TNCC 9th Edition final Exam Test Bank Latest Update 2024 2025 | questions with correct ve, Exams of Nursing

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TNCC 9th Edition final Exam Test Bank Latest

Update 2024 2025 | questions with correct verified

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1. An adult patient who sustained a severe head trauma has been intubated 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 important intervention 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. - ANSWER A. Decrease the rate of manual ventilation
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 - ANSWER B. Amputation of a limb 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.
3. What is the most important consideration during the initial assessment when 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 - ANSWER B. Medical history including current medications

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 appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - ANSWER C. Notify the physician
5. When should the definitive calculation for intravenous fluid resuscitation rate be performed for a patient with burns? A. As soon as the patient arrives B. After removal of clothing C. Only at a burn center D. During the circulation assessment - ANSWER B. After removal of clothing Rationale: Musculoskeletal and Wounds\Burns Some fluid will be given initially, but an accurate fluid total is based on percentage of total body surface area which requires a good skin assessment and is calculated after clothing is removed.
6. In a motor vehicle collision, which injury pathway is most likely to increase the patient's morbidity and mortality? A. Rotational

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 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. - ANSWER C. Reposition the endotracheal tube.
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 - ANSWER D. Hypotension
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 intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - ANSWER A. Initiate transfer to a trauma center
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 - ANSWER C. Apply direct pressure to the wound

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 on the right, and a Grade III liver injury. The patient was intubated and placed on a ventilator with PEEP. Chest tube was deferred at this time. Upon reassessment, which finding is most concerning? A. Severely diminished breath sounds on the right B. Guarding in the right upper quadrant C. Ecchymosis in the right upper quadrant D. Crepitus to the right chest - ANSWER A. Severely diminished breath sounds on the right
14. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an indication of the body's response to these findings? A. Increased respiratory effort B. Widening pulse pressure C. Reflex tachycardia D. Reflex hypotension - ANSWER B. Widening pulse pressure Rationale: Head and Torso Trauma\Head Trauma This patient has a CPP (MAP − ICP) of less than 60 mm Hg (8 kPa) which is associated with poor outcomes. When the CPP falls below normal levels, the central nervous system initiates the Cushing response in an attempt to increase mean arterial pressure and improve CPP. Cushing response assessment findings include widening pulse pressure, reflex bradycardia, and irregular, decreased respiratory effort.

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.

1. Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is concerned about injury to which organ? A. Transverse colon B. Pancreas C. Liver D. Spleen - ANSWER C. Liver 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
2. 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 C. Retrobulbar hematoma D. Retinal detachment - ANSWER B. Globe rupture Rationale: Head and Torso Trauma\Head Trauma The globe of the eye consists of multiple layers. The sclera is the white outer layer, while the cornea covers the iris and pupil. When a full thickness injury occurs to the cornea, sclera, or both, the globe will rupture, causing the shape of the pupil to become irregular or teardrop- shaped

21. An adult arrives at the emergency department with superficial burns to the extremities following a house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the most likely cause of these symptoms? A. Capillary leak syndrome B. Rhabdomyolysis C. Carbon monoxide poisoning D. Hypothermia - ANSWER C. Carbon monoxide poisoning
22. An adult patient is being treated in the emergency department after falling 30 feet and landing on their head. The patient has been intubated and initial stabilization efforts are ongoing. The vital signs are BP 70/40 mm Hg, HR 44 beats/minute, and respirations are being assisted at 16 breath/minute. The patient's skin is warm, dry, and of a normal color. These findings are most consistent with what type of shock? A. Spinal B. Hypovolemic C. Obstructive D. Neurogenic - ANSWER D. Neurogenic
23. A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the water seal chamber during inspiration and expiration. What is the best action for the nurse to take? A. Clamp the chest tube B. Return to the emergency department C. Assist ventilations with bag-mask device D. Continue to the intensive care unit - ANSWER D. Continue to the intensive care unit
24. 1. Which one of the following characteristics is found in high performing teams? A. Interdisciplinary collaboration