Download TNCC Final Exam Test 2024 Open Book With 100% Correct And Verified Answers and more Exams Advanced Education in PDF only on Docsity! TNCC Final Exam Test 2024 Open Book With 100% Correct And Verified 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 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 D) hypotension that worsens with inspiration - Correct Answer-D) hypotension that worsens with inspiration. Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis. 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? A) 2280 mL B) 3840 mL C) 4560 mL D) 7680 mL - Correct Answer-A) 2280 mL (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 Which of the following is a component of the trauma triad of death? A) Acidosis B) hyperthermia C) hemorrhage D) sepsis - Correct Answer-A) Acidosis hypothermia, metabolic acidosis, coagulopathy 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? A) Expedite transport to the CT scanner B) prepare the patient for spinal radiographs C) expedite transfer to the closest trauma center 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 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 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 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 D) elevated GFR - Correct Answer-A) elevated creatine kinase 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? A) 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 - 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 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 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 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? D) ice and elevation of the scrotum - Correct Answer-C) straight cath for urine sample 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 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 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