TNCC 9th Edition Verified Questions and Answers 2025, Exams of Nursing

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TNCC 9th Edition

Which intervention is recommended regarding the use of drug-assisted intubation and rapid sequence intubation? - Answers>> Pre-oxygenate to prolong the time to hypoxia Which normal anatomic or physiologic change in an older adult places them at a higher risk for aspiration? - Answers>> Relaxed muscles of the oropharynx A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would indicate sacral sparing? - Answers>> Voluntary anal sphincter tone An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2 hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 mL/hour. The urine output over the last hour was 15mL. What intervention should the nurse anticipate? - Answers>> Increase isotonic crystalloid infusion rate

A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is consistent with spinal shock? - Answers>> Loss of reflexes A patient is brought to the emergency department following a motor vehicle rollover and is complaining of left upper abdominal pain and left shoulder pain. This presentation is most consistent with an injury to which organ? - Answers>> Spleen An adult patient is brought to the emergency department following a motor vehicle collision with complaints of neck pain. They have identified as a person in the process of transitioning from male to female. What effect of hormone therapy should be considered when planning care for this patient? - Answers>> Testosterone therapy may decrease blood pressure Correct rationale: 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.

An adult was thrown against a concrete wall during a factory explosion and sustained a femur fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred during what level of blast trauma? - Answers>> Tertiary An obese trauma patient requires intubation. Assuming there are no contraindications, which position will provide the best visualization for insertion of the endotracheal tube? - Answers>> Ramped A patient who jumped out of a second-floor window landing on their feet is diagnosed with a lumbar spine fracture. What is the most likely concurrent injury to have occurred? - Answers>> Calcaneus fracture A patient arrives with a large metal rod embedded in their left thigh and no active bleeding. Which intervention is most appropriate for this patient? - Answers>> Prepare the patient for surgery to remove the rod Which findings are most consistent with a complete transection of the spinal cord? - Answers>> Absence of sensory and motor function below the level of injury

Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing intervention? - Answers>> Notify the provider of the change While caring for a child who has been injured, what nursing intervention is consistent with a family-center approach? - Answers>> Allowing family to participate in the care of the patient Identification of delayed complications following blunt abdominal trauma is best accomplished by which method? - Answers>> Repeat computerized tomography with contrast Three adults present at different times during a one-hour period with a high fever, fatigue, and headache. All three patients have a rash which started on their mouth, face, and arms with progression to the chest and abdomen. They all visited the same grocery store within the last week. What is the most appropriate intervention from triage for these

most likely to have begun at the time of injury? - Answers>> Coagulopathy An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the patient is only responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to the face. What is the priority intervention? - Answers>> Use a jaw thrust to open the airway and look for signs of obstruction In a motor vehicle collision, which injury pathway is most likely to increase the patient's morbidity and mortality? - Answers>> Ejection An adult trauma patient has received 1 liter of isotonic crystalloid solution, 6 units of packed red blood cells, 6 units of fresh frozen plasma, and 1 combined unit of platelets during the initial fluid resuscitation phase. Re-assessment includes: BP 104/66 mm Hg, HR 112 beats/minute, intermittent ventricular bigeminy on the cardiac monitor, and the presence of muscle tremors. What should the nurse anticipate administering based on these findings? - Answers>> Calcium gluconate

When transporting an intubated patient, which monitoring adjunct will provide the best real-time information regarding respiratory status? - Answers>> Waveform capnography What technique is most appropriate when obtaining a history from a patient who has experienced a sexual assault? - Answers>> Applying active listening During the primary survey, which tool is most effective in identifying the need for an airway intervention? - Answers>> AVPU What type of wound is most likely to become embedded with gravel or dirt causing a black, blue, or grey discoloration? - Answers>> Abrasion 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 with clear breath sounds bilaterally. 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 96%. BP is 142/70 mm Hg. What is the most important intervention to manage cerebral blood flow? - Answers>> Decrease the rate of manual ventilation

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? - Answers>> Cardiogenic 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 additional finding should also be anticipated? - Answers>> Widening pulse pressure You are speaking with the family of a critically injured patient. The spouse is crying loudly and the daughter is angry and yelling at the staff. Which of the following nursing interventions is most appropriate? - Answers>> Ask if the family would like spiritual support A seriously injured patient is noted to have a weak, thready pulse and cool, clammy skin. There is instability of the pelvis on palpation and blood at the urinary meatus. A pelvic binder is appropriately applied and balanced fluid resuscitation is

being managed by the team. What is the priority diagnostic intervention? - Answers>> Retrograde urethrogram Correct rationale: The patient is hemodynamically unstable, so quick identification of potential bleeding sources is imperative. A focused assessment sonography for trauma (FAST) exam can be performed at the bedside to identify pathological fluid in the abdominal and pelvic cavities. 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? - Answers>> Carbon monoxide poisoning What assessment finding is consistent with impending herniation syndrome? - Answers>> Unilaterally fixed and dilated pupil A patient presents to the emergency department with a degloving injury involving the entire forearm. What should the nurse consider when planning care for a patient with this injury? - Answers>> Surgical intervention will be needed

the priority intervention? - Answers>> Initiate cervical spine stabilization Which measurement is concerning for a patient with head trauma and increased intracranial pressure? - Answers>> Brain tissue oxygen tension (PbtO2) of 16 mm Hg (2.1 kPa) Correct rationale: A PaCO2 of 47 mm Hg indicates the patient is retaining carbon dioxide which promotes vasodilation and increases intracranial pressure. What is the priority intervention for a child who has been diagnosed with an atlanto-occipital dislocation following a high-speed motor vehicle collision? - Answers>> Maintaining spinal motion restriction