Download TNCC Final Exam Questions: Trauma Assessment and Management and more Exams Nursing in PDF only on Docsity! TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ 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 - answerA) 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 TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? Answer: c - answera) to measure oxygenation and ventilation b) to quantify the base deficit for the adequacy of cellular perfusion c)*to gauge end-organ perfusion and tissue hypoxia ** d) to determine the underlying cause of shock A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+B)the vehicle collides with a tree TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ C)the aorta is torn at its attachment with the ligamentum arteriosum D) the airbag deploys and strikes the front seat passenger *** A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority interventions? Answer: A - answerA) initiate transfer to a trauma center ** B)provide report to the operating room nurse C)Obtained imaging studies D)Place a gastric tube Which of the following injuries is LEAST likely to be promptly identified? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: C - answerA) spleen B)lung C)bowel *** D)brain Patients with a crush injury should be monitored for which of the following conditions? Answer: C - answerA) Hypernatremia B)Hypercalcemia C)Dysrhthmias ** D)polyuria What finding raises suspicion of complete spinal cord injury? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: C - answerA) 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 - answerA) 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. TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Which of the following is a late sign of increased intracranial pressure? Answer: C Cushing Response Widening pulse pressure Reflex bradycardia Decreased RR - answerA) Restlessness or drowsiness B)Nausea and vomiting C)Decreased respiratory effort** D)amnesia and anxiety TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Which of the following mnemonics can help the nurse prioritize care for a TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ 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 - answerA) 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 isexpected with a TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+musculoskeletal complication associated with this presentation? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: A - answerA) elevated creatine kinase *** B)decreased potassium level C)decreased WBC D)elevated GFR 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 - answerA) 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 TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: B - answerA) oculomotor nerve palsy B)globe rupture *** C)uncal herniation D) retinal detachment Which of the following is true about the log roll maneuver? Answer: C - answerA) it causes less spinal motion than the lift and slide manuever B)it is recommended for patients with unstable pelvic fractures C) it can worsen cord damage from an unstable spinal injury *** D) it does not increases the risk of life threatening hemorrhage from unstable injuries TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+EMS arrives with the intoxicated driver of a car involved in a MVC. EMS TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ reports significant damage to the drivers side of the car. The patient is asking to have the cervical color removed. when is it appropriate to remove the cervical collar? Answer: A - answerA) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan *** B)after physician evaluation if the patient has not neurologic abnormalities on exam C)after palpation of the spine if the patient has no point tenderness the the vertebral column D)after physical examination if the patient has not neck pain with movement Tearing of the bridging veins is most frequently associated with which brain injury? Answer: B - answerA) epidural hematoma TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ D) intracerebral hematoma If a patient has received multiple transfusions of banked blood preserved with citrate, whichelectrolyte is most likely to drop and require supplementation? Answer: D - answerA) potassium B)magnesium C)sodium D)calcium *** A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT scanner will be out of service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma teams communication? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: D - answerA) Brief B)loop C)debrief D)huddle *** The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total BSA burned, how much IV fluids would be administered in the first 8 hours? (upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA. 120 kg x (2 mL) x (19% TBSA) = 4560 mL TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ 4560 / 2 (half of fluids given in first 8 hours) = 2280 mL Answer: A - answerA) 2280 mL *** B)3840 mL C)4560 mL D)7680 mL Which of the following assessment findings differentiates a tension PTX from a simple PTX? answer: D Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ D) falls TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ 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 - answerA) 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 - answerA) acceleration B)mass TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ C)velocity *** D) inertia During the primary survey of an unconscious patient with multi-system trauma, the nurse notessnoring respirations. Which priority nursing interventions should be performed next? Answer: D - answerA) 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 TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ The most reassuring finding for a male patient with hop pain after a fall is which of the following? Answer: D - answerA) 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 TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED 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 ruleout 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. - answerA) 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 achest drainage system? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: D - answerA) 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 - answerA) 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. TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ C)Tissue oxygenation (PaO2) increases TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ D)Hemoglobin molecule saturation (SaO2) decreases A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicyclecross bars which performing an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurse questions? Answer: C - answerA) Fast exam B)CT scan C)straight cath for urine sample *** D) ice and elevation of the scrotum You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+begin fluid resuscitation? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ D)capnography and capnometry Which if the following values indicates the need for alcohol withdrawal interventions? Answer: A - answerA) CIWA-Ar of 36 *** B)GCS 13 C)ETCo2 of 48 mm Hg D)heart rate of 45 beats/min An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respiratory, and dusky skin. the trauma team has administered medications for drug assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+ Answer: A - answerA) Ventilate with a BVM *** B)Prepare for cricothyroidotomy C)administer reversal medications D)contact anesthesia for assistance The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? Answer: C - answerA) Intraosseous line B)orogastric tube C)ET tube *** D)urinary catheter You are caring for a patient who was involved in a MVA and is 32 TNCC FINAL EXAM 2 LATEST VERSIONS 2024-2025 CONTAINS 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+weeks pregnant. Findings of your