TNCC Practice Exam with Rationale 20 Questions with Verified Answers,100% CORRECT, Exams of Nursing

Download TNCC Practice Exam with Rationale 20 Questions with Verified Answers,100% CORRECT and more Exams Nursing in PDF only on Docsity! TNCC Practice Exam 20 Questions with Verified Answers What is the key to a high-performance trauma team? a. Individual goals b. Use of Team STEPPS c. Identification of a single decision maker d. Effective communication - CORRECT ANSWER d. Effective communication Rationale: Skilled communication, cooperation, and coordination are the cornerstones of high-performance teams and high-quality trauma care (p. 5). When obtaining a history for an injured patient, understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the trauma provider in: a. Evaluating and anticipating the types of injury that may be present b. Deciding whether law enforcement should be notified c. Determining needed laboratory tests d. Predicting the need for a surgical procedure - CORRECT ANSWER a. Evaluating and anticipating the types of injury that may be present Rationale: Mechanism of injury and energy transfer can assist the provider in evaluating and anticipating damage (p. 23). The major preventable cause of death in the trauma patient is: a. Airway compromise b. Ineffective ventilation c. Secondary head injury d. Uncontrolled hemorrhage - CORRECT ANSWER d. Uncontrolled hemorrhage Rationale: Uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment to identify uncontrolled hemorrhage is key to the initial assessment process (p. 29). The across-the-room observation step in the initial assessment provides the opportunity to: a. Assess for uncontrolled internal hemorrhage b. Accurately triage the patient c. Reprioritize circulation before airway or breathing d. Activate the trauma team - CORRECT ANSWER c. Reprioritize circulation before airway or breathing. Rationale: The across-the-room observation is done at the beginning of the primary survey to rapidly assess the need to reprioritize circulation before airway or breathing. This is done if uncontrolled external hemorrhage is identified (p. 28). Which of the following accurately describes ventilation principles associated with a bag-mask device? a. Ventilate at a rate of 10 to 12 breaths/minute b. Deliver 100% oxygen c. Compress the bag-mask device completely d. Maintain the oxygen saturation level between 92% and 94% - CORRECT ANSWER a. Ventilate at a rate of 10 to 12 breaths/minute Rationale: If ventilation is ineffective, assist ventilations at 10 to 12 breaths/minute or one every 5 to 6 seconds (p. 32). Which of the following is the best measure of the adequacy of cellular perfusion and helps to predict the outcome of resuscitation? a. End-tidal carbon dioxide b. Hypoxia c. Base deficit d. Oxygen saturation - CORRECT ANSWER c. Base deficit Rationale: Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and when used in conjunction with serum lactate helps predict the success of the resuscitation (p. 57). What is a safe pharmacological alternative to opioids for rib fracture pain management in the anticoagulated patient? a. Corticosteroids b. Intercostal nerve blocks c. Nonsteroidal anti-inflammatory drugs d. Epidural anesthetics - CORRECT ANSWER b. Intercostal nerve blocks Rationale: Continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and effective pain management for the anticoagulated patient (pp. 271, 273). In a patient with severe traumatic brain injury, hypocapnia causes: While performing an assessment on a 13-month-old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a potential sign of mental status changes? a. Sunken fontanel b. Crying, but consolable c. Hyperglycemia d. Cooperation with the assessment - CORRECT ANSWER d. Cooperation with the assessment Rationale: An alert older infant or toddler will recognize his or her caregiver, be cautious of strangers, and may not respond to commands, which is a normal response (p. 235). What is the best position for maintaining an open airway in the bariatric patient? a. Prone b. Supine c. Reverse Trendelenburg d. Right lateral recumbent - CORRECT ANSWER c. Reverse Trendelenburg Rationale: The reverse Trendelenburg position will benefit both airway maintenance and work of breathing in the bariatric patient (p. 285). The nurse is obtaining a history for a patient who presents following sexual assault. This history is completed using which of the following techniques? a. Bring the family in to the interview room b. Use direct quotes to record information c. Obtain information specific to the assault, not what happened afterward d. Provide food and drink before creating a rapport - CORRECT ANSWER b. Supine Rationale: In the supine position, the chest and diaphragm can become obstructed due to excess abdominal mass, hindering effective ventilation. The reverse Trendelenburg position, not the supine position, will benefit both airway maintenance and work of breathing in the bariatric patient (p. 281, 285). A trauma nurse cared for a child with devastating burns two weeks ago. She called in sick for a couple of days and is now back working on the team. Which of the following behaviors would indicate this nurse is coping well? a. She is talking about taking the emergency nursing certification examination b. She keeps requesting to be assigned to the walk-in/ambulatory area c. She is impatient and snaps at coworkers d. She is thinking about transferring out of the emergency department - CORRECT ANSWER a. She is talking about taking the emergency nursing certification examination Rationale: This is an indication she is taking positive steps to advance her own practice, a sign of resilience (p. 338). Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment are examples of which phase of injury? a. Primary b. Secondary c. Tertiary d. Quaternary - CORRECT ANSWER b. Secondary Rationale: The secondary phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries (p. 20). A patient fell two weeks ago, striking his head. He came to the emergency department with a persistent headache and nausea. He was diagnosed with a small subdural hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports that he has been anxious, restless, and shaky. He vomited twice during the night. He tells the day shift nurse that he couldn't sleep because a young child kept coming into his room. What is a likely cause for these signs and symptoms? a. Increased intracranial pressure b. Alcohol withdrawal c. Rhabdomyolysis d. Pulmonary embolus - CORRECT ANSWER b. Alcohol withdrawal Rationale: Alcohol withdrawal is a common delayed condition because symptoms are difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting, psychomotor agitation, anxiety, insomnia, hallucinations, or seizures (p. 397).