TNCC Final Exam Test open book 50 Questions with Verified Answers,100% CORRECT, Exams of Nursing

Download TNCC Final Exam Test open book 50 Questions with Verified Answers,100% CORRECT and more Exams Nursing in PDF only on Docsity! TNCC Final Exam Test open book 50 Questions with 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 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? A) spleen B) lung C) bowel D) brain - CORRECT ANSWER C) bowel Patients with a crush injury should be monitored for which of the following conditions? A) Hypernatremia B) Hypercalcemia C) Dysrhythmias D) polyuria - CORRECT ANSWER C) Dysrhythmias What finding raises suspicion of complete spinal cord injury? A) Weakness in the lower extremities B) Priapism C) voluntary anal sphincter tone D) intact reflexes distal to the injury - CORRECT ANSWER B) Priapism A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? 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 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 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 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 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 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 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 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 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