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TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK | INCLUDES 3 TESTED VERSIONS OF THE EXA, Exams of Nursing

TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK | INCLUDES 3 TESTED VERSIONS OF THE EXAM-with 100% verified solutions 2024-2025

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Download TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK | INCLUDES 3 TESTED VERSIONS OF THE EXA and more Exams Nursing in PDF only on Docsity! TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK | INCLUDES 3 TESTED VERSIONS OF THE EXAM- with 100% verified solutions 2024-2025 With 50Q&A 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 b. Brachial plexus injury 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 open wound with sterile saline dressings b. Initiate direct pressure 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 c. Reverse Trendelenburg 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 that may be present b. Deciding whether law enforcement should be notified c. Determining needed laboratory tests d. Predicting the need for a surgical procedure a. Anticipating the types of injuries that may be present What is the leading cause of preventable death for the trauma patient in the prehospital environment? a. Airway compromise b. Ineffective ventilation c. Secondary head injury d. Uncontrolled external hemorrhage d. Uncontrolled external hemorrhage A adult patient with a knife injury to the neck has an intact airway and is hemodynamically stable. They complain of difficulty swallowing and speaking. In the primary survey, further assessment is indicated next for which of the following conditions? a. Damage to the cervical spine b. An expanding pneumothorax c. Laceration of the carotid artery d. Injury to the thyroid gland a. Damage to the cervical spine 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 c. Base deficit Which of 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 d. Effective communication The nurse is obtaining a history for a patient who presents following sexual assault. This history is completed using which of the following techniques? a. Bring the family in to the interview room. b. Use direct quotes to record information. c. Obtain information specific only to the assault. d. Provide food and drink to help create rapport. b. Use direct quotes to record information. In a patient with severe traumatic brain injury, hypocapnia causes which condition? a. Respiratory acidosis b. Metabolic acidosis c. Neurogenic shock d. Cerebral vasoconstriction d. Cerebral vasoconstriction 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. a. They are talking about taking the emergency nursing certification examination. Which of the following accurately describes ventilation principles associated with use of a bag- mask device for an adult? a. Compress the bag-mask device at a rate of one breath every 6 seconds. b. Delivers 100% oxygen. c. Squeeze the bag-mask device completely for each breath. d. Maintain the oxygen saturation levels between 92% and 94%. a. Compress the bag-mask device at a rate of one breath every 6 seconds. The general impression step in the initial assessment provides the opportunity to do which of the following? a. Assess for uncontrolled internal hemorrhage b. Accurately triage the patient c. Reprioritize circulation before airway or breathing. d. Activate the trauma team c. Reprioritize circulation before airway or breathing. 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 b. Normal vital signs in pregnancy While performing an assessment on a 13-month-old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a sign of possible altered mental status? a. Sunken fontanel b. Crying, but consolable c. Spontaneous movement of arms and legs d. Cooperation with the assessment d. Cooperation with the assessment An adult pt 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 pt has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. the PaCO2 is 30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most important intervention to manage the cerebral blood flow? Decrease the rate of manual ventilation An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The pt 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 pt is currently on anticoagulant therapy. What is most likely the cause of their symptoms? post-concussive syndrome A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medication. Which of the following is the priority nursing intervention? Elevating the leg to the LEVEL of the heart (compression/crush- level of the heart) (regular fracture- above the heart) A pt involved in a high-speed rollover is complaining of increased difficulty breathing. There is a small penetrating wound to the 6th intercostal space in the left lateral chest. Which finding is most consistent with an injury to the diaphragm? Bowel sounds heard in the lower left chest A pt has been in the emergency department for several hours waiting to be admitted. They sustained multiple rib fractures and a femur fracture after a fall. The pt has been awake, alert, and complaining of leg pain. Their spouse reported that the pt suddenly became anxious and confused. Upon reassessment, the pt is restless, with respiratory distress and petechiae to his neck. The pt is exhibiting signs and symptoms most commonly associated with which of the following conditions? Fat embolism 3 adult pts present at different times during a 1-hour period with a high fever, fatigue, and headache. All 3 pts 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 pts? Immediately initiate contact precautions 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. Witai type of injury is suspecied? Globe rupture 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 ? 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 ? 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 ? 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 ? 3240 mL 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 from abrasions , IV sites , the nose , and gums . What condition is most consistent with these findings ? Disseminated intravascular coagulopathy A patient is brought to the emergency department following a snowmobile crash with prolonged exposure time prior to transport . The patient is confused . Vital signs are BP 96/54 mm Hg , HR 114 beats / minute , RR 24 breaths / minute , T 34.60C ( 94.20F ) and an SpO2 of 90 % on oxygen at 15L per non - rebreather mask . Other findings include ETCO2 24 , scrum lactate of 6 mmol / L , and a pH of 6.8 . Based on these findings what is the most appropriate intervention Initiate warming measures Which of the following is a late sign of increased intracranial pressure ? Decreased respiratory effort Based on fall mechanism , which patient warrants prehospital transfer to a trauma center ? A 2 - year - old lands on grass from a second - story balcony nurse is caring for an unrestrained 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 mun Hg ( 2.93 kPa ) . Which finding is most likely an indication of the body's response to these findings ? Widening pulse pressure An unconscious patient arrives following a motor vehicle collision . The patient is on a backboard with a cervical collar in place and one intravenous line running . Respirations are shallow and there is active brisk bleeding from a large leg wound . What is the priority intervention for this patient ? Control the bleeding An obese trauma patient requires intubation . Assuming there are no contraindications , which position will provide the best visualization for insertion of the endotracheal tube ? Ramped 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 subsequeni 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 ? Notify the provider of the change A severely injured patient has been intubated and is being mechanically ventilated . The patient has received a balanced resuscitation including multiple blood producis . Under which circumstance will it be harder for the hemoglobin to release oxygen to the tissues ? Decreased body temperature A patient is thrown against a car during a tornado and presents with obvious bilateral femur fractures . The patient is paie , aleri , disoriented , and has delayed capillary refill . Which of the following interventions would be most appropriate for this patient based on the disaster triage principles ? Initiate two large caliber intravenous lines for isotonic crystalloid administration . A patient arrives with a large open chest wound after being assaulted with a machete . Prehospital providers placed nonporous dressing over the chest wound and taped it on three sides . The patient is now showing signs of anxiety , restlessness , severe respiratory distress , cyanosis , and decreasing blood pressure . Which of the following is the MOST appropriate immediate intervention ? Dressing removal A driver involved in a high - speed motor vehicle collision arrives in the emergency department . The vehicle's air - bag failed to deploy . The patient is drowsy bui arousable and complaining of chest pain wit ecchymosis noted to the chest . The patient is tachycardic and hypotensive with no evidence of uncontrolled bleeding . Cardiac monitor shows premature ventricular contractions Which of the following is the most appropriate intervention for this patient? Inotropic support Which of the following situations could cause functional grief ? Amputation of a limb Using the American College of Surgeons screening guidelines what assessment finding would prompt the nurse to prepare a patient for cervical spine imaging ? Alert with no neurologic deficits 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 ? Tertiary 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 ? Use a law thrust to open the air way and look for signs of obstruction An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph . The patient is awake and alert and the right leg is shortened . Following initial resuscitation with fluids , the patient remains hypotensive . What would be the priority intervention ? Apply a pelvic binder A patient has a closed fracture to the left lower leg. Which symptoms are consistent with compartment syndrome Pain, diminished pedal pulse, pressure Which of the following characteristics is found in high performing teams Interdisciplinary collaboration An unresponsive patient has an oropharyngeal airway in place, shallow and labored respirations, and dusky skin. Medication for drug-assisted intubation have been administered but intubation was unsuccessful. What is the most appropriate next step? Ventilate with a bag-mask device 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 most likely cause of these symptoms? CO2 poisoning An adult patient was a restrained passenger involved in a high-speed motor vehicle collision. The patient complained of generalized abdominal and left leg pain. A FAST exam was negative for fluid in the abdominal cavity. While awaiting inpatient bed placement, the patient develops increased abdominal pain w/rebound tenderness, fever and elevated WBC. These findings are most consistent w/ an injury to which organ? Small bowel A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority intervention? Apple direct pressure to the wound A 36 year old patient has a deformity of left wrist after a fall. The patient is reluctant to move their hand due to pain. Which of the following is the most appropriate intervention? Apply a splint and elevate the extremity above the level of the heart A trauma patient is being resuscitated in the emergency department when the radiology staff notifies the charge nurse that the 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 teams communication? Huddle A seriously injured patient is noted to have a weak, thready pulse and cool, clammy skin. There is instability of the pelvis on palpating and blood at the urinary meatus. A pelvic binder is appropriately applied and balanced fluid resuscitation is being managed by the team. What would be the most appropriate next intervention for this patient? Insertion of a suprapubic catheter A teenaged patient presents to the ED w/ left arm pain after a ground level fall. The patient identifies as transgender and shares they are homeless. The ED staff are concerned the patient is experiencing human trafficking. What is the most consistent w/ human trafficking Those experiencing human trafficking rarely self disclose An older patient w/a history of anticoagulant use presents after a fall at home the previous day. They deny loss of consciousness. The patient has a hematoma to their forehead and complains of headache, dizziness, left arm weakness, and nausea. What is the most likely cause of these symptoms? Subdural hematoma Which of the following is an expected finding when assessing a patient with a tube thoracostomy connected to a chest drainage system Fluctuation in the water seal chamber Version 2 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. 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 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. 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 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. 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 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. B. After removal of clothing 6. In a motor vehicle collision, which injury pathway is most likely to increase the patient's morbidity and mortality? A. Rotational B. Ejection C. Lateral D. Rollover B. Ejection 7. 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? A. Elevating the leg above the level of the heart B. Repositioning the leg and applying ice C. Elevating the leg to the level of the heart D. Preparing the patient for ultrasound of the leg Rationale: Musculoskeletal and Wounds\Musculoskeletal This patient is exhibiting signs of possible compartment syndrome which is a dangerous complication of fractured extremities. The pain is often out of proportion to the injury and might not respond to pain medications. Elevate 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. A teenaged patient presents to the emergency department with left arm pain after a ground level fall. The patient identifies as transgender and shares they 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 experiencing human trafficking rarely self-disclose. 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. 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. Post-concussive syndrome 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 D. Airway and ventilation support 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 from abrasions, 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 coagulopathy 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 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. 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 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. B. Globe rupture 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 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 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 D. Continue to the intensive care unit 24. 1. Which one of the following characteristics is found in high performing teams? A. Interdisciplinary collaboration B. Provide on-the-job training C. Work individually D. Minimal feedback to decrease confusion A. Interdisciplinary collaboration 25. 1. A severely injured patient has been intubated and is being mechanically ventilated. The patient has received a balanced resuscitation including multiple 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 making it harder to release for use by the tissues. Factors that can cause this shift include an elevated pH, decreased carbon dioxide, decreased temperature, and low metabolic demand. C. Decreased body temperature A) Weakness in the lower extremities B) Priapism *** C) voluntary anal sphincter tone D) intact reflexes distal to the injury A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? Answer: D A) Bradycardia and ipsilateral absences of motor function B) Tachycardia and respiratory depression C) Tachycardia and absent motor function below the level of injury D) Bradycardia and absent motor function below the level of the injury *** 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: A A) report your suspicion of the maltreatment in accordance with local regulations *** B) apply ice to the bruises and consult wound care C) engage in therapeutic communication to determine the MOI D) provide the family with injury prevention resourse A patient with 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: C A) elevating the extremity above the level of the heart B) repositioning and apply ice C) Elevating the extremity to the level of the heart *** D) Preparing the patient for ultrasound 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: B A) apply a sling and elevate the extremity to the level of the heart. B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART *** C) Apply a sling and elevate the extremity above the level of the heart D) apply a splint and elevate the extremity to the level of the heart. Which of the following is a late sign of increased intracranial pressure? Answer: C Cushing Response Widening pulse pressure Reflex bradycardia Decreased RR A) Restlessness or drowsiness B) Nausea and vomiting C) Decreased respiratory effort** D) amnesia and anxiety Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Answer: B A) ABC B) MARCH*** C) AVPU D) VIPP 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 cap refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principle? Answer: A A) initiate two large caliber intravenous lines for Ringers lactate solution administration *** B) Administer Dilaudid for pain control and provide comfort care C) Place the patient in an observation area for care within the next few hours D) Contact the command center for the personnel to notify next of kin. A patient arrives with a large open chest wound after being assault ed with a machete, Prehospital providers placed a nonporous dressing over the chest wound and tapes it on 3 sides. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST appropriate interventions? Answer: C A) needle decompression B) tube thoracostomy C) dressing removal ** D) surgical repair A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values is expected with a musculoskeletal complication associated with this presentation? Answer: A A) elevated creatine kinase *** B) decreased potassium level C) decreased WBC D) elevated GFR A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows: BP 98/71 HR 125 beats/min RR 26 breaths/min SpO2 94% on high flow O2 via NRB mask which of the following is the priority intervention for this patient? Answer: C A) Expedite transport to the CT scanner B) prepare the patient for spinal radiographs C) expedite transfer to the closest trauma center *** D) notify the patients family Caregivers carry a 2-year old into the ED who fell out of 2nd 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: A A) padding the upper back while stabilizing the cervical spine *** B) applying a tight-fitting NRB mask with an attached resevior C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation Which of the following is a component of the trauma triad of death? Answer: A hypothermia, metabolic acidosis, coagulopathy severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis. A) increased work of breathing B) unilaterally diminished breath sounds C) pleuritic chest pain D) hypotension that worsens with inspiration *** Which of the following considerations is most important when caring for a geriatric trauma patient? Answer: B A) head to to exam B) medical history ** C) incontinence D) falls 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 interventions? Answer: D A) call for a portable CXR stat B) chest to make sure the ventilator is plugged in C) suction the ET tube D) confirm ET tube placement What factor contributes most the kinetic energy of a body in motion? answer: C A) acceleration B) mass C) velocity *** D) inertia During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which priority nursing interventions should be performed next? Answer: D A) open the airway with the head-tilt/chin lift maneuver B) auscultate bilateral breath sounds to assess ventilatory status C) assist respirations using a BVM D) insert an oropharyngeal airway if there is no gag reflex *** 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 future disaster. Which phase of the disaster life cycle does this describe? Answer: A A) mitigation *** B) preparedness C) response D) recovery Which pulse pressure description is an indication of early hypovolemic shock? Answer: B A) widened B) narrowed *** C) bounding D) weak The most reassuring finding for a male patient with hop pain after a fall is which of the following? Answer: D A) a normal prostate exam B) absence of abdominal distension C) a normal fast exam D) pelvic stability *** A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative fast exam except which of the following? Answer: A The FAST exam is done at the bedside to identify pathological fluid in the abdominal and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be repeated if clinical changes or hemodynamic changes occur. A negative FAST study does not rule out injury and may warrant a follow-up computed tomography scan. Serial FAST exams can identify increasing abdominal fluid collections from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is performed by the surgical team to rapidly identify the presence of hemorrhage in patients who are hemodynamically unstable after trauma. A) diagnostic peritoneal lavage *** B) serial fast exams C) abdominal and pelvic CT scans D) serial abdominal assessments Which of the following is an expected finding in a patient with a thoracostomy connected to a chest drainage system? Answer: D A) output of 200 mL/hr B) tubing clamp closed for transport C) dependent loops in the tubing to promote drainage D) fluctuations in the water serial chamber *** Which of the following patients warrants referral to a burn center? Answer: C A) a 21- year old female with a partial thickness burn to the right forearm B) a 40-year old hypertensive male with a superficial burn to the back C) a 52-year old diabetic male with partial thickness burn to the left lower leg *** D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. A patient has been in the ED 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 c/o leg pain. His wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with which of the following conditions? Answer: B A) acute lung injury B) fat embolism *** C) PTX D) pulmonary contusion Which is the effect of hypothermia on the oxyhemoglobin dissociation curve? Answer: A