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A practice exam or study guide for the trauma nursing core course (tncc) exam. It contains a series of multiple-choice questions and answers related to various trauma nursing topics, such as assessment and management of trauma patients, including vital signs, airway management, hemorrhage control, and neurological evaluation. The questions cover a wide range of trauma-related scenarios and require the test-taker to demonstrate their knowledge and critical thinking skills in providing appropriate nursing interventions. This document could be a valuable resource for nursing students or professionals preparing for the tncc exam, as it provides a comprehensive review of the key concepts and principles in trauma nursing practice.
Typology: Exams
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The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following? A. Decompensated shock B. Normal vital signs in pregnancy C. Compensated shock D. Supine hypotension syndrome - Correct Answer-Normal sings in pregnancy 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 only to the assault. D. Provide food and drink to help create rapport. - Correct Answer-Use direct quotes to record information What is the appropriate technique for palpating the pelvis for stability? A. Apply gentle pressure over the iliac crests, downward and laterally. B. Apply gentle pressure over the iliac crests, downward and medially. C. Apply firm pressure over the iliac crests, downward and laterally. D. Apply firm pressure over the iliac crests, downward and medially. - Correct Answer- B. Apply gentle pressure over the iliac crests, downward and medially. Treatment for frostbite can include which of the following interventions? A. Warm the affected part over 30 to 60 minutes B. Use gentle friction to improve circulation C. Administer tissue plasminogen activator D. Leave all of the blisters intact - Correct Answer-Administer tissue plasminogen activator What is the leading cause of preventable death for the trauma patient in the prehospital environment? A. Airway compromise B. Ineffective ventilation C. Secondary head injury D. Uncontrolled external hemorrhage - Correct Answer-Uncontrolled external hemorrhage Which of the following accurately describes ventilation principles associated with use of a bag-mask device for an adult?
A. Compress the bag-mask device at a rate of one breath every 6 seconds. B. Delivers 100% oxygen. C. Squeeze the bag-mask device completely for each breath. D. Maintain the oxygen saturation levels between 92% and 94%. - Correct Answer- Compress the bag-mask device at a rate of one breath every 6 seconds. A adult patient with a knife injury to the neck has an intact airway and is hemodynamically stable. They complain of difficulty swallowing and speaking. In the primary survey, further assessment is indicated next for which of the following conditions? A.Damage to the cervical spine B.An expanding pneumothorax C.Laceration of the carotid artery D.Injury to the thyroid gland - Correct Answer-Damage to cervical spine 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-Secondary Understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the trauma care provider in which of the following? A. Anticipating the types of injuries 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-Anticipating the types of injuries that may be present The general impression step in the initial assessment provides the opportunity to do which of the following? 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-Reprioritize circulation before airway or breathing. A patient with a spinal cord injury at C5 is being cared for in the emergency department while awaiting transport to a trauma center. Which of the following represents the highest priority for ongoing assessment and management for this patient? A.Maintain adequate respiratory status. B.Administer balanced resuscitation fluid. C.Perform serial assessments of neurologic function. D.Maintain core temperature. - Correct Answer-Maintain adequate respiratory status
In a patient with severe traumatic brain injury, hypocapnia causes which condition? A.Respiratory acidosis B.Metabolic acidosis C.Neurogenic shock D.Cerebral vasoconstriction - Correct Answer-Cerebral Vasoconstriction A trauma nurse cared for a child with devastating burns two weeks ago. The nurse 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.They are talking about taking the emergency nursing certification examination. B.They keep requesting to be assigned to the walk-in/ambulatory area. C.They are impatient and snap at their coworkers. D.They are thinking about transferring out of the emergency department. - Correct Answer-They are talking about taking the emergency nursing certification examination 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 sign of possible altered mental status? A.Sunken fontanel B.Crying, but consolable C.Spontaneous movement of arms and legs D.Cooperation with the assessment - Correct Answer-Cooperates with assessment. Which of the following is considered a cornerstone of a high-performance trauma team? A.Individual goals B.Use of TeamSTEPPS C.Identification of a single decision maker D.Effective communication - Correct Answer-Effective communication What is the best measure of the adequacy of cellular perfusion and can help to predict the outcome of resuscitation? A.End-tidal carbon dioxide B.Hematocrit level C.Base deficit D.Oxygen saturation - Correct Answer-Base deficit. 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. What is the best position for maintaining an open airway in the obese patient? A.Prone B.Supine C.Reverse Trendelenburg D.Right lateral recumbent - Correct Answer-The reverse Trendelenburg position will benefit both airway maintenance and work of breathing in the obese patient.
A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn't sleep because a young child kept coming into the room. What is the most likely cause for these signs and symptoms? A. Increased intracranial pressure B. Alcohol withdrawal C. Rhabdomyolysis D. Pulmonary embolus - Correct Answer-B- Alcohol withdrawal A: Signs of increased intracranial pressure include headache, nausea and vomiting, amnesia, behavioral changes, and altered level of consciousness. B: 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, transient hallucinations, or seizures. C: Signs of rhabdomyolysis include muscle pain or weakness, dark red or brown urine, general weakness or malaise, and elevated creatinine kinase levels. D: Signs of pulmonary embolus include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distension, or hypotension. A patient arrives at the emergency department by private vehicle after sustaining an injury to the right lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant bleeding. What is the priority intervention? A.Elevate the extremity to the level of the heart B.Initiate direct pressure C.Apply a tourniquet D.Cover the open wound with sterile saline dressings - Correct Answer-B. The first step in controlling any bleeding is application of direct pressure. A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest. Which concurrent injury is most commonly associated with this fracture? A.Blunt cardiac injury B.Brachial plexus injury C.Pneumothorax D.Hemothorax - Correct Answer-B: First and second rib fractures are most commonly associated with great vessel, head and spinal cord, and brachial plexus injuries.