TNCC 8th Edition Questions and Answers: Trauma Nursing Core Curriculum, Exams of Nursing

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TNCC 8th edition questions answered

The major cause of preventable death after injury - correct answer Uncontrolled hemorrhage The best measure of the adequacy of cellular perfusion and helps to predict the outcome of resuscitation - correct answer Base deficit Examples of primary blast injuries - correct answer Blast lung, ruptured tympanic membrane, TBI, abdominal hemorrhage Examples of secondary blast injuries - correct answer Wounds from debris and bomb fragments Examples of tertiary blast injuries - correct answer Blunt or penetrating trauma from the body being thrown by the blast Examples of quaternary blast injuries - correct answer Injuries or illness related to explosion: burns, toxic injury from chemicals Examples of quinary blast injuries - correct answer Injuries associated with exposure to hazardous materials from the components of the blast Questions to ask for airway assessment (need 4) - correct answer 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 answer 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 answer 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 answer ETT placement at teeth or gums Situations that require a definitive airway - correct answer 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 answer 2nd intercostal space at midclavicular line and 5th intercostal space at anterior axillary line King airway - correct answer A multidimensional esophageal airway that traps the glottis opening between an esophageal cuff and an oropharyngeal cuff 3 things to assess for circulation - correct answer Palpate central pulse Assess (again) for external hemorrhage Inspect and palpate skin for color, temp, and moisture. When do you establish IV access? - correct answer Right after the circulatory assessment At what point to you evaluate need for transfer or definitive care? - correct answer After the primary survey How do you palpate the iliac crests? - correct answer Downward and medially The 3 components of the pediatric assessment triangle - correct answer Skin circulation, work of breathing, general appearance What type of fluids should you give kids with normal blood glucose? - correct answer Fluids with dextrose to prevent hypoglycemia How much fluid do you give a kid? - correct answer 20mL/kg What assessment finding gives concern for severe brain injury? - correct answer Bulging fontanels

Parkland formula - correct answer 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 answer First half over 8 hours and second half over 16 hours Normal baseline FHR - correct answer 120- What does Kleihaver-Betke test for? - correct answer Tests for fetal RBCs I. Maternal circulation, which is abnormal and could indicate fetomaternal hemorrhage has occurred Symptoms of abruptly placentae - correct answer Dark red bleeding, sudden sharp abdominal pain, "board-like" uterus, increased FHR Symptoms of uterine rupture - correct answer 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 answer 15 degrees 3 parts of the trauma triad of death - correct answer Hypothermia, coagulopathy, metabolic acidosise Examples of obstructive shock - correct answer Tension pneumo, cardiac tamponade, pulmonary artery embolism Symptoms of stage 1 of shock - correct answer Change in neuro status, increased DBP, decreased UO, tachycardia Symptoms of stage 2 of shock - correct answer Declining neuro status, tachycardia, narrow pulse pressure, weak thready pulse, cool skin, abnormal base deficit, increased lactate symptoms of epidural hematoma - correct answer Transient LOC with a lucid period, HA, N/V, rapidly declining neuro status For what reasons would you not give mannitol? - correct answer An active bleed or hypotension What is Beck triad for cardiac tamponade? - correct answer Hypotension, distended neck veins, muffled heart sounds Solid abdominal organs and what are they prone to? - correct answer Liver, spleen, gallbladder, pancreas, prone to lacerations

Hollow abdominal organs and what are they prone to - correct answer Stomach, bowels, uterus, bladder, prone to rupture Big symptom of splenic injury - correct answer Left shoulder pain Where do you secure a pelvic binder? - correct answer At the level of the greater trochanter and symphysis pubis What is Turners sign? - correct answer Ecchymosis over the flank at the 11th and 12th ribs, in renal injury What organs do you ultrasound in a FAST exam? - correct answer Bladder, liver, spleen What kind of dressing do you apply to an open pneumo? - correct answer Nonporous dressing (petroleum gauze or plastic wrap) and tape on 3 sides