TNCC Written Exam Questions and Answers, Exams of Nursing

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TNCC Written Exam Questions And Answers Correct 100% What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - ANSWERSBase deficit used in conjunction with serum lactate Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - ANSWERSVasoconstriction What results from tissue hypo perfusion and oxygen deficit? - ANSWERSMetabolic acidosis What type of shock results in generalized vasodilation? - ANSWERSNeurogenic shock Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - ANSWERSPhrenic nerve; paralyzed diaphragm and inability to breath Extremity elevation AT the level of the heart is beneficial for what type of injury? - ANSWERSCompartment Syndrome What is a high risk of frostbite? - ANSWERSThrombus formation What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - ANSWERSTissue plasminogen activator or non steroidal anti- inflammatory medication (NSAIDS) An rise in diastolic blood pressures is a sign of increasing what? - ANSWERSPeripheral resistance What position will benefit the airway and work of breathing for the bariatric patient? - ANSWERSReverse Trendelenburg Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries? - ANSWERSSecondary Phase What phase of a blast results from any explosion-related illness or injury including hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - ANSWERSQuaternary Phase What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or any hard object? - ANSWERSTertiary Phase What phase of a blast results from impact of the over and under pressurization wave with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal hemorrhage, globe rupture, and mild traumatic brain injury? - ANSWERSPrimary Phase Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or malaise, and elevated creatinine kinase levels? - ANSWERSRhabdomyolosis Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - ANSWERSPulmonary Embolus Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of consciousness? - ANSWERSIncreased intracranial pressure Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? - ANSWERSLate signs of increased ICP with Herniation Syndrome What is caused by the tear of the bridging veins or middle meningeal artery? - ANSWERSSubdural and Epidural Hematoma Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - ANSWERSPostconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - ANSWERSPostconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - ANSWERSMAP - ICP What is the range for CO2 to maximize perfusion? - ANSWERS35-45 Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - ANSWERSDilation and increase in ICP due to high CO2 Hyperventilation cause dilation or constriction? - ANSWERSConstriction d/t low CO2 Pupils with pressure on cranial nerve - ANSWERSFixed and dilated Pupils with opiates vs stimulants - ANSWERSsmall; large Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - ANSWERSlarge Sluggish reaction of pupils is an early sign of what? - ANSWERSIncreasing ICP What syndrome occurs most often in burns greater than 20% BSA and lasts for approximately 6-12 hours? - ANSWERSCapillary Leak Syndrome Fluid replacement goals/calculation - ANSWERS2mL/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 - ANSWERS0.5 mL/kg (30-50mL/hr) Disaster Definition - ANSWERSA 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 - ANSWERSA foundation to limit the potential impact of a disaster Triage colors and meanings: - ANSWERSGreen - minor, walking wounded Yellow - delayed Red - immediate Black - expectant, deceased When should the decision to transfer be made? - ANSWERSWhen the patient's needs outweigh the capabilities of your facility Tertiary care facility, teaching hospital, comprehensive care from resuscitation or rehabilitation, research, injury prevention. - ANSWERSLevel 1 Trauma Center Trauma rescucitation and definitive trauma care. Specialty and rehabilitation care may not be as comprehensive, may not conduct research. - ANSWERSLevel 2 Trauma Center Provides ATLS assessment, intervention, resuscitation and emergency surgery. Generally does not accept transfers. - ANSWERSLevel 3 Trauma Center Provides ATLS assessment, intervention, and resuscitation. May be in a remote area, has 24 hour physician and NP coverage. - ANSWERSLevel 4 Trauma Center Greatest risk to the patient during interfaculty transfer/transport? - ANSWERSLoss of airway and respiratory compromise What survey is a complete exam within 24 hours of arrival and identified injuries missed during primary assessment, reviews radiology studies, orders more studies, and assesses for hidden injuries? - ANSWERSTertiary Survey Stages of shock - ANSWERS1. Compensatory Shock 2. Decompensatory Shock (progressive, hypotensive) 3. Irreversible Shock Anxiety, confusion, restlessness, narrowing pulse pressure, tachycardia, bounding pulse, and decreasing urinary output are signs of what? - ANSWERSCompensated Shock Decreased level of consciousness, hypotension, narrowed pulse pressure, tachycardia with weak pulse, tachypnea, and cool, clammy, cyanotic skin are signs of what? - ANSWERSDecompensated/Progressive shock Obtunded/comatose, profound hypotension, bradycardia, dysrhythmias, slow shallow respirations, petechiae/purpura are signs of what? - ANSWERSIrreversible shock Benefits of the trauma nursing process - ANSWERSSystematic approach to the evaluation of each trauma patient. Identifies life-threatening conditions, determines priorities of care. Efficient production of ATP, which maintains cellular metabolic function, is seen with what type of metabolism? - ANSWERSAerobic metabolism Inefficient production of ATP, byproduct is lactic acid, leads to metabolic acidosis, cellular dysfunction leads to cell death with what type of metabolism? - ANSWERSAnaerobic metabolism The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal waste products. - ANSWERSAerobic metabolism The cellular process in which glucose is metabolized into energy without oxygen. Energy is produced in an inefficient manner with many waste products. - ANSWERSAnaerobic metabolism What is included in the Trauma Triad of Death? - ANSWERSCoagulopathy Acidosis Hypothermia Pump failure, caused by blunt cardiac injury, dysrhythmias, or myocardial infarction is what type of shock? - ANSWERSCardiogenic Shock What type of shock is caused by cardiac tamponade or tension pneumothorax? Ventricular failure is seen. - ANSWERSObstructive Shock Reservoir depletion and hemorrhage cause which type of shock? - ANSWERSHypovolemic Shock Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - ANSWERSDistributive Shock Options for hemorrhage - ANSWERSPressure at site, tourniquet, hemostatic dressings, Massive Transfusion Protocol, Tranexamic Acid (clotting promoter) Treatment for cariogenic shock - ANSWERSinotropic support, anti-dysrhythmic medications, treat myocardial infarction or other underlying cause Treatment for obstructive shock - ANSWERSpericardiocentesis, cardiac window, needle decompression, position pregnant patient on L side Treatment for distributive shock - ANSWERSSupport ventilations, vasopressors, pain management, apply warming methods Treatment for hypovolemic shock - ANSWERSTourniquet, 1:1:1 blood products, massive transfusion protocol, TXA, surgical repair Subdural hematoma is caused by tearing of the ______ veins and symptoms usually present within ____ hours of the accident. - ANSWERSBridging; 72 Epidural hematoma is caused by an arterial or venous bleed? Sx are transient LOC followed by a lucid period. - ANSWERSArterial Hyperventilation causes cerebral blood vessels to do what? - ANSWERSConstrict