TNCC Written Exam Question & Answers 2024, Exams of Nursing

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What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - Correct Answers ✅Base deficit used in conjunction with serum lactate Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - Correct Answers ✅Vasoconstriction What results from tissue hypo perfusion and oxygen deficit? - Correct Answers ✅Metabolic acidosis What type of shock results in generalized vasodilation? - Correct Answers ✅Neurogenic shock Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - Correct Answers ✅Phrenic nerve; paralyzed diaphragm and inability to breath Extremity elevation AT the level of the heart is beneficial for what type of injury? - Correct Answers ✅Compartment Syndrome What is a high risk of frostbite? - Correct Answers ✅Thrombus formation

What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - Correct Answers ✅Tissue plasminogen activator or non steroidal anti-inflammatory medication (NSAIDS) An rise in diastolic blood pressures is a sign of increasing what? - Correct Answers ✅Peripheral resistance What position will benefit the airway and work of breathing for the bariatric patient? - Correct Answers ✅Reverse Trendelenburg Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries? - Correct Answers ✅Secondary Phase What phase of a blast results from any explosion-related illness or injury including hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - Correct Answers ✅Quaternary Phase What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or any hard object? - Correct Answers ✅Tertiary Phase

Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - Correct Answers ✅Postconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - Correct Answers ✅Postconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - Correct Answers ✅MAP - ICP What is the range for CO2 to maximize perfusion? - Correct Answers ✅35- Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - Correct Answers ✅Dilation and increase in ICP due to high CO Hyperventilation cause dilation or constriction? - Correct Answers ✅Constriction d/t low CO Pupils with pressure on cranial nerve - Correct Answers ✅Fixed and dilated

Pupils with opiates vs stimulants - Correct Answers ✅small; large Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - Correct Answers ✅large Sluggish reaction of pupils is an early sign of what? - Correct Answers ✅Increasing ICP Glasgow Coma Score with Mild, Moderate, and Severe TBI - Correct Answers ✅Mild = 13- Moderate = 9- Severe = 3- Goal value for ICP - Correct Answers ✅< Goal value for Cerebral Perfusion Pressure (CPP) - Correct Answers ✅> Le Fort Fracture - Correct Answers ✅Fracture of the maxilla

Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high mechanism of injury. - Correct Answers ✅Thoracic Aortic Disruption Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what? - Correct Answers ✅Myocardial contusion from Blunt Cardiac Injury Decreased/absent breath sounds ipsilaterally, JVD, hypotension, and tracheal deviation to the contralateral side (late sign) is seen with what? Can lead to what? - Correct Answers ✅Tension Pneumothorax; PEA Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and alveolar opacities are signs of what? - Correct Answers ✅Pulmonary Contusion Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation and elevated with exhalation are signs of what? - Correct Answers ✅Flail Chest (caused by chest wall injury) Open wound on chest wall resulting in sucking sound, decreased breath sounds, chest movement, and hyper-resonance ipsilaterally, subcutaneous emphysema, and tachycardia are signs of what? - Correct Answers ✅Open Pneumothorax

Hear bowel sounds in chest and Kehr's sign seen with what? - Correct Answers ✅Traumatic Diaphragmatic Tear Referred pain down the left shoulder; indicative of a ruptured spleen. - Correct Answers ✅Kehr's Sign Diaphragmatic Tears are seen with what types of injuries? - Correct Answers ✅Penetrating injuries between T4-T12, or rapid deceleration causing severe blunt trauma to the torso. Incision with blood clot, edges approximated with suture closer, and results in a fine scar. This is __________ Intention. - Correct Answers ✅Primary Irregular large wound with blood clot, no closure, granulation tissue fills in the wound, results in large scar. This is ________ Intention. - Correct Answers ✅Secondary Contaminated wound, granulation tissue, delayed closure with suture. This is _______ Intention. - Correct Answers ✅Tertiary

What syndrome occurs most often in burns greater than 20% BSA and lasts for approximately 6-12 hours? - Correct Answers ✅Capillary Leak Syndrome Fluid replacement goals/calculation - Correct Answers ✅2mL/kg LR x TBSA% (give 1/2 over first 8 hours (minus transport time) and 1/2 over next 16 hours) Urine Output goals for fluid replacement therapy - Correct Answers ✅0.5 mL/kg (30-50mL/hr) Disaster Definition - Correct Answers ✅A sudden calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic losses that exceed the community's or society's ability to cope using its own resources. Mitigation - Correct Answers ✅A foundation to limit the potential impact of a disaster Triage colors and meanings: - Correct Answers ✅Green - minor, walking wounded Yellow - delayed Red - immediate Black - expectant, deceased

When should the decision to transfer be made? - Correct Answers ✅When the patient's needs outweigh the capabilities of your facility Tertiary care facility, teaching hospital, comprehensive care from resuscitation or rehabilitation, research, injury prevention. - Correct Answers ✅Level 1 Trauma Center Trauma rescucitation and definitive trauma care. Specialty and rehabilitation care may not be as comprehensive, may not conduct research. - Correct Answers ✅Level 2 Trauma Center Provides ATLS assessment, intervention, resuscitation and emergency surgery. Generally does not accept transfers. - Correct Answers ✅Level 3 Trauma Center Provides ATLS assessment, intervention, and resuscitation. May be in a remote area, has 24 hour physician and NP coverage. - Correct Answers ✅Level 4 Trauma Center Greatest risk to the patient during interfaculty transfer/transport? - Correct Answers ✅Loss of airway and respiratory compromise

Efficient production of ATP, which maintains cellular metabolic function, is seen with what type of metabolism? - Correct Answers ✅Aerobic metabolism Inefficient production of ATP, byproduct is lactic acid, leads to metabolic acidosis, cellular dysfunction leads to cell death with what type of metabolism? - Correct Answers ✅Anaerobic metabolism The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal waste products.

• Correct Answers ✅Aerobic metabolism The cellular process in which glucose is metabolized into energy without oxygen. Energy is produced in an inefficient manner with many waste products. - Correct Answers ✅Anaerobic metabolism What is included in the Trauma Triad of Death? - Correct Answers ✅Coagulopathy Acidosis Hypothermia Pump failure, caused by blunt cardiac injury, dysrhythmias, or myocardial infarction is what type of shock? - Correct Answers ✅Cardiogenic Shock

What type of shock is caused by cardiac tamponade or tension pneumothorax? Ventricular failure is seen. - Correct Answers ✅Obstructive Shock Reservoir depletion and hemorrhage cause which type of shock? - Correct Answers ✅Hypovolemic Shock Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - Correct Answers ✅Distributive Shock Options for hemorrhage - Correct Answers ✅Pressure at site, tourniquet, hemostatic dressings, Massive Transfusion Protocol, Tranexamic Acid (clotting promoter) Treatment for cariogenic shock - Correct Answers ✅inotropic support, anti-dysrhythmic medications, treat myocardial infarction or other underlying cause Treatment for obstructive shock - Correct Answers ✅pericardiocentesis, cardiac window, needle decompression, position pregnant patient on L side