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

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TNCC 9TH REAL EXAM ACTUAL VERIFIED EXAM

TESTBANK | INCLUDES 3 TESTED VERSIONS OF

THE EXAM WITH 50 MULTIPLE CHOICE

QUESTIONS AND ANSWERS EACH | EXPERT

VERIFIED DETAILED ANSWERS | GUARANTEED

PASS | ALREADY GRADED A

VERSION 1

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 theright 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 energytransfer 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 prehospitalenvironment? 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 theoutcome 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 historyis 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

What is the appropriate technique for palpating the pelvis for stability? a. Apply gentle pressure over the iliac crests, downward and laterally. b. Apply gentle pressure over the iliac crests, downward and medially. c. Apply firm pressure over the iliac crests, downward and laterally. d. Apply firm pressure over the iliac crests, downward and medially. b. Apply gentle pressure over the iliac crests, downward and medially. A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn'tsleep because a young child kept coming into the room. What is the most likely cause for these signs and symptoms? a. increase intracranial pressure b. alcohol withdrawal c. rhabdomyolysis d. pulmonary embolus b. alcohol withdrawal Treatment for frostbite can include which of the following interventions? a. warm the affected part over 30 - 60 minutes b. use gentle friction to improve circulation c. administer tissue plasminogen activator d. leave all of the blisters intact c. administer tissue plasminogen activator 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 forongoing assessment and management for this patient? a. maintain adequate respiratory status. b. administer balanced resuscitation fluid c. perform serial assessments of neurologic function d. maintain core temperature a. maintain adequate respiratory status Following a bomb explosion, fragmentation injuries from the bomb or objects in the environmentare examples of which phase of injury? a. primary b. secondary c. tertiary

d. quaternary b. secondary

A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sickfor 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 thefollowing? 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 emergencynurse 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, thenurse 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. kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the mostimportant 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 ofconsciousness 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, minimallyrelieved 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 asmall 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, andcomplaining 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 tothe 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. Ateardrop-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 assessingventilatory 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 ofa 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. Thepatient 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 prolongedexposure time prior to transport. The patient is confused. Vital signs are BP 96/54 mm Hg , HR114 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 6mmol / 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

The trauma nurse is caring for an unrestrained driver who struck their head on the windshieldfollowing a high - speed MVC. The patient has been diagnosed with an anterior spinal cord injury at the level of C6. Which assessment finding would be most concerning? Increasing work of breathing While caring for a child who has been injured , what nursing intervention consistent with afamily center approach Allowing family to participate in the care of the patient 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 Thereis 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 Cardiogenic Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadiani , crepitus in the lower right ribs , and cechymosis around the umbilicus The nurse is concerned about injury to which organ Liver A 5 - year - old child presents to the emergency department 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. Whichof the following is the priority nursing intervention? Report your suspicion of maltreatment in accordance with local regulations A patient arrives with a large metal rod embedded in their left thigh and no active bleeding.Which intervention is most appropriate for this patent? Prepare the patient for surgery to remove the rod. When should the definitive calculation for intravenous fluid resuscitation rate be performed for apatient with burns? During the secondary survey Which of the following is true about use of the focused assessment

sonography for trauma examfor a patient with abdominal trauma? It can be used in hypotensive patients too unstable for computed tomography scan What is the priority intervention for a child who has been diagnosed th an atlanto - occipitaldislocation following a high - speed motor vehicle collision?

Maintaining spinal motion restriction What position optimizes ventilation in the obese patient with a lumbar FractureReverse Trendelenburg During the primary survey of an unconscious patient with multi system trauma , the nurse notessnoring respirations Which priority nursing tervention should be performed next? Insert an oropharyngeal airway if there is no gag reflex The patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadrani , crepitus in the lower rigini rius , and cechymosis around the umbilicus. The nurse is concerned about injury to which organ? Liver A patient arrives following prolonged exposure of their left hand to the cold The patient is awakeand alert and complains of a tingling sensation to the fingers. Assessment reveals swelling and bright red skin to the left hand and a 1 - inch round clear blister to the dorsum of that hand. Which of the following nursing interventions is most appropriate for this patient ?Gently rewarm over 15 to 30 minutes A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during astaffing crisis. The nurse expresses anger stating that the patients did not receive quality care and begins exhibiting aggression toward colleagues. This is most consistent with which condition ? Moral injury What is the rationale for obtaining a serum lactate level during the initial assessment of a traumapatient? Gauges end organ perfusion and tissue hypoxia What is the most important consideration during the initial assessment when caring for an olderadult who has sustained serious injuries? Medical history including current medications Following a gun shot wound , pre - hospital providers report diminished breath sounds bilaterally

. Upon emergency department arrival , the patient is unresponsive with shallow respirations andan 02 sai of 90 %. What is the priority intervention

for this patient? Assist ventilation with a bag - mask device A patient is diagnosed with a T12 spinal cord injury following a 20 - foot fall. Which finding isconsistent with spinal shock? Loss of reflexes

A patient with a traumatic brain injury has a mean arterial pressure ( MAP ) of 65 mm Hg ( 8.66kPa ) 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 areshallow 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 of13 ( E - 3 , V - 4 , M - 6 ). The patient has bilateral subdural hematomas and is awaiting transferto 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 patienthas 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 thefollowing 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 immediateintervention? 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 contractionsWhich 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 wouldprompt 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. Onarrival , 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 withcompartment syndrome Pain, diminished pedal pulse, pressure Which of the following characteristics is found in high performing teamsInterdisciplinary 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 followinga 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. Thepatient 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 thepriority 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 movetheir 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 teamgathers 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. Thereis 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 isexperiencing 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 ofheadache, 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 thoracostomyconnected to a chest drainage system Fluctuation in the water seal chamber

What two noninvasive interventions are used to assess for the adequacy of oxygenation andeffectiveness of ventilation Pulse oxide try and capnography A trauma patient involved in a fall from 25 ft has a TBI, three anterior rib fractures on the right side, a small pneumothorax on the right, and grade III liver injury. The patient was intubated andplaced on a ventilator w/ PEEP. Chest tube was deferred at this time. Upon reassessment, which finding is most concerning Severely diminished breath sounds on the right Which blood pressure finding is associated with early or compensated hypovolemic shock?Rising diastolic What assessment finding is consistent w/impending herniation syndrome?Unilaterally fixed and dilated pupil Which commonly prescribed medication may worsen a complication that is associated withmassive transfusion Diltiazem Patient w/ a crush injury should be monitored for which of the following conditionsDysthymias 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 forthis patient? Reposition the endotracheal tube A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding wouldindicate sacral sparing Voluntary anal sphincter tone You are caring for a patient who was shot multiple times in the chest and abdomen. The patientis unresponsive w/snoring, shallow respirations. Assessment reveals absent radial pulses, weakand carotid pulse, and cool, diaphoretic skin. Which management strategy should the nurse anticipate? Massive transfusion While caring for a trauma patient in the ED, what finding raises suspicion of

a complete spinalcord injury? Urinary incontinence