TNCC Final Exam 2023-2024: Trauma Nursing Core Course Q&A, Exams of Nursing

Download TNCC Final Exam 2023-2024: Trauma Nursing Core Course Q&A and more Exams Nursing in PDF only on Docsity! TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ 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 - ansA) 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 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycle cross 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 - ansA) Fast exam B) CT scan C) straight cath for urine sample *** D) ice and elevation of the scrotum A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is suspected? Answer: B - ansA) oculomotor nerve palsy B) globe rupture *** C) uncal herniation D) retinal detachment 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 - ansA) 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. 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 LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |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 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. - ansA) diagnostic peritoneal lavage *** B) serial fast exams C) abdominal and pelvic CT scans D) serial abdominal assessments 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 - ansA) 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 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 - ansA) initiate transfer to a trauma center ** B) provide report to the operating room nurse C) Obtained imaging studies D) Place a gastric tube 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? TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ Answer: D - ansA) 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 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? Answer: A - ansA) Ventilate with a BVM *** B) Prepare for cricothyroidotomy C) administer reversal medications D) contact anesthesia for assistance 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 - ansA) 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 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 - ansA) 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 *** EMS arrives with the intoxicated driver of a car involved in a MVC. EMS 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 - ansA) 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 TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? Answer: D - ansA) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath *** 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 - ansA) mitigation *** B) preparedness C) response D) recovery If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? Answer: D - ansA) potassium B) magnesium C) sodium D) calcium *** Patients with a crush injury should be monitored for which of the following conditions? Answer: C - ansA) Hypernatremia B) Hypercalcemia C) Dysrhthmias ** D) polyuria Tearing of the bridging veins is most frequently associated with which brain injury? Answer: B - ansA) epidural hematoma B) subdural hematoma *** C) diffuse axonal injury D) intracerebral hematoma The most reassuring finding for a male patient with hop pain after a fall is which of the following? TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ Answer: D - ansA) a normal prostate exam B) absence of abdominal distension C) a normal fast exam D) pelvic stability *** 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 4560 / 2 (half of fluids given in first 8 hours) = 2280 mL Answer: A - ansA) 2280 mL *** B) 3840 mL C) 4560 mL D) 7680 mL The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? Answer: C - ansA) Intraosseous line B) orogastric tube C) ET tube *** D) urinary catheter What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? Answer: A - ansA) pulse oximetry and capnogaphy ** B) respiratory rate and capnography C) pulse oximetry and respiratory rate D) capnography and capnometry What factor contributes most the kinetic energy of a body in motion? answer: C - ansA) acceleration B) mass C) velocity *** D) inertia TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ D) cardiac cath Which of the following is possible complication of positive-pressure ventilation? Answer: A - ansA) worsening pneumothorax B) worsening flail chest C) reabsorption of pleural air D) negative intrapleural pressure Which of the following is true about the log roll maneuver? Answer: C - ansA) 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 Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? Answer: B - ansA) ABC B) MARCH*** C) AVPU D) VIPP Which of the following occurs during the third impact of a motor vehicle crash? Answer: C - ansA) The driver of the vehicle collides with the steering wheel B) the vehicle collides with a tree C) the aorta is torn at its attachment with the ligamentum arteriosum D) the airbag deploys and strikes the front seat passenger *** Which of the following patients warrants referral to a burn center? Answer: C - ansA) 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. Which pulse pressure description is an indication of early hypovolemic shock? Answer: B - ansA) widened B) narrowed *** C) bounding TNCC FINAL EXAM LATEST VERSIONS 2023-2024 CONTAINS 250 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) TESTBANK |ALREADY GRADED A+ D) weak Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? Answer: c - ansa) 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 You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are most consistent with which of the following? Answer: A - ansA) placental abruption *** B) preterm labor C) uterine rupture D) fetal demise 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 begin fluid resuscitation? Answer: B - ansA) 1000 mL/hr B) 500 mL/hr *** C) 250 mL/hr D) 125 mL/hr