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TNCC 9 TH EDITION TNP 2025 WITH
VERIFIED QUESTIONS AND 100% CORRECT
SOLUTIONS| LATEST UPDATE|PASS WITH
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An adult patient involved in an assault presents with shortness of breath, BP 88/50 mmHg, heart rate of 130 beats/minute, and RR 32 breaths/minute. The patient has muffled heart sounds and is cyanotic. What is the priority intervention?
A. Needle thoracotomy
B. Chest tube insertion
C. Pericardiocentesis
D. Tracheal intubation - ANSWER-C. Pericardiocentesis
An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - ANSWER-post-concussive syndrome
Which of the following is a late sign of increased intracranial pressure?
A.Restlessness
B.Vomiting
C.Decreased respiratory effort
D.Narrowing pulse pressure - ANSWER-C.Decreased respiratory effort
Based on fall mechanism, which patient warrants prehospital transfer to a trauma center?
A.A 35-year-old lands on a wooden porch from an 8-foot ladder
B.A 2-year-old lands on grass from a second-story balcony
C.A 14-year-old forcefully pushed onto cement from standing
D.A 50-year-old lands on a carpeted floor after tripping - ANSWER-B.A 2-year-old lands on grass from a second-story balcony
A patient is brought to the emergency department with chest pain and shortness of breath following a high-speed motor vehicle collision in which they were the unrestrained driver. There is crepitus to the left chest with clear and equal breath sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40 breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular contractions. These findings are most consistent with which type of shock?
A.Cardiogenic
B.Neuroge - ANSWER-A.Cardiogenic
A trauma patient who is 30-weeks pregnant arrives at the emergency department following a motor vehicle collision. Which normal physiologic change should be considered when assessing ventilatory status?
A.Increased functional reserve capacity
B.Increased oxygen consumption
C.Decreased minute ventilation
D.Slower desaturation rates with apnea - ANSWER-B.Increased oxygen consumption
A patient who sustained severe injuries was brought to the emergency department following a high-speed motor vehicle collision. Interventions for
hypovolemic shock have been initiated. What component of the trauma triad of death is most likely to have begun at the time of injury? - ANSWER- D.Coagulopathy
An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural critical access facility. They complain of neck pain, shortness of breath, and diffuse abdominal pain. The Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, and SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is the priority intervention for this patient? - ANSWER-C.Expedite transfer to the closest trauma center
A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness burns to both upper extremities and chest with a total body surface area burned of 27%. How much intravenous fluid should be administered in the first 8 hours? - ANSWER-C.3240 mL (2ml LR x kg x %TBSA) = total volume in 24 hours. Half of calculated total should be given in first 8 hours.
A patient has a closed fracture to the left lower leg. Which symptoms are consistent with compartment syndrome?
A. Shortness of breath, tachypnea, petechieae
B. Pain, numbness, bounding peripheral pulses
coagulopathy due to depletion of clotting factors from whole blood loss. Some may also have been on medications that can impair platelet function or anticoagulation prior to their injury.
SPECIAL POPULATIONS/LGTBQ+ - ANSWER-A person who is in the process of transitioning from male to female will usually be taking female hormones such as estrogen/estradiol to assist with the transition. This can cause a decrease in muscle mass, increased risk of thromboembolism, and possibly increased bone density. These patients would not be taking testosterone.
PRIMARY ASSESSMENT/SHOCK - ANSWER-Diltiazem is a calcium channel blocker and in combination with the citrate used as a preservative in blood products, put the patient at a higher risk for significant hypocalcemia and cardiac dysrhythmias.
A patient arrives with a 3-inch laceration to their forearm from a tree branch. Which of the following methods will the nurse use to remove small piles of debris from the wound?
A. Low pressure irrigation
B. High pressure irrigation
C. Scrubbing with normal saline
D. Scrubbing with tap water - ANSWER-B. High pressure irrigation
High-pressure irrigation is the best method to remove smaller contaminants and bacteria from a wound. Low pressure can be used for larger contaminants.
PRIMARY ASSESSMENT/SHOCK - ANSWER-This patient has signs of hypovolemic shock from a probable closed femur fracture. The patient needs fluid resuscitation while maintaining a minimum urine output of 0.5 mL/kg/hour which is a good indicator or adequate fluid resuscitation and end organ perfusion
HEAD AND TORSO TRAUMA/THORACIC AND NECK TRAUMA - ANSWER-Positive pressure ventilation in a patient with even a small pneumothorax can increase the risk of worsening the pneumothorax, or possibly developing a tension pneumothorax. Increasing respiratory distress along with severely diminished of absent breath sounds on the affected side would be noted.
HEAD AND TORSO TRAUMA/HEAD TRAUMA - ANSWER-Diffuse axonal injury (DAI) is widespread microscopic damage, primarily to the axons. DAI results from diffuse shearing, tearing, or compressive stresses from a rational or acceleration/deceleration mechanism of injury. Deeper brain structures, the brain stem, and the reticular activating system are most at risk for injury. Assessment findings can include unconsciousness, abnormal motor posturing, signs of increased ICP, hyperthermia, and excessive sweating.
Treatment for frostbite can include which of the following interventions?
A. Warm the affected part over 30 to 60 minutes
B. Use gentle friction to improve circulation
C. Administer tissue plasminogen activator
D. Drainage of all large and small blisters - ANSWER-C. Administer tissue plasminogen activator
With frostbite, thrombus formation is a risk. Tissue plasminogen activator, a thrombolytic medication, has been effective in maintaining perfusion and decreasing the need for amputation when administered within 24 hours of rewarming.
A patient arrives at the emergency department by private vehicle after sustaining an injury to the right lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant bleeding. What is the priority intervention?
A. Elevate the extremity to the level of the heart
B. Initiate direct pressure
C. Apply a tourniquet
D. Cover the ope wound with sterile saline dressings - ANSWER-B. Initiate direct pressure
The first step in controlling any bleeding is application of direct pressure.
A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest. Which concurrent injury is most commonly associated with this fracture?
A. Blunt Cardiac Injury
B. Brachial plexus injury
C. Pneumothorax
D. Hemothorax - ANSWER-B. Brachial plexus injury
First and second rib fractures are most commonly associated with great vessel, head and spinal cord, and brachial plexus injuries.
A patient with a spinal cord injury at C5 is being cared for in the emergency department while awaiting transport to a trauma center. Which of the following represents the highest priority for ongoing assessment and management for this patients?
Understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the trauma care provider in which of the following?
A. Anticipating the types of injuries the may be present
B. Deciding whether law enforcement should be notified
C. Determining needed laboratory tests
D. Predicting the need for a surgical procedure - ANSWER-A. Anticipating the types of injuries the may be present
Mechanism of injury and energy transfer can assist the provider in anticipating and evaluation the types of injuries that may be present and their severity.
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick for a couple of days and is now back working on the team. Which of the following behaviors would indicate this nurse is coping well?
A. They are talking about taking the emergency nursing certification examination
B. They keep requesting to be assigned to the walk-in/ambulatory area
C. They are impatient and snap at their coworkers
D. They are thinking about transferring out of the emergency department - ANSWER-A. They are talking about taking the emergency nursing certification examination
This is an indication the nurse is taking positive steps to advance their own practice, a sign of resilience.
What is the appropriate technique for palpating the pelvis for stability? - ANSWER-B. Apply gentle pressure over the iliac crests, downward and medially
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome - ANSWER-b. Normal vital signs in pregnancy
In pregnancy, the resting heart rate increases by 10 to 20 beats/minute. This is also a small decrease in systolic blood pressure and a larger decrease in diastolic
The general impression is formed at the beginning o fate riorary survey to rapidly assess the need to reprioritize circulation before airway or breathing. this is done if uncontrolled external hemorrhage is identified.
What technique is most appropriate when obtaining a history from a patient who has experienced a sexual assault?
A. Sitting next to the patient
B. Ensuring the patient answers all the questions
C. Asking for information only related to the assault
D. Applying active listening - ANSWER-D. Applying active listening
Therapeutic communication techniques such as active listening decrease unintentional distress during the interaction
A patient fell two weeks ago, striking his head. He came to the emergency department with a persistent headache and nausea. He was diagnosed with a small subdural hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports he has been anxious, restless, and shaky. he vomited twice during the night. He tells the day shift nurse he couldn't sleep because a young child kept coming into his room. What is a likely cause for these signs and symptoms?
A. Increased intracranial pressure
B. Alcohol withdrawal
C. Rhabdomyolysis
D. Pulmonary embolus - ANSWER-B. Alcohol withdrawal
Alcohol withdrawal is a common delayed condition because symptoms are difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting, psychomotor agitation, anxiety, insomnia, transient hallucinations, or seizures.
Which o the following is considered a cornerstone of a high-performance trauma team?
A. Individual goals
B. Use of TeamSTEPPS
C. Identification of a single decision maker
D. Effective communication - ANSWER-D. Effective communication
Skilled communication, cooperation, and coordination are the cornerstones of high-performance teams and high-quality trauma care
Penetrating neck trauma may include concurrent injuries to the cereal spine and cord, airway, or vascular neck structures. With an intact airway and hemodynamic stability, the other common concurrent injury is to the cervical spine
What is the best position for maintaining an open airway in the obese patient?
A. Prone
B. Supine
C. Reverse Trendelenburg
D. Right lateral recumbent - ANSWER-C. Reverse Trendelenburg
In a patient with severe traumatic brain injury, hypocapnia causes which condition?
A. Respiratory acidosis
B. Metabolic acidosis
C. Neurogenic shock
D. Cerebral vasoconstriction - ANSWER-D. Cerebral vasoconstriction
Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the cerebral vasculature.
What is the best measure of the adequacy of cellular perfusion and can help to predict the outcome of resuscitation?
A. End-tidal carbon dioxide
B. Hematocrit level
C. Base deficit
D. Oxygen saturation - ANSWER-C. Base deficit
Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and, when used in conjunction with serum lactate, helps predict the success of the resuscitation
A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right lower chest and complaints of shortness of breath. What is the priority intervention?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support - ANSWER-D. Airway and ventilation support
