TNCC Test Prep: Trauma Nursing Questions and Answers, Exams of Nursing

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Expedite |transfer |to |the |closest |trauma |center |- |correct |answer-A | 56 |y/o |M |pt |involved |in |a |motor | vehicle |crash |is |brought |to |the |ED |of |a |rural |critical |access |facility. |He |complains |of |neck |pain, |SOB, | and |diffuse |abd |pain. |His |GCS |is |15. |His |VS: |BP |98/71, |HR |125, |RR |26, |SpO2 |94% |on |high-flow |O2 |via | NRB |mask. |Which |of |the |following |is |the |priority |intervention |for |this |patient? a |pertinent |medical |hx |is |crucial |- |correct |answer-Which |of |the |following |considerations |is |the |most | important |when |caring |for |a |geriatric |trauma |pt? Mitigation |- |correct |answer-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 |a |future |disaster |. |Which | phase |of |the |disaster |life |cycle |does |this |describe? Multiple |requests |for |water |- |correct |answer-EMS |brings |a |pt |who |fell |while |riding |his |bicycle. |Using | the |American |College |of |Surgeobs |screening |guidelines, |which |assessment |finding |would |prompt |the | RN |to |prepare |the |pt |for |a |radiologic |spine |clearance? hemoglobin |does |not |readily |release |O2 |for |use |by |the |tissues |- |correct |answer-What |is |the |effect |of | hypothermia |on |the |oxyhemoglobin |dissociation |curve? acidosis |- |correct |answer-Which |of |the |following |is |a |component |of |the |trauma |triad |of |death? Complete |- |correct |answer-EMS |brings |a |pt |from |MVC. |VS: |BP |90/49, |HR |48, |RR |12, |temp |97.2F |(36.2 | C). |The |pt |exhibits |urinary |incontinence |and |priapism. |These |assessment |findings |are |most |consistent | with |which |of |the |following |types |of |spinal |cord |injury? flucuation |in |the |water |seal |chamber |- |correct |answer-Which |of |the |following |is |an |expected |finding | in |a |pt |with |a |tube |thoracstomy |connected |to |a |chest |drainage |system?

insert |an |oropharyngeal |airway |if |there |is |no |gag |reflex |- |correct |answer-During |the |primary |survey |of |an |unconscious |pt |with |multi-system |trauma, |the |nurse |notes |snoring |respirations. |What |priority | nursing |interventions |should |be |preformed |next? globe |rupture |- |correct |answer-A | 35 |y/o |M |presents |with |facial |trauma |after |being |struck |in |the |face | with |a |baseball. |A |teardrop-shaped |left |pupil |is |noted |on |exam. |What |type |of |injury |is |suspected? compensated |- |correct |answer-A |trauma |pt |is |restless |and |repeatedly |asking |"where |am |i?" |VS |upon | arrival: |BP |110/60, |HR96, |RR |24. |Her |skin |is |cool |and |dry. |Current |VS |are |BP |104/84, |HR |108, |RR |28. | The |pt |is |demonstrating |s/sx |of |which |stage |of |shock? ventilate |with |a |bag |mask |device |- |correct |answer-An |unresponsive |trauma |pt |has |an |oropharygeal | airway |in |place, |shallow |and |labored |respirations, |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? within | 24 |hrs |of |trauma |- |correct |answer-When |is |the |tertiary |survey |completed |fora |trauma |pt? pressure |- |correct |answer-An |intubated |and |sedated |pt |in |the |ED |has |multiple |extremity |injuries |with | the |potential |for |causing |compartment |syndrome. |What |is |the |most |reliable |indication |of | compartment |syndrome |in |a |patient |who |is |unconscious? worsening |pneumothorax |- |correct |answer-Which |of |the |following |is |possible |complication |of | positive-pressure |ventilation? pelvic |stability |- |correct |answer-the |most |reassuring |finding |for |a |male |pt |with |hip |pain |after |a |fall |is | which |of |the |following? narrowed |- |correct |answer-Which |of |the |following |pulse |pressures |indicate |early |hypovolemic |shock? dysrhythmias |- |correct |answer-Patients |with |a |crush |injury |should |be |monitored |for |which |of |the | following |conditions?

subdural |hematoma |- |correct |answer-Tearing |of |the |bridging |veins |is |most |frequently |associated |with | which |brain |injury? straight |cath |for |urine |sample |- |correct |answer-A | 20 |y/o |M |presents |to |the |ED |complaining |of |severe | lower |abd |pain |after |landing |hard |on |the |bicycle |cross |bars |while |preforming |an |aerial |BMX | maneuver. |Secondary |assessment |reveals |lower |abd |tenderness |and |scrotal |ecchymosis. |Which |of |the |following |orders |would |the |RN |question? placental |abruption |- |correct |answer-You |are |caring |for |a |pt |who |was |involved |in |a |MVC |and |is | 32 | weeks |pregnant. |Findings |of |your |secondary |survey |include |abd |pain |on |palpation, |fundal |ht |at |the | costal |margin, |and |some |dark |bloody |show. |Varying |accelerations |and |decelerations |are |noted |on | cariocgraphy. |These |findings |are |most |consistent |with |which |of |the |following? it |can |worsen |cord |damage |from |an |unstable |spinal |injury |- |correct |answer-Which |of |the |following |is | true |about |the |log-roll? defusings |- |correct |answer-All |of |these |are |considered |a |critical |communication |point |in |trauma |care | EXCEPT |which |of |the |following? pulse |oximetry |and |capnography |- |correct |answer-What |bedside |monitoring |parameters |are |used |to | assess |for |adequacy |of |O2 |and |effectiveness |of |ventilation? padding |the |upper |back |while |stabilizing |the |cervical |spine |- |correct |answer-Caregivers |carry |in |a | 2 | y/o |into |the |ED |who |fell |out |of |a |second-story |window. |The |pt |is |awake |and |crying |with |increased | work |of |breathing |and |pale |skin. |Which |of |the |following |interventions |has |the |highest |priority? bowel |- |correct |answer-Which |of |the |following |injuries |is |LEAST |likely |to |be |promptly |identified? Initiate |transfer |to |a |trauma |center |- |correct |answer-A |pt |is |brought |to |the |ED |of |a |rural |hospital | following |a |high-speed |MVC. |When |significant |abd |and |pelvic |injuries |are |noted |in |the |primary | survey, |which |of |the |following |is |the |priority |interventions?

bardycardia |and |absent |motor |function |below |the |level |of |injury |- |correct |answer-A |pt |with |a | complete |spinal |cord |injury |in |neurogenic |shock |will |demonstrate |hypotension |and |which |other | clinical |signs? apply |splint |and |elevate |above |the |level |of |the |heart |- |correct |answer-a | 37 |y/o |F |has |a |deformity |of | the |L |wrist |after |a |fall. |She |is |reluctant |to |move |her |hand |due |to |pain. |Which |of |the |following |is |the | most |appropriate |intervention? the |aorta |is |torn |at |its |attachment |with |the |ligamentum |arteriosum |- |correct |answer-which |of |the | following |occurs |during |the |third |impact |of |a |motor |vehicle |crash? Report |your |suspicion |of |maltreatment |in |accordance |with |local |regulations |- |correct |answer-a | 5 |y/o | child |presents |to |the |ED |with |bruises |to |the |upper |arm |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 |survey. |Which | of |the |following |is |the |priority |nursing |intervention? to |guage |end-organ |perfusion |and |tissue |hypoxia |- |correct |answer-Why |is |a |measure |of |serum |lactate |obtained |in |the |initial |assessment |of |a |trauma |patient? elevating |the |extremity |to |the |level |of |the |heart |- |correct |answer-A |pt |with |a |lower |extremity |fracture |complains |of |severe |pain |and |tightness |in |his |calf, |minimally |by |pain |medications. |Which |of |the | following |is |the |priority |nursing |intervention? velocity |- |correct |answer-What |factor |contributes |most |to |the |kinetic |energy |of |a |body |in |motion? subdural |hematoma |- |correct |answer-An |elderly |patient |with |a |history |of |anticoagulant |use |presents | after |a |fall |at |home |today. |She |denies |any |loss |of |consciousness. |She |has |a |hematoma |to |her | forehead |and |complains |of |headache, |dizziness, |and |nausea. |What |is |the |most |likely |cause |of |her | symptoms? fat |embolism |- |correct |answer-a |pt |has |been |in |the |ED |for |several |hrs |waiting |to |be |admitted. |He | sustained |multiple |rib |fractures |and |a |femur |fracture |after |a |fall. |He |has |been |awake, |alert, |and | complaining |of |leg |pain. |His |wife |reported |that |he |suddenly |became |anxious |and |confused. |Upon |

reassessment, |the |pt |is |restless |with |respiratory |distress |and |petechiae |to |his |neck. |The |pt |is | exhibiting |s/sx |most |commonly |associated |with |which |of |the |following |conditions? nausea |and |vomiting |- |correct |answer-Which |of |the |following |is |a |late |sign |of |increased |intracranial | pressure? serial |FAST |exams |- |correct |answer-a | 49 |y/o |restrained |driver |involved |in |a |MVC |presents |to |the | trauma |center |complaining |of |abd, |pelvic, |and |bilateral |lower |extremity |pain. |VS |are |stable. |The |nurse |can |anticipate |all |of |these |after |a |negative |FAST |exam |EXCEPT |which |of |the |following? pericardiocentesis |- |correct |answer-Which |of |the |following |is |NOT |considered |goal-directed |therapy | for |cardiogenic |shock? endotracheal |tube |- |correct |answer-The |trauma |nurse |knows |that |placing |a |bariatric |patient |in |a | ramped |position |providers |better |visualization |during |the |insertion |of |which |device? increased |work |of |breathing? |- |correct |answer-which |of |the |following |assessment |findings | differentiates |a |tension |pneumothorax |from |a |simple |pneumothorax? calcium |- |correct |answer-if |a |pt |has |received |multiple |transfusions |of |banked |blood |preserved |with | citrate, |which |electrolyte |is |most |likely |to |drop |and |require |supplementation? identifying |individuals |who |made |mistakes |during |the |traumatic |event |- |correct |answer-Which |of |the | following |is |NOT |considered |a |benefit |of |debriefings? 500 |mL/hr |- |correct |answer-You |are |treating |a | 27 |y/o |M |in |respiratory |distress |who |was |involved |in |a |house |fire. |Calculating |TBSA |burned |is |deferred |due |to |the |need |for |emergent |intubation. |At |what | rate |should |you |begin |fluid |resuscitation? advanced |age |- |correct |answer-Which |of |the |following |is |most |likely |to |contribute |to |inadequate | oxygenation |and |ventilation?

a | 52 |y/o |diabetic |male |with |a |partial |thickness |burn |to |the |left |lower |leg |- |correct |answer-Which |of | the |following |patients |warrants |referral |to |a |burn |center? dressing |removal |- |correct |answer-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 |taped |it |on |three |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 | immediate |intervention? after |a |physical |examination |if |the |pt |has |no |radiologic |abnormalities |on |CT |- |correct |answer-EMS | arrives |with |the |intoxicated |driver |of |a |car |involved |in |a |MVC. |EMS |reports |significant |damage |to |the | drivers |side |of |the |car. |The |pt |is |asking |to |have |the |cervical |collar |removed. |When |it |is |appropriate |to |remove |the |cervical |collar? MARCH |- |correct |answer-Which |of |the |following |mnemonics |can |help |the |nurse |prioritize |care |for |a | trauma |patient |with |massive |uncontrolled |hemorrhage?