TNCC Test Prep: Questions and Answers for the Written Exam, Exams of Nursing

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TNCC Prep, TNCC EXAM, TNCC 8th

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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? - ANSWER>>Expedite transfer to the closest trauma center Which of the following considerations is the most important when caring for a geriatric trauma pt? - ANSWER>>a pertinent medical hx is crucial 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? - ANSWER>>Mitigation 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? - ANSWER>>Multiple requests for water What is the effect of hypothermia on the oxyhemoglobin dissociation curve? - ANSWER>>hemoglobin does not readily release O2 for use by the tissues Which of the following is a component of the trauma triad of death? - ANSWER>>acidosis 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? - ANSWER>>Complete Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system? - ANSWER>>flucuation in the water seal chamber

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? - ANSWER>>insert an oropharyngeal airway if there is no gag reflex 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? - ANSWER>>globe rupture 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? - ANSWER>>compensated An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drugassisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? - ANSWER>>ventilate with a bag mask device When is the tertiary survey completed fora trauma pt? - ANSWER>>within 24 hrs of trauma 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? - ANSWER>>pressure Which of the following is possible complication of positive-pressure ventilation? - ANSWER>>worsening pneumothorax the most reassuring finding for a male pt with hip pain after a fall is which of the following? - ANSWER>>pelvic stability Which of the following pulse pressures indicate early hypovolemic shock? - ANSWER>>narrowed Patients with a crush injury should be monitored for which of the following conditions? - ANSWER>>dysrhythmias Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER>>subdural hematoma 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? - ANSWER>>straight cath for urine sample

intervention? - ANSWER>>Report your suspicion of maltreatment in accordance with local regulations Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? - ANSWER>>to guage end-organ perfusion and tissue hypoxia 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?

• ANSWER>>elevating the extremity to the level of the heart What factor contributes most to the kinetic energy of a body in motion? - ANSWER>>velocity 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? - ANSWER>>subdural hematoma 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? - ANSWER>>fat embolism Which of the following is a late sign of increased intracranial pressure? - ANSWER>>nausea and vomiting 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? - ANSWER>>serial FAST exams Which of the following is NOT considered goal-directed therapy for cardiogenic shock? - ANSWER>>pericardiocentesis The trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device? - ANSWER>>endotracheal tube which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? - ANSWER>>increased work of breathing?

if a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? - ANSWER>>calcium Which of the following is NOT considered a benefit of debriefings? - ANSWER>>identifying individuals who made mistakes during the traumatic event 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? - ANSWER>>500 mL/hr Which of the following is most likely to contribute to inadequate oxygenation and ventilation? - ANSWER>>advanced age Which of the following patients warrants referral to a burn center? - ANSWER>>a 52 y/o diabetic male with a partial thickness burn to the left lower leg 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? - ANSWER>>dressing removal 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? - ANSWER>>after a physical examination if the pt has no radiologic abnormalities on CT Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? - ANSWER>>MARCH