Download TNCC STUDY GUIDE 2025| BRAND NEW ACTUAL EXAM. and more Exams Nursing in PDF only on Docsity!
TNCC STUDY GUIDE 2025| BRAND NEW
ACTUAL EXAM WITH 100% VERIFIED
QUESTIONS AND CORRECT SOLUTIONS|
GUARANTEED VALUE PACK| ACE YOUR
GRADES.
Describe the care of an amputated part - correct answer - - Keep the amputated part cool by wrapping it in slightly saline-moistened sterile gauze, and then place it in a sealed plastic bag
- The bag containing the amputated part is then placed in a second bag containing ice water
- Do not allow the amputated part to freeze or be submerged in liquid
- Label the bag with appropriate patient identifiers
- Administer antibiotics as ordered
- Administer tetanus prophylaxis according to current CDC guidelines Abrasion - correct answer - - A partial or full thickness wound that denudes the skin
- Commonly occurring with falls and bicycle or motorcycle collisions
- Can be mild to severe
- Road burn or abrasions, resulting in a low side crash or laying down a motorcycle--large surface area Avulsion - correct answer - - Full thickness wounds caused by a tearing or ripping of skin and soft tissue
- Wound edges are not well approximated
- Often fingers, scalps, noses and can occur as a result of working with machinery or from MVCs
- Degloving Contusion - correct answer - - A closed wound in which a ruptured blood vessel or capillary bed hemorrhages into the surrounding tissue Hematoma - correct answer - - A hematoma occurs when blood leaks under the skin surface and often forms a palpable mass (blood clot) under the skin Laceration - correct answer - - Open wounds that result from shearing forces through the dermis and epidermis with potential
- Guard against further injury to the area, affected extremities can be splinted
- Prevent or limit the risk of thrombus formation
- Early trials the use of tPA has been effective in maintaining perfusion and decreasing the need for amputation Describe signs of burns to the airway that may indicate airway edema - correct answer - Burns to tissue can cause massive edema and airway edema is life threatening. A hoarse voice, carbonaceous sputum, burns around the mouth or nares, stridor may indicate burns to the airway What burn injuries meet the criteria for admission to a burn center? - correct answer - 1. Partial thickness burns greater than 10% TBSA
- Burns that involve the face, hands, feet, genitalia, perineum, or major joints
- 3rd degree burns in any age group
- Electrical burns, including lightning injury
- Chemical burns
- Inhalation injury
- Burn injury in patients with pre-existing medical disorder that could complicate management, prolong recovery, or affect mortality
- Any patient with burns or concomitant (fractures) in which the burn injury poses the greatest risk of morbidity or mortality
- Burned children in hospitals without qualified personnel or equipment for the care of children
- Burn injury in patients who will require special social, emotional, or rehab interventions What complications are associate with electrical burns? - correct answer - - AC: can cause tetany, which can cause tightening on the grip and longer exposure
- The higher the voltage, the greater the degree of internal thermal injury
- Cardiac dysrhythmias Discuss the importance of temperature regulation with burns - correct answer - Maintenance of body temperature is crucial in patients with burns since they have lost all their protective skin barrier Differentiate between the resuscitation replacement guidelines for thermal burns > 20% and electrical burns - correct answer - - Begin fluid resuscitation with ringer's lactate solution at 2 mL/kg/percentage of TBSA
What tools can be used to promote communication within a team member? What are the benefits of each? - correct answer - 1. SBAR: Situation, Background, Assessment, Recommendations- To provide a framework for communication among members of the healthcare team
- DESC: Describe the specific situation or behavior, Express your concerns or how the situation makes you feel, Suggest alternatives and seek agreement, state Consequences in terms of impact on performance goals-Used in conflict management, paraphrasing the other person's comments is an important technique that should be done throughout the DESC support
- CUS: I am Concerned, I am Uncomfortable, This is a Safety issue/I am Stressed-Used to "stop the line" if a team member senses or discovers an essential safety breach Kinematics - correct answer - The study of energy transfer as it applies to identifying actual or potential injuries Biomechanics - correct answer - The general study of forces and their effects
Mechanism of Injury - correct answer - How external energy forces in the environment are transferred to the body Newton's First Law of Motion - correct answer - A body rest will remain at rest, and a body in motion will stay in motion Newton's Second Law of Motion - correct answer - Force = mass x acceleration Newton's Third Law of Motion - correct answer - For every action, there is an equal and opposite reaction Law of Conservation of Energy - correct answer - Energy can neither be created nor destroyed, but can change form Describe how Newton's Laws of Motion and the Law of Conservation affect energy transfer in traumatic injury, and give an example - correct answer - - 1st: weight and speed are reasonable substitutions for mass and velocity, higher mass and/or higher speed delivers greater energy
What are the five forms in which energy exist? - correct answer -
- Mechanical: energy transfer form one object to another in the form of motion
- Thermal: energy transfer of heat in the environment to the host
- Chemical: heat energy transfer from active chemical substances, chlorine, drain cleaner, acids, or plants
- Electrical: energy transfer from light socket, power lines, or lightning
- Radiant: energy transfer from blast sound waves, radioactivity such as a nuclear facility, or rays of the sun Differentiate between internal and external forces of energy transfer in the context of trauma - correct answer - External forces:
- Can be exerted on the body by deceleration, acceleration, compression forces
- Deceleration forces include those applied in falls and collisions where injuries are cause by a sudden stop in the body's motion
- Acceleration forces are not as common as deceleration forces and result from a sudden and rapid onset of motion, like a parked car that is hit y vehicle traveling at the high rate of speed
- Compression force is an external force applied at time of impact, like stationary objects-dashboards or steering wheels that collide with or push up into a person. Objects in motion-bullets, stabbing, bats, balls, fists and feet, or heavy falling objects
- Blast forces Internal forces:
- Stress describes the internal force that resists the applied external force
- Stress is exerted on the body as tissues and organs change their dimensions
- Body tissues respond differently to energy impact, and the capacity to withstand energy transfer is based on the characteristics, combined with biomechanics and MOIs
- The strength of bone varies and can be augmented by adjacent muscle systems
- Solid organs tolerated pressure-wave energy better than air-filled organs
- Air-filled organs can often resist shear forces better than solid organs How do internal forces protect the body from injury? - correct answer - - Compression strength: ability of tissue to resist crush injury or force
- Tensile strength: ability to resist being pulled apart when stretched
List the four main types of traumatic injury and give an example of each - correct answer - 1. Blunt trauma: falls, MVA, vehicle vs. pedestrian collisions, assaults
- Penetrating trauma: gunshots, cavitation
- Thermal trauma: burns
- Blast trauma: explosions Differentiate between deceleration and acceleration forces - correct answer - Deceleration forces: occurs as energy that is dispersed from the moving object. For example, a body sliding across pavement transfers energy to the pavement through friction Acceleration forces: the sample principles used to describe deceleration forces apply to acceleration forces. For example, as energy is slowly transferred to the stationary pieces of gravel, the gravel accelerates while the body and internal organs continue to travel as a single entity What environmental and pathophysiologic factors are considered when the mechanism of injury is a fall? - correct answer - Consider the old adult who becomes dizzy and falls from a standing position. The energy transfer begins as the patient begins to fall through the air. When the patient falls to the ground, the impact of the ground or floor causes energy to transfer and injuries related to the following:
- The point of impact on the patient's body (head, hip, outstretched arm) determines the major point of energy transfer and underlying injuries or tissues impacted
- The type of surface that is hit (tile floor, grassy yard, carpeted floor) and the extent that surface can absorb the energy affects injuries. Carpet and grass can help to absorb energy, but tile does not
- The tissue's ability to resist also affects potential injuries, bone is less flexible than soft tissue. Air-filled organs may rupture; solid organs may fracture
- If a person is pushed or accidentally knocked down, acceleration increases, causes additional transfer of energy, and results in a greater impact on deceleration Describe the three impacts in the motor vehicle impact sequence
- correct answer - 1. The first impact occurs when the vehicle hits another object such asa tree. The occupants experience a relative acceleration as the vehicle stops over the distance of the crushing metal, but they have not begun to absorb the energy if the abrupt vehicle stop
- The second impact occurs when the vehicle occupant collides with the interior of the vehicle, yet the internal organs continue in motion. After the initial impact, the occupant continues to move in the original direction of travel until they collide with the interior of the vehicle or meet the resistance of a seatbelt or airbag
- The third impact occurs when internal structures collide within the body cavity. The organs meet the resistance of the structures
- Places emphasis of countermeasures, which are more effective on changing human behavior
- Led to the introduction of passive restraints, airbags, vehicle design, and road blueprints as opposed to active restraints
- Describes three phases of the injury event: pre-event, the event, and post-event
- For each phase of the event, countermeasures for prevention can be applied
- They include the host (human), the agent (motor vehicle), and the physical environment (socioeconomic environment) Example Pre-event:
- Host: driver is studying for exams and did not get much sleep
- Agent: motor vehicle is old, small and not well designed for crash protection
- Physical environment: it is raining
- Socioeconomic environment: driver was at. party and had 2- 3 drinks Event:
- Host: driver did not see the sign to slow down for a curve ahead
- Agent: vehicle tires are worn
- Physical environment: the exit ramp roadway slants outward and not inward (centrifugal force)
- Socioeconomic environment: occupants are arguing and radio has loud music playing Post-event:
- Host: driver has a history of diabetes
- Agent: seats break apart and occupants trapped
- Physical environment: temperature below 38 F
- Socioeconomic environment: people drive by but delay in notifying 911 Fill in the blanks of the steps of initial assessment: Preparation and _____ Across-the-room observation to identify any uncontrolled ___________ and reprioritize to ___________________ - correct answer - Preparation and triage Across-the-room observation to identify any uncontrolled hemorrhage and reprioritize to CABC Primary survery - correct answer - A-Airway and Alertness with simultaneous cervical spine stabilization B-Breathing and ventilation
Reevaluation and post resuscitation care Definitive care or transfer Why is there repeated emphasis on assessment for hemorrhage throughout the initial assessment? - correct answer - Uncontrolled hemorrhage is the major cause of preventable death after injury Which tool can be used to rapidly assess the LOC during A- Airway and Alertness step? Why is it important to determine alertness along with airway? What are the components of this tool? - correct answer - A - Alert V - Verbal stimuli; if verbal stimuli needed to respond, an airway adjunct may be needed to keep to keep tongue from obstructing airway P - Responds to pain; if pt responds only to pain, may need airway adjunct while determining need for intubation U - Unresponsive; announce loudly to team; get someone to check for pulse while you assess airway Uses LOC to determine need for airway
Airway may be compromised with V,P, or U What method of opening airway is recommended for use in trauma? - correct answer - Jaw thrust Describe the current guidelines for volume resuscitation in hemorrhagic shock - correct answer - Component therapy is now suggested for fluid resuscitation to replace patient losses, including administer red blood cells, plasma, and platelets. This balanced approach to resuscitation includes massive transfusion so that oxygen delivery is optimized, acidosis is correct, coagulopathy is prevented, and damage control surgery is performed Exposure and environmental control is included in the Primary survey. Why is it such a high priority? - correct answer - Hypothermia combined with hypotension and acidosis is a potentially lethal combination in the injured patient. This assessment parameter is intentionally placed in the primary survey in order to assure that aggressive measures are taken to prevent the loss of body heat
