TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES, Exams of Nursing

Download TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES and more Exams Nursing in PDF only on Docsity! 1 / TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES A 1.1. An adult patient who sustained a severe head trauma has been intubat- ed and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa),and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most importantintervention to manage the cerebral blood flow? A. Decrease the rate of manual ventilation B. Initiate another fluid bolus. C. Recheck endotracheal tube placement. D. Increase the amount of oxygen delivered.: A. Decrease the rate of manual ventilation 2.2. Which of the following situations could cause functional grief? A. Inability to live at home B. Amputation of a limb C. Loss of one's self-image D. Destruction of the patient's car 2 / TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES Rationale: Preparation and Ongoing Care\Psychosocial Aspects Functional grief relates to the loss of body function or body parts such as amputation of a limb, paralysis, or loss of sight.: B. Amputation of a limb 3.3. What is the most important consideration during the initial assessmentwhen caring for an older adult who has sustained serious injuries? A. They are likely to be fearful in the emergency department B. Medical history including current medications C. Availability of support systems after discharge D. Accessibility to a primary care physician: B. Medical history including current medication 4.4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear.Which of the following is the most appropriatenext step? 5 / TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES the limb to the level of the heart to decrease dependent edema but not above the heart, which can cause increased venous congestion and pressure within the compartment.: C. Elevating the leg to the level of the heart 8.8. A teenaged patient presents to the emergency department with left arm pain after a ground level fall. The patient identifies as transgender and sharesthey are homeless. The ED staff are concerned the patient is experiencing human trafficking. What is most consistent with human trafficking? A. The individual appears well nourished. B. Those who are being trafficked rarely seek medical care. C. It is infrequently associated with substance abuse. D.Those experiencing human trafficking rarely self-disclose.: D. Those experi- encing human trafficking rarely self-disclose. 9.9. An intubated trauma patient has just been transported back from CT scan.Upon arrival to their room in the emergency department, resistance is noted with bag-mask ventilations and auscultation reveals unequal breath 6 / TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES sounds.What is the most appropriate initial intervention for this patient? A. Place the patient back on the ventilator. B. Extubated the patient. C. Reposition the endotracheal tube. D. Suction the endotracheal tube.: C. Reposition the endotracheal tube. 10.10. Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? A. Increased work of breathing B. Unilaterally diminished breath sounds C. Tachycardia D. Hypotension: D. Hypotension 11.11. 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, what is the priority inter-vention? A. Initiate transfer to a trauma center 7 / TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter: A. Initiate transfer to a trauma center 12.12. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority intervention? A. Initiate two intravenous access sites B. Place the patient on supplemental oxygen C. Apply direct pressure to the wound D. Use a tourniquet to control the bleeding: C. Apply direct pressure to the wound 13.13. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib fractures on the right side, a small pneumothorax onthe right, and a Grade III liver injury. The patient was intubated and placed ona ventilator with PEEP. Chest tube was deferred at this time. Upon reassess-ment, which finding is most concerning? A. Severely diminished breath sounds on the right 10 TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES especially in patients who are on anticoagulants.: Post-concussive syndrome 16.16. 1. An older adult presents to the emergency department with com- plaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness anda hematoma is noted to the forehead.The patient is currently on anticoagulanttherapy. What is most likely the cause of their symptoms? A. Intracerebral hemorrhage B. Epidural hematoma C. Diffuse axonal injury D. Post-concussive syndrome Rationale: Special Populations\Older Adult Post-concussive syndrome can occur days to weeks after injury or trauma. The other three conditions present as a more rapid decline, especially in patients who are on anticoagulants.: D. Post- concussive syndrome 11 TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES 17.A patient presents, after a 25-foot fall, with paradoxical chest wall move-ment to the right lower chest and complaints of shortness of breath. What isthe priority intervention? A. Surgical intervention B. Chest tube insertion C. Needle decompression D. Airway and ventilation support: D. Airway and ventilation support 18.18. A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient sustained a femur fracture and required multiple blood products. The patient now has blood oozing fromabrasions, IV sites, the nose, and gums. What condition is most consistent with these findings? A. Rhabdomyolysis B. Fat embolism C. Disseminated intravascular coagulopathy D. Multiple organ dysfunctions syndrome: C. Disseminated intravascular coagu- lopathy 19.1. Your patient was the unrestrained driver involved in a moderate 12 TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES speedmotor vehicle collision. Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbili-cus. The nurse is concerned about injury to which organ? A. Transverse colon B. Pancreas C. Liver D. Spleen Rationale: Head and Torso Trauma\Abdominal and Pelvic Trauma Liver injuries are associated with right, lower rib fractures. They also can present with tenderness, guarding, or rigidity in the right upper quadrant, along with ecchymosis of the right upper quadrant or around the umbilicus,known as Cullen's sign.: C. Liver 20.20. 1. 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? A. Oculomotor nerve palsy B. Globe rupture 15 TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES A. Interdisciplinary collaboration B. Provide on-the-job training C. Work individually D. Minimal feedback to decrease confusion: A. Interdisciplinary collaboration 25.25. 1. A severely injured patient has been intubated and is being mechan-ically ventilated. The patient has received a balanced resuscitation includingmultiple blood products. Under which circumstance will it be harder for the hemoglobin to release oxygen to the tissues? A. Decreased pH B. Elevated carbon dioxide level C. Decreased body temperature D. Increased metabolic demand Rationale: Primary Assessment\Airway and Ventilation If the blood is not sufficiently warmed when transfused, it can produce hypothermia. In the oxyhemoglobin dissociation curve, a shift to the left increases the affinity of hemoglobin for oxygen 16 TNCC 9TH EDITION EXAM LATEST 2023-2024 COMPLETE QUESTIONS AND ANSWERS WITH RATIONALES making it harder to releasefor use by the tissues. Factors that can cause this shift include an elevatedpH, decreased carbon dioxide, decreased temperature, and low metabolic demand.: C. Decreased body temperature