TNCC Final Exam Test 2024-2025 Q&A, Exams of Nursing

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BookTNCC final examtest Q&AS LATEST UPDATE2024/2925 openbook GRADED A+

TNCC final examtest Q&AS LATEST UPDATE2024/2025 openbook

GRADED A+

Whyisameasureofserumlactateobtainedintheinitialassessmentofthetraumapatient? Answer:ccorrectanswera)tomeasureoxygenationandventilation b) toquantifythebasedeficitfortheadequacyofcellularperfusion c) togaugeend-organperfusionandtissuehypoxia* d) todeterminetheunderlyingcauseofshock Atraumapatientisrestlessandrepeatedlyasking"whereamI?"vitalsignsuponarrivalwereBP100/60 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? Answer:AcorrectanswerA)compensated** B) Progressive C) irreversible D) decompensated Anelderlypatientwithahistoryofanticoagulantusepresentsafterafallathomethatday.shedenies anylossofconsciousness.Shehasahematomatoherforeheadandcomplainsofheadache,dizziness, and nausea. Which is a most likely cause of her symptoms? Answer:DcorrectanswerA)epiduralhematoma B) diffuseaxonalinjury C) post-concussivesyndrome

BookTNCC final examtest Q&AS LATEST UPDATE2024/2025 openbook

GRADED A+

Book D) subduralhematoma***

EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines,whichassessmentfindingwouldpromptthenursetopreparethepatientforradiologicspine clearance? Answer:DcorrectanswerA)Alertwithnoneurologicdeficits B) Multipleabrasionstotheextremities C) Multiplerequestsofwater D) Smellofalcoholonbreath *** Whichofthefollowingoccursduringthethirdimpactofamotorvehiclecrash? Answer:CcorrectanswerA)Thedriverofthevehiclecollideswiththesteeringwheel B) thevehiclecollideswithatree C) theaortaistornatitsattachmentwiththeligamentumarteriosum D) theairbagdeploysandstrikesthefrontseatpassenger*** A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. Whensignificantabdominalandpelvicinjuriesarenotedintheprimarysurvey,whichofthefollowingis the priority interventions? Answer:AcorrectanswerA)initiatetransfertoatraumacenter** B) providereporttotheoperatingroomnurse C) Obtainedimagingstudies D) Placeagastrictube

Book WhichofthefollowinginjuriesisLEASTlikelytobepromptlyidentified?

Answer:CcorrectanswerA)spleen B) lung C) bowel*** D) brain Patientswithacrushinjuryshouldbemonitoredforwhichofthefollowingconditions? Answer:CcorrectanswerA)Hypernatremia B) Hypercalcemia C) Dysrhthmias** D) polyuria Whatfindingraisessuspicionofcompletespinalcordinjury? Answer:BcorrectanswerA)Weaknessinthelowerextremities B) Priapism *** C) voluntaryanalsphinctertone D) intactreflexesdistaltotheinjury Apatientwithacompletespinalcordinjuryinneurogenicshockwilldemonstratehypotensionand which other clinical signs? Answer:DcorrectanswerA)Bradycardiaandipsilateralabsencesofmotorfunction B) Tachycardiaandrespiratorydepression

Book C) Tachycardiaandabsentmotorfunctionbelowthelevelofinjury

D) Bradycardiaandabsentmotorfunctionbelowtheleveloftheinjury*** A 5-year old child presents to the ED with bruisesto the upper arms and buttocks in variousstages of healingandmultiplesmall,clean,roundburnstotheback.Therearenoabnormalitiesfoundbasedon the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? Answer:AcorrectanswerA)reportyoursuspicionofthemaltreatmentinaccordancewithlocal regulations

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B) applyicetothebruisesandconsultwoundcare C) engageintherapeuticcommunicationtodeterminetheMOI D) providethefamilywithinjurypreventionresourse Apatientwithlowerextremityfracturecomplainsofseverepainandtightnessinhiscalf,minimally relieved by pain medications. Which of the following is the priority nursing intervention? Answer:CcorrectanswerA)elevatingtheextremityabovetheleveloftheheart B) repositioningandapplyice C) Elevatingtheextremitytotheleveloftheheart*** D) Preparingthepatientforultrasound A36-yearoldfemalehasadeformityoftheleftwristafterafall.Sheisreluctanttomoveherhanddue to pain. Which of the following is the most appropriate intervention? Answer:BcorrectanswerA)applyaslingandelevatetheextremitytotheleveloftheheart. B) applyasplintandELEVATEABOVETHELEVELOFTHEHEART*** C) Applyaslingandelevatetheextremityabovetheleveloftheheart

Book D) applyasplintandelevatetheextremitytotheleveloftheheart.

Whichofthefollowingisalatesignofincreasedintracranialpressure? Answer:C Cushing Response Wideningpulsepressure Reflex bradycardia Decreased RRcorrectanswerA)Restlessnessordrowsiness B) Nauseaandvomiting C) Decreasedrespiratoryeffort** D) amnesiaandanxiety Whichofthefollowingmnemonicscanhelpthenurseprioritizecareforatraumapatientwithmassive uncontrolled hemorrhage? Answer:BcorrectanswerA)ABC B) MARCH*** C) AVPU D) VIPP Apatientisthrownagainstacarduringatornadoandpresentswithobviousbilateralfemoralfractures. 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?

Book Answer:AcorrectanswerA)initiatetwolargecaliberintravenouslinesforRingerslactatesolution

administration *** B) AdministerDilaudidforpaincontrolandprovidecomfortcare C) Placethepatientinanobservationareaforcarewithinthenextfewhours D) Contactthecommandcenterforthepersonneltonotifynextofkin. A patient arrives with a large open chest wound after being assault ed with a machete, Prehospital providersplaced anonporous dressingoverthe chestwound andtapes iton3 sides. He is nowshowing signsofanxiety,restlessness,severerespiratorydistress,cyanosis,anddecreasingbloodpressure.Which of the following is the MOST appropriate interventions? Answer:CcorrectanswerA)needledecompression B) tubethoracostomy C) dressingremoval** D) surgicalrepair Apatientisfoundlyingonthefloorafterfalling13hoursago.Whichofthefollowinglabvaluesis expected with a musculoskeletal complication associated with this presentation? Answer:AcorrectanswerA)elevatedcreatinekinase*** B) decreasedpotassiumlevel C) decreasedWBC D) elevatedGFR A56-year-malepatientinvolvedinaMVCisbroughttotheEDofaruralcriticalaccessfacility.Hec/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows: BP 98/ HR125 beats/min

Book RR26breaths/min

SpO294%onhighflowO2viaNRBmask whichofthefollowingisthepriorityinterventionforthispatient? Answer:CcorrectanswerA)ExpeditetransporttotheCTscanner B) preparethepatientforspinalradiographs C) expeditetransfertotheclosesttraumacenter*** D) notifythepatientsfamily Caregiverscarrya2-yearoldintotheEDwhofelloutof2ndstorywindow.Thepatientisawakeand cryingwithincreased workof breathingandpale skin.whichofthe followinginterventions hasthe highest priority? Answer:AcorrectanswerA)paddingtheupperbackwhilestabilizingthecervicalspine*** B) applyingatight-fittingNRBmaskwithanattachedresevior C) establishingintravenousaccessandadministeringa20mL/kgbolus D) preparingfordrugassistedintubation Whichofthefollowingisacomponentofthetraumatriadofdeath? Answer:A hypothermia,metabolicacidosis,coagulopathycorrectanswerA)Acidosis** B) hyperthermia C) hemorrhage

Book D) sepsis

A35-yearoldmalepresentswithfacialtraumaafterbringstruckinthefacewithabaseball.atear-drop shaped left pupil is noted on exam. What type of injury is suspected? Answer:BcorrectanswerA)oculomotornervepalsy B) globerupture*** C) uncalherniation D) retinaldetachment Whichofthefollowingistrueaboutthelogrollmaneuver? Answer:CcorrectanswerA)itcauseslessspinalmotionthantheliftandslidemanuever B) itisrecommendedforpatientswithunstablepelvicfractures C) itcanworsencorddamagefromanunstablespinalinjury *** D) itdoesnotincreasestheriskoflifethreateninghemorrhagefromunstableinjuries EMSarriveswiththeintoxicateddriverofacarinvolvedinaMVC.EMSreportssignificantdamagetothe driverssideofthecar.Thepatientisaskingtohavethecervicalcolorremoved.whenisitappropriateto remove the cervical collar? Answer:AcorrectanswerA)afteraphysicalexaminationifthepatienthasnoradiologicabnormalitieson a computed tomography scan *** B) afterphysicianevaluationifthepatienthasnotneurologicabnormalitiesonexam C) afterpalpationofthespineifthepatienthasnopointtendernessthethevertebralcolumn D) afterphysicalexaminationifthepatienthasnotneckpainwithmovement

Book Tearingofthebridgingveinsismostfrequentlyassociatedwithwhichbraininjury?

Answer:BcorrectanswerA)epiduralhematoma B) subduralhematoma*** C) diffuseaxonalinjury D) intracerebralhematoma Ifapatienthasreceivedmultipletransfusionsofbankedbloodpreservedwithcitrate,whichelectrolyte is most likely to drop and require supplementation? Answer:DcorrectanswerA)potassium B) magnesium C) sodium D) calcium*** AtraumapatientisenroutetoaruralED.RadiologynotifiesthechargenursethattheCTscannerwillbe out of service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma teams communication? Answer:DcorrectanswerA)Brief B) loop C) debrief D) huddle*** Thenurseiscaringfora120kgmaleisbroughtinafterawarehousefireandiscalculatingthepatient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities andsuperficialburnstotheanteriorchest.UsingthemodifiedLundandBrowdercharttocalculatethe total BSA burned, how much IV fluids would be administered in the first 8 hours?

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(upperarm4+4/lowerarm3+3/hand2.5+2.5)=19%TBSA. 120kgx(2mL)x(19%TBSA)=4560mL 4560/2(halfoffluidsgiveninfirst8hours)=2280 mL Answer:AcorrectanswerA)2280mL*** B) 3840 mL C) 4560 mL D) 7680 mL WhichofthefollowingassessmentfindingsdifferentiatesatensionPTXfromasimplePTX? answer:D Assessmentfindingsassociatedwithtensionpneumothoraxincludeanxiety,severerestlessness,severe respiratorydistress,andabsentbreathsoundsontheinjuredside.Hypotensionduetocompressionof the heart and great vessels is consistent withobstructive shock. Hypotension worsens with inspiration duetoincreasedintrathoracicpressure.Latesignsincludedistendedneckveins,trachealdeviation,and cyanosis. correct answerA) increased work of breathing B) unilaterallydiminishedbreathsounds C) pleuriticchestpain D) hypotensionthatworsenswithinspiration*** Whichofthefollowingconsiderationsismostimportantwhencaringforageriatrictraumapatient?

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Answer:BcorrectanswerA)headtotoexam B) medicalhistory** C) incontinence D) falls Anintubatedtraumapatientisbeingtransferredtoatertiarycarecenter.Aftermovingthepatienttothe stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is the priority interventions? Answer:DcorrectanswerA)callforaportableCXRstat B) chesttomakesuretheventilatorispluggedin C) suctiontheET tube D) confirmETtubeplacement Whatfactorcontributesmostthekineticenergyofabodyinmotion? answer:CcorrectanswerA)acceleration B) mass C) velocity*** D) inertia Duringtheprimarysurveyofanunconsciouspatientwithmulti-systemtrauma,thenursenotessnoring respirations. Which priority nursing interventions should be performed next? Answer:DcorrectanswerA)opentheairwaywiththehead-tilt/chinliftmaneuver B) auscultatebilateralbreathsoundstoassessventilatorystatus

Book C) assistrespirationsusingaBVM

D) insertanoropharyngealairwayifthereisnogagreflex*** Followingareviewofrecentdrillsandarealdisasterevent,ahospitalhasidentifieddeficienciesandis takingstepstominimizethe impactof futuredisaster.Whichphaseofthe disaster lifecycle doesthis describe? Answer:AcorrectanswerA)mitigation*** B) preparedness C) response D) recovery Whichpulsepressuredescriptionisanindicationofearlyhypovolemicshock? Answer:BcorrectanswerA)widened B) narrowed*** C) bounding D) weak Themostreassuringfindingforamalepatientwithhoppainafterafalliswhichofthefollowing? Answer:DcorrectanswerA)anormalprostateexam B) absenceofabdominaldistension C) anormalfastexam D) pelvicstability***

Book A49-yearoldrestraineddriverinvolvedinaMVCpresentstothetraumacenterc/oabd,pelvic,andbil lower

extremity pain Vitals signs are stable. The nurse can anticipate all of these negative fast exam except which of the following? Answer: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 changesorhemodynamicchangesoccur.AnegativeFASTstudydoesnotruleoutinjuryandmaywarrant a follow-up computed tomography scan. Serial FAST exams can identify increasing abdominal fluid collectionsfromhemorrhage.Diagnosticperitoneallavage/diagnosticperitonealaspirationisperformed by the surgical team to rapidly identify the presence of hemorrhage in patients who are hemodynamically unstable after trauma. correct answerA) diagnostic peritoneal lavage *** B) serialfastexams C) abdominalandpelvicCTscans D) serialabdominalassessments Whichofthefollowingisanexpectedfindinginapatientwithathoracostomyconnectedtoachest drainage system? Answer:DcorrectanswerA)outputof200mL/hr B) tubingclampclosedfortransport C) dependentloopsinthetubingtopromotedrainage D) fluctuationsinthewaterserialchamber*** Whichofthefollowingpatientswarrantsreferraltoaburncenter?

Book Answer:CcorrectanswerA)a21-yearoldfemalewithapartialthicknessburntotherightforearm

B) a40-yearoldhypertensivemalewithasuperficialburntotheback C) a52-yearolddiabeticmalewithpartialthicknessburntotheleftlowerleg*** D) a35-yearoldhyperlipidemicfemalewithsuperficialburnstotheanteriorthorax. ApatienthasbeenintheEDforseveralhourswaitingtobeadmitted.Hesustainedmultipleribfractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. Hiswife 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? Answer:BcorrectanswerA)acutelunginjury B) fatembolism*** C) PTX D) pulmonarycontusion Whichistheeffectofhypothermiaontheoxyhemoglobindissociationcurve? Answer:AcorrectanswerA)Hemoglobindoesnotreadilyreleaseoxygenforusebythetissues*** B) Theamountofoxygenavailabletothetissuesincreases C) Tissue oxygenation(PaO2)increases D) Hemoglobinmoleculesaturation(SaO2)decreases A20-yearoldmalepresentstotheEDc/oseverelowerabdpainafterlandinghardonthebicyclecross bars which performing an aerial BMXmaneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurse questions? Answer:CcorrectanswerA)Fastexam

Book B) CTscan

C) straightcathforurinesample*** D) iceandelevationofthescrotum Youaretreatinga27-yearoldmaleinrespiratorydistresswhowasinvolvedinahousefire.Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation? Answer:BcorrectanswerA)1000mL/hr B) 500mL/hr*** C) 250mL/hr D) 125mL/hr Whichofthefollowingispossiblecomplicationofpositive-pressureventilation? Answer:AcorrectanswerA)worseningpneumothorax B) worseningflailchest C) reabsorptionofpleuralair D) negativeintrapleuralpressure WhichofthefollowingisNOTconsideredgoal-directedtherapyofcardiogenicshock? Answer:CcorrectanswerA)controlledfluidboluses B) antidysrhythmicadministration C) pericardiocentesis*** D) cardiaccath

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Whatbedsidemonitoringparametersareusedtoassessforadequacyofoxygenationandeffectiveness of ventilation? Answer:AcorrectanswerA)pulseoximetryandcapnogaphy** B) respiratoryrateandcapnography C) pulseoximetryandrespiratoryrate D) capnographyandcapnometry Whichifthefollowingvaluesindicatestheneedforalcoholwithdrawalinterventions? Answer:AcorrectanswerA)CIWA-Arof36*** B) GCS 13 C) ETCo2of48mmHg D) heartrateof45beats/min Anunresponsivetraumapatienthasanoropharyngealairwayinplace,shallowandlaboredrespiratory, 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:AcorrectanswerA)VentilatewithaBVM*** B) Prepareforcricothyroidotomy C) administerreversalmedications D) contactanesthesiaforassistance Thetraumanurseknowsthatplacingabariatricpatientsina"rampedposition"providesbetter visualization during the insertion of which device?

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Answer:CcorrectanswerA)Intraosseousline B) orogastrictube C) ETtube*** D) urinarycatheter You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your secondarysurveyincludeabdpainonpalpation,fundalhighatthecostalmargin,andsomedarkbloody show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are most consistent with which of the following? Answer:AcorrectanswerA)placentalabruption*** B) pretermlabor C) uterinerupture D) fetaldemise