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TNCC Written EXAM WITH COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS (DETAILED ANSWERS) ALREADY GRADED A+ 100% GUARANTEED TO PASS CONCEPTS!! What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - ✔✔ANSWER✔✔->>>>>>>>Base deficit used in conjunction with serum lactate Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - ✔✔ANSWER✔✔-
Vasoconstriction What results from tissue hypo perfusion and oxygen deficit? - ✔✔ANSWER✔✔->>>>>>>>Metabolic acidosis
What type of shock results in generalized vasodilation? - ✔✔ANSWER✔✔->>>>>>>>Neurogenic shock Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - ✔✔ANSWER✔✔-
Phrenic nerve; paralyzed diaphragm and inability to breath Extremity elevation AT the level of the heart is beneficial for what type of injury? - ✔✔ANSWER✔✔->>>>>>>>Compartment Syndrome What is a high risk of frostbite? - ✔✔ANSWER✔✔- Thrombus formation What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - ✔✔ANSWER✔✔->>>>>>>>Tissue plasminogen activator or non steroidal anti-inflammatory medication (NSAIDS) An rise in diastolic blood pressures is a sign of increasing what?
- ✔✔ANSWER✔✔->>>>>>>>Peripheral resistance
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or malaise, and elevated creatinine kinase levels? - ✔✔ANSWER✔✔-
Rhabdomyolosis Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - ✔✔ANSWER✔✔->>>>>>>>Pulmonary Embolus Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of consciousness? - ✔✔ANSWER✔✔->>>>>>>>Increased intracranial pressure Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? - ✔✔ANSWER✔✔->>>>>>>>Late signs of increased ICP with Herniation Syndrome What is caused by the tear of the bridging veins or middle meningeal artery? - ✔✔ANSWER✔✔->>>>>>>>Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - ✔✔ANSWER✔✔-
Postconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - ✔✔ANSWER✔✔->>>>>>>>Postconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - ✔✔ANSWER✔✔->>>>>>>>MAP - ICP What is the range for CO2 to maximize perfusion? - ✔✔ANSWER✔✔->>>>>>>>35- 45 Pupils with anticholinergics such as atropine, ipratropium, and Rhabdomyolosis Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - ✔✔ANSWER✔✔->>>>>>>>Pulmonary Embolus Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of consciousness? - ✔✔ANSWER✔✔->>>>>>>>Increased intracranial pressure Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? - ✔✔ANSWER✔✔->>>>>>>>Late signs of increased ICP with Herniation Syndrome What is caused by the tear of the bridging veins or middle meningeal artery? - ✔✔ANSWER✔✔->>>>>>>>Subdural and Epidural Hematoma Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - ✔✔ANSWER✔✔- >>>>>>>>Postconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - ✔✔ANSWER✔✔->>>>>>>>Postconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - ✔✔ANSWER✔✔->>>>>>>>MAP - ICP What is the range for CO2 to maximize perfusion? - ✔✔ANSWER✔✔->>>>>>>>35- 45 Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - ✔✔ANSWER✔✔->>>>>>>>large Sluggish reaction of pupils is an early sign of what? - ✔✔ANSWER✔✔->>>>>>>>Increasing ICP
- Muffled heart sounds What is pulsus paradoxus? And what is it a sign of? - ✔✔ANSWER✔✔->>>>>>>>Drop in blood pressure with inspiration, sign of cardiac tamponade Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - ✔✔ANSWER✔✔->>>>>>>>Dilation and increase in ICP due to high CO Hyperventilation cause dilation or constriction? - ✔✔ANSWER✔✔->>>>>>>>Constriction d/t low CO Pupils with pressure on cranial nerve - ✔✔ANSWER✔✔-
Fixed and dilated Late signs of increased ICP with Herniation Syndrome What is caused by the tear of the bridging veins or middle meningeal artery? - ✔✔ANSWER✔✔->>>>>>>>Subdural and Epidural Hematoma Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. - ✔✔ANSWER✔✔- >>>>>>>>Postconcussive Syndrome/ Mild Traumatic Brain Injury Signs and symptoms similar to early signs of increased ICP but do not worsen. - ✔✔ANSWER✔✔->>>>>>>>Postconcussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - ✔✔ANSWER✔✔->>>>>>>>MAP - ICP What is the range for CO2 to maximize perfusion? - ✔✔ANSWER✔✔->>>>>>>>35- 45 Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - ✔✔ANSWER✔✔->>>>>>>>large Sluggish reaction of pupils is an early sign of what? - ✔✔ANSWER✔✔->>>>>>>>Increasing ICP 3. Muffled heart sounds What is pulsus paradoxus? And what is it a sign of? - ✔✔ANSWER✔✔->>>>>>>>Drop in blood pressure with inspiration, sign of cardiac tamponade Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - ✔✔ANSWER✔✔->>>>>>>>Dilation and increase in ICP due to high CO Hyperventilation cause dilation or constriction? - ✔✔ANSWER✔✔->>>>>>>>Constriction d/t low CO Pupils with pressure on cranial nerve - ✔✔ANSWER✔✔- >>>>>>>>Fixed and dilated Pupils with opiates vs stimulants - ✔✔ANSWER✔✔- small; large Tachycarida, weak pulses, hypotension, cool periphery, delayed
cap refill, anxiety and agitation are signs of what type of shock? Seen with what? - ✔✔ANSWER✔✔->>>>>>>>Obstructive Shock; Cardiac Tamponade
Persistent blood loss following chest tube insertion is a sign of what? - ✔✔ANSWER✔✔->>>>>>>>Hemothorax Ipsilateral diminished breath sounds and chest movement is a sign of what? - ✔✔ANSWER✔✔->>>>>>>>Hemothorax Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high mechanism of injury. - ✔✔ANSWER✔✔->>>>>>>>Thoracic Aortic Disruption Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation and elevated with exhalation are signs of what? - ✔✔ANSWER✔✔->>>>>>>>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? - ✔✔ANSWER✔✔-
Open Pneumothorax
Soft, dry, red wound with intact skin that blanches with pressure. No blistering or sloughing. What degree burn? - ✔✔ANSWER✔✔->>>>>>>>First degree; superficial Moist wound, weeping, red or pink edematous skin that blanches with pressure, some blisters. What degree burn? - ✔✔ANSWER✔✔->>>>>>>>Second degree; superficial partial thickness Wet, waxy, red to pale skin that does not blanch, multiple sisters. What degree burn? - ✔✔ANSWER✔✔->>>>>>>>Second degree; deep partial thickness Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what? - ✔✔ANSWER✔✔-
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? - ✔✔ANSWER✔✔- Tension Pneumothorax; PEA
Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and alveolar opacities are signs of what? - ✔✔ANSWER✔✔->>>>>>>>Pulmonary Contusion Waxy white to leathery gray to charred skin that is dry and firm with absent hair, no blanching. What degree burn? - ✔✔ANSWER✔✔->>>>>>>>Third degree; full thickness Burn extends into the fascia and/or muscle. What degree burn?
- ✔✔ANSWER✔✔->>>>>>>>Fourth degree; full thickness Zones of burn injury (3) - ✔✔ANSWER✔✔->>>>>>>>Zone of coagulation Zone of stasis Zone of hyperemia What syndrome occurs most often in burns greater than 20% BSA and lasts for approximately 6-12 hours? - ✔✔ANSWER✔✔-
Capillary Leak Syndrome
Provides ATLS assessment, intervention, and resuscitation. May be in a remote area, has 24 hour physician and NP coverage. - ✔✔ANSWER✔✔->>>>>>>>Level 4 Trauma Center Greatest risk to the patient during interfaculty transfer/transport? - ✔✔ANSWER✔✔->>>>>>>>Loss 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? - ✔✔ANSWER✔✔->>>>>>>>Tertiary Survey Stages of shock - ✔✔ANSWER✔✔->>>>>>>>1. 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? - ✔✔ANSWER✔✔->>>>>>>>Compensated Shock Decreased level of consciousness, hypotension, narrowed pulse pressure, tachycardia with weak pulse, tachypnea, and cool,
clammy, cyanotic skin are signs of what? - ✔✔ANSWER✔✔-
Decompensated/Progressive shock Obtunded/comatose, profound hypotension, bradycardia, dysrhythmias, slow shallow respirations, petechiae/purpura are signs of what? - ✔✔ANSWER✔✔->>>>>>>>Irreversible shock Benefits of the trauma nursing process - ✔✔ANSWER✔✔- Systematic 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? - ✔✔ANSWER✔✔->>>>>>>>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? - ✔✔ANSWER✔✔- Anaerobic metabolism The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal
Black - expectant, deceased What is included in the Trauma Triad of Death? - ✔✔ANSWER✔✔->>>>>>>>Coagulopathy Acidosis Hypothermia Pump failure, caused by blunt cardiac injury, dysrhythmias, or myocardial infarction is what type of shock? - ✔✔ANSWER✔✔-
Cardiogenic Shock What type of shock is caused by cardiac tamponade or tension pneumothorax? Ventricular failure is seen. - ✔✔ANSWER✔✔- Obstructive Shock Reservoir depletion and hemorrhage cause which type of shock? - ✔✔ANSWER✔✔->>>>>>>>Hypovolemic Shock Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - ✔✔ANSWER✔✔->>>>>>>>Distributive Irreversible shock Benefits of the trauma nursing process - ✔✔ANSWER✔✔- >>>>>>>>Systematic 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? - ✔✔ANSWER✔✔->>>>>>>>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? - ✔✔ANSWER✔✔- >>>>>>>>Anaerobic metabolism The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal Black - expectant, deceased What is included in the Trauma Triad of Death? - ✔✔ANSWER✔✔->>>>>>>>Coagulopathy Acidosis Hypothermia Pump failure, caused by blunt cardiac injury, dysrhythmias, or myocardial infarction is what type of shock? - ✔✔ANSWER✔✔- >>>>>>>>Cardiogenic Shock What type of shock is caused by cardiac tamponade or tension pneumothorax? Ventricular failure is seen. - ✔✔ANSWER✔✔- >>>>>>>>Obstructive Shock Reservoir depletion and hemorrhage cause which type of shock? - ✔✔ANSWER✔✔->>>>>>>>Hypovolemic Shock Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - ✔✔ANSWER✔✔->>>>>>>>Distributive Shock
Options for hemorrhage - ✔✔ANSWER✔✔->>>>>>>>Pressure at site, tourniquet, hemostatic dressings, Massive Transfusion Protocol, Tranexamic Acid (clotting promoter) Treatment for cariogenic shock - ✔✔ANSWER✔✔-
inotropic support, anti-dysrhythmic medications, treat myocardial infarction or other underlying cause Treatment for obstructive shock - ✔✔ANSWER✔✔- pericardiocentesis, cardiac window, needle decompression, position pregnant patient on L side Treatment for distributive shock - ✔✔ANSWER✔✔- Support ventilations, vasopressors, pain management, apply warming methods Treatment for hypovolemic shock - ✔✔ANSWER✔✔- Tourniquet, 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. - ✔✔ANSWER✔✔->>>>>>>>Bridging; 72
