TNCC 8th Edition Study Guide Exam Questions (50 Terms), Exams of Nursing

Download TNCC 8th Edition Study Guide Exam Questions (50 Terms) and more Exams Nursing in PDF only on Docsity!

TNCC 8th Edition Study Guide Exam

Questions (50 Terms) with Definite

Answers Rated A+ 2023-2024.

The trauma nurse knows that placing a bariatric patient in a "ramped position"

provides better visualization during the insertion of which device? - Answer:

endotracheal tube Tearing of the bridging veins is most frequently associated with which brain

injury? - Answer: subdural hematoma

A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is expected with a musculoskeletal complication

associated with this presentation? - Answer: Elevated creatine kinase

A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority

intervention? - Answer: Initiate transfer to a trauma center

Which of the following injuries is LEAST likely to be promptly identified? -

Answer: bowel

Which of the following patients warrants referral to a burn center? - Answer: A

52-year-old diabetic male with a partial-thickness burn to the left lower leg

A patient has been in the emergency department for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and symptoms most commonly associated with which of the

follow conditions? - Answer: fat embolism

A 36-year-old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate

intervention? - Answer: Apply a splint and elevate the extremity ABOVE the level

of the heart A 56-year-old male patient involved in a motor vehicle crash is brought to the emergency department of a rural critical assess facility. He complaints of neck pain, shortness of breath, and diffuse abdominal pain. His Glasgow Coma Score is

15. His vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which

of the follow is the priority intervention for this patient? - Answer: Expedite

transfer to the closest trauma center Which of the following values indicates the need for alcohol withdrawal

interventions? - Answer: CIWA-Ar of 36

A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the

following terms best describes this trauma team's communication? - Answer:

huddle A patient with a complete spinal cord injury in neurogenic shock will demonstrate

hypotension and which other clinical signs? - Answer: Bradycardia and absent

motor function below the level of injury

Which of the following is true about the log-roll maneuver? - Answer: It can

worsen cord damage from a unstable spinal injury What factor contributes most to the kinetic energy of a body in motion? -

Answer: velocity

A 5-year-old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? -

Answer: Report your suspicion of maltreatment in accordance with local

regulations

A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower abdominal tenderness and scrotal

ecchymosis. Which of the following orders would the nurse question? - Answer:

Straight catheter for urine sample You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal margin, and some dark bloody show. Varying accelerations and decelerations are note don cardiotocography. These findings are

most consistent with which of the following? - Answer: placental abruption

Which of the following occurs during the third impact of a motor vehicle crash? -

Answer: The aorta is torn at its attachment with the ligmentum arteriosum

Which pulse pressure description is an indication of early hypovolemic shock? -

Answer: narrowed

An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was

unsuccessful. What is the most appropriate immediate next step? - Answer:

Ventilate with a bag-mask device

Which of the following assessment findings differentiates a tension pneumothorax

from a simple pneumothorax? - Answer: Hypotension that worsens with

inspiration A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the

priority nursing intervention? - Answer: Elevating the extremity TO the level of

the heart A 49-year-old restrained driver involved in a motor vehicle collision present to the trauma center complaining of abdominal, pelvis, and bilateral lower extremity pain. Vital signs are stable. The nurse can anticipate all of these after a negative

FAST exam EXCEPT which of the following? - Answer: diagnostic peritoneal

lavage

What finding raises suspicion of a complete spinal cord injury? - Answer:

priapism EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When is it appropriate to remove the cervical

collar? - Answer: After a physical examination if the patient has no radiologic

abnormalities on a computed tomography scan

During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which priority nursing intervention should

be performed next? - Answer: Insert an oropharyngeal airway if there is no gag

reflex Why is a measure of serum lactate obtained in the initial assessment of a trauma

patient? - Answer: To gauge end-organ perfusion and tissue hypoxia

A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Currently vital signs are BP 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs and

symptoms of which stage of shock? - Answer: compensated

Which of the following is a possible complication of positive-pressure ventilation?

• Answer: Worsening pneumothorax An elderly patient with a history of anticoagulant use presents after a fall at home that day. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most

likely cause of her symptoms? - Answer: subdural hematoma

An intubated trauma patient is being transferred to a tertiary care center. After moving the patient to the stretcher for transport, a drop in pulse oximetry to 85%

is noted. Which of the following is the priority intervention? - Answer: Check to

make sure the ventilator is plugged in The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total body surface area burned, how much intravenous fluid would be administered in the

first 8 hours? - Answer: 2280 mL

Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future

disaster. Which phase of the disaster life cycle does this describe? - Answer:

mitigation A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures. The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the following interventions would be most appropriate for

this patient based on the disaster triage principles? - Answer: Initiate two large-

caliber intravenous lines for Ringer's lactate solution administration A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is

suspected? - Answer: globe rupture

EMS brings a patient who fell while riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the

nurse to prepare the patient for radiologic-spine clearance? - Answer: smell of

alcohol on breath If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? -

Answer: calcium

What is the effect of hypothermia on the oxyhemoglobin dissociation curve? -

Answer: Hemoglobin does not readily release oxygen for use by the tissues

Which of the following is NOT considered goal-directed therapy for cardiogenic

shock? - Answer: pericardiocentesis

A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now showing signs of anxiety, restlessness, severe respiratory distressed, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate

intervention? - Answer: dressing removal

Which of the following is an expected finding in a patient with a tube thoracotomy

connected to a chest drainage system? - Answer: Fluctuation in the water seal

chamber Which of the following considerations is most important when caring for geriatric

trauma patient? - Answer: medical history

Which of the following is a late sign of increased intracranial pressure? - Answer:

Decreased respiratory effort Which of the following mnemonics can help the nurse prioritize care for a trauma

patient with massive uncontrolled hemorrhage? - Answer: MARCH

Caregivers carry a 2-year-old into the emergency department who fell out of a second-story window. The patient is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest

priority? - Answer: Padding the upper back while stabilizing the cervical spine

You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating total body surface area (TBSA) burned is deferred due to the need for emergent intubation. A what rate should you begin fluid

resusitation? - Answer: 500 ml/hour

Which of the following is a component of the trauma triad of death? - Answer:

acidosis Patients with a crush injury should be monitored for which of the following

conditions? - Answer: dysrhythmias

What bedside monitoring parameters are used to assess for adequacy of

oxygenation and effectiveness of ventilation? - Answer: Pulse oximetry and

capnography The most reassuring finding for a male patient with hip pain after a fall is which of

the following? - Answer: Pelvic stability