal blood glucose? - Correct Ans: ✔✔Fluids with dextrose to prevent hypoglycemia How much fluid do you give a kid? - Correct Ans: ✔✔20mL/kg What assessment finding gives concern for severe brain injury? - Correct Ans: ✔✔Bulging fontanels

Parkland formula - Correct Ans: ✔✔3mL x the weight in kg x % TBSA = the fluid to go over 24 hours How do you give the fluid over 24 hours in parkland formula? - Correct Ans: ✔✔First half over 8 hours and second half over 16 hours Normal baseline FHR - Correct Ans: ✔✔ 120 - 160 What does Kleihaver-Betke test for? - Correct Ans: ✔✔Tests for fetal RBCs I. Maternal circulation, which is abnormal and could indicate fetomaternal hemorrhage has occurred Symptoms of abruptly placentae - Correct Ans: ✔✔Dark red bleeding, sudden sharp abdominal pain, "board-like" uterus, increased FHR Symptoms of uterine rupture - Correct Ans: ✔✔Sudden sharp abdominal or suprapibic pain, asymmetry of uterus, decreased FHR What degree to you tilt the supine pregnant patient to prevent supine hypotension? - Correct Ans: ✔✔15 degrees 3 parts of the trauma triad of death - Correct Ans: ✔✔Hypothermia, coagulopathy, metabolic acidosise

Examples of obstructive shock - Correct Ans: ✔✔Tension pneumo, cardiac tamponade, pulmonary artery embolism Symptoms of stage 1 of shock - Correct Ans: ✔✔Change in neuro status, increased DBP, decreased UO, tachycardia Symptoms of stage 2 of shock - Correct Ans: ✔✔Declining neuro status, tachycardia, narrow pulse pressure, weak thready pulse, cool skin, abnormal base deficit, increased lactate symptoms of epidural hematoma - Correct Ans: ✔✔Transient LOC with a lucid period, HA, N/V, rapidly declining neuro status For what reasons would you not give mannitol? - Correct Ans: ✔✔An active bleed or hypotension What is Beck triad for cardiac tamponade? - Correct Ans: ✔✔Hypotension, distended neck veins, muffled heart sounds Solid abdominal organs and what are they prone to? - Correct Ans: ✔✔Liver, spleen, gallbladder, pancreas, prone to lacerations

Hollow abdominal organs and what are they prone to - Correct Ans: ✔✔Stomach, bowels, uterus, bladder, prone to rupture Big symptom of splenic injury - Correct Ans: ✔✔Left shoulder pain Where do you secure a pelvic binder? - Correct Ans: ✔✔At the level of the greater trochanter and symphysis pubis What is Turners sign? - Correct Ans: ✔✔Ecchymosis over the flank at the 11th and 12th ribs, in renal injury What organs do you ultrasound in a FAST exam? - Correct Ans: ✔✔Bladder, liver, spleen What kind of dressing do you apply to an open pneumo? - Correct Ans: ✔✔Nonporous dressing (petroleum gauze or plastic wrap) and tape on 3 sides The major cause of preventable death after injury - Correct Ans: ✔✔Uncontrolled hemorrhage The best measure of the adequacy of cellular perfusion and helps to predict the outcome of resuscitation - Correct Ans: ✔✔Base deficit

Examples of primary blast injuries - Correct Ans: ✔✔Blast lung, ruptured tympanic membrane, TBI, abdominal hemorrhage Examples of secondary blast injuries - Correct Ans: ✔✔Wounds from debris and bomb fragments Examples of tertiary blast injuries - Correct Ans: ✔✔Blunt or penetrating trauma from the body being thrown by the blast Examples of quaternary blast injuries - Correct Ans: ✔✔Injuries or illness related to explosion: burns, toxic injury from chemicals Examples of quinary blast injuries - Correct Ans: ✔✔Injuries associated with exposure to hazardous materials from the components of the blast