Download TNCC final exam test 2022 open book Questions And Answers and more Exams Nursing in PDF only on Docsity! TNCC final exam test 2022 open book Questions And Answers 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? A) 1000 mL/hr B) 500 mL/hr C) 250 mL/hr D) 125 mL/hr - correct answer B) 500 mL/hr 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? A) acute lung injury B) fat embolism C) PTX TNCC final exam test 2022 open book Questions And Answers D) pulmonary contusion - correct answer B) fat embolism Which pulse pressure description is an indication of early hypovolemic shock? A) widened B) narrowed C) bounding D) weak - correct answer B) narrowed Which of the following considerations is most important when caring for a geriatric trauma patient? A) head to to exam B) medical history C) incontinence D) falls - correct answer B) medical history Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? A) increased work of breathing TNCC final exam test 2022 open book Questions And Answers 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? 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 - correct answer C) expedite transfer to the closest trauma center An elderly patient with a history of anticoagulant use presents after a fall at home that day. she denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms? A) epidural hematoma B) diffuse axonal injury C) post-concussive syndrome TNCC final exam test 2022 open book Questions And Answers D) subdural hematoma - correct answer D) subdural hematoma 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? A) compensated B) Progressive C) irreversible D) decompensated - correct answer A) compensated Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a) 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 TNCC final exam test 2022 open book Questions And Answers d) to determine the underlying cause of shock - correct answer c) to gauge end-organ perfusion and tissue hypoxia 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? A) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath - correct answer D) Smell of alcohol on breath Which of the following occurs during the third impact of a motor vehicle crash? A) 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 TNCC final exam test 2022 open book Questions And Answers 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 - correct answer 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? 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 recourses - correct answer A) report your suspicion of the maltreatment in accordance with local regulations TNCC final exam test 2022 open book Questions And Answers 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? 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. - correct answer B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART 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? 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 - correct answer C) Elevating the extremity to the level of the heart TNCC final exam test 2022 open book Questions And Answers Which of the following is a late sign of increased intracranial pressure? A) Restlessness or drowsiness B) Nausea and vomiting C) Decreased respiratory effort D) Amnesia and anxiety - correct answer C) Decreased respiratory effort 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? A) initiate two large bore 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. - correct answer A) initiate two large TNCC final exam test 2022 open book Questions And Answers C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation - correct answer A) padding the upper back while stabilizing the cervical spine A 35-year old male presents with facial trauma after bring struck in the face with a baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is suspected? A) oculomotor nerve palsy B) globe rupture *** C) Uncal herniation D) retinal detachment - correct answer B) globe rupture Which of the following is true about the log roll maneuver? A) it causes less spinal motion than the lift and slide maneuver B) it is recommended for patients with unstable pelvic fractures TNCC final exam test 2022 open book Questions And Answers 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 - correct answer C) it can worsen cord damage from an unstable spinal injury 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? A) 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 - correct answer A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan TNCC final exam test 2022 open book Questions And Answers If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? A) potassium B) magnesium C) sodium D) calcium - correct answer D) calcium Tearing of the bridging veins is most frequently associated with which brain injury? A) epidural hematoma B) subdural hematoma *** C) diffuse axonal injury D) intracerebral hematoma - correct answer B) subdural hematoma 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 test 2022 open book Questions And Answers C) response D) recovery - correct answer A) mitigation 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? A. Diagnostic peritoneal lavage B. Serial FAST exams C. Abdominal and pelvic CT scans D. Serial abdominal assessments - correct answer A) diagnostic peritoneal lavage 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 TNCC final exam test 2022 open book Questions And Answers rapidly identify the presence of hemorrhage in patients who are hemodynamically unstable after trauma. The most reassuring finding for a male patient with hop pain after a fall is which of the following? A) a normal prostate exam B) absence of abdominal distension C) a normal fast exam D) pelvic stability - correct answer D) pelvic stability Which of the following is an expected finding in a patient with a thoracostomy connected to a chest drainage system? 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 - correct answer D) fluctuations in the water serial chamber TNCC final exam test 2022 open book Questions And Answers Which of the following patients warrants referral to a burn center? 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. - correct answer C) a 52- year old diabetic male with partial thickness burn to the left lower leg Which is the effect of hypothermia on the oxyhemoglobin dissociation curve? A) Hemoglobin does not readily release oxygen for use by the tissues B) The amount of oxygen available to the tissues increases C) Tissue oxygenation (PaO2) increases TNCC final exam test 2022 open book Questions And Answers Which of the following values indicates the need for alcohol withdrawal interventions? A) CIWA-Ar of 36 *** B) GCS 13 C) ETCo2 of 48 mm Hg D) heart rate of 45 beats/min - correct answer A) CIWA- Ar of 36 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? A) Ventilate with a BVM B) Prepare for cricothyroidotomy C) administer reversal medications D) contact anesthesia for assistance - correct answer A) Ventilate with a BVM TNCC final exam test 2022 open book Questions And Answers The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? A) Intraosseous line B) orogastric tube C) ET tube *** D) urinary catheter - correct answer C) ET tube 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? A) placental abruption B) preterm labor C) uterine rupture D) fetal demise - correct answer A) placental abruption