TNCC final exam test 2024 open book questions and answers, Exams of Nursing

Download TNCC final exam test 2024 open book questions and answers and more Exams Nursing in PDF only on Docsity! TNCC final exam test 2024 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 D) pulmonary contusion - - correct answer ✅B) fat embolism TNCC final exam test 2024 open book questions and answers 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 B) unilaterally diminished breath sounds C) pleuritic chest pain TNCC final exam test 2024 open book questions and answers 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 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 TNCC final exam test 2024 open book questions and answers 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 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 TNCC final exam test 2024 open book questions and answers 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 D) the airbag deploys and strikes the front seat passenger - - correct answer ✅C) the aorta is torn at its attachment with the ligamentum arteriosum 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? A) initiate transfer to a trauma center B) provide report to the operating room nurse C) Obtained imaging studies D) Place a gastric tube - - correct answer ✅A) initiate transfer to a trauma center Which of the following injuries is LEAST likely to be promptly identified? TNCC final exam test 2024 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 Which of the following is a late sign of increased intracranial pressure? A) Restlessness or drowsiness TNCC final exam test 2024 open book questions and answers 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 bore intravenous lines for Ringers lactate solution administration Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? A) ABC TNCC final exam test 2024 open book questions and answers B) MARCH C) AVPU D) VIPP - - correct answer ✅B) MARCH A patient arrives with a large open chest wound after being assaulted 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? A) needle decompression B) tube thoracostomy C) dressing removal D) surgical repair - - correct answer ✅C) dressing removal 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? A) elevated creatine kinase B) decreased potassium level C) decreased WBC TNCC final exam test 2024 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? A) Brief TNCC final exam test 2024 open book questions and answers B) loop C) debrief D) huddle - - correct answer ✅D) huddle 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? 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 - - correct answer ✅D) confirm ET tube placement What factor contributes most the kinetic energy of a body in motion? A) acceleration B) mass C) velocity D) inertia - - correct answer ✅C) velocity TNCC final exam test 2024 open book questions and answers 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? 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 - - correct answer ✅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? A) mitigation B) preparedness 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 TNCC final exam test 2024 open book questions and answers 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 D) Hemoglobin molecule saturation (SaO2) decreases - - correct answer ✅A) Hemoglobin does not readily release oxygen for use by the tissues 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? A) Fast exam B) CT scan C) straight cath for urine sample D) ice and elevation of the scrotum - - correct answer ✅C) straight cath for urine sample TNCC final exam test 2024 open book questions and answers Which of the following is possible complication of positive-pressure ventilation? A) worsening pneumothorax B) worsening flail chest C) reabsorption of pleural air D) negative intrapleural pressure - - correct answer ✅A) worsening pneumothorax Which of the following is NOT considered goal-directed therapy of cardiogenic shock? A) controlled fluid boluses B) antidysrhythmic administration C) pericardiocentesis D) cardiac cath - - correct answer ✅C) pericardiocentesis What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? A) pulse oximetry and capnogaphy ** B) respiratory rate and capnography TNCC final exam test 2024 open book questions and answers C) pulse oximetry and respiratory rate D) capnography and capnometry - - correct answer ✅A) pulse oximetry and capnogaphy 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