Trauma Nursing Core Course (TNCC)- 9th edition 33 Questions with Verified Answers, Exams of Nursing

Download Trauma Nursing Core Course (TNCC)- 9th edition 33 Questions with Verified Answers and more Exams Nursing in PDF only on Docsity! Trauma Nursing Core Course (TNCC)- 9th edition 33 Questions with Verified Answers A patient with a spinal cord injuryt at C5 is being cared for in the emergency department while awaiting transport to a trauma center. Which of the following represents the highest priority for ongoing assessment and management for this patient? a. maintain adequate respiratory status b. administer balanced fluid resucscitation c. perform serial assessment of neurological function d. maintain core temperature - CORRECT ANSWER A. Maintain respiratory status- injuries at C3-C5 can cause loss of phrenic nerve function, resulting in a paralyzed diaphragm and inability to breathe. Maintenance of respiratory function is the highest priority. What is the best position for maintaining an open airway in the obese patient? a. Prone b. Supine c. Reverse trendelenburg d. right lateral recumbent - CORRECT ANSWER c. Reverse trendelenburg An adult patient sustained a knife injury to the neck. The airway is intact and the patient is hemodynamically stable. they complain of difficulty swallowing and speaking. What is the most likely cause of these symptoms. a. damage to the cervical spine b. an expanding pneumothorax c.laceration of the carotid artery d. injury to the thyroid gland - CORRECT ANSWER a. damage to the cervical spine- penetrating neck trauma may include concurrent injuries to the cervical spine and cord, airway. or vascular neck structures. With an intact airway and hemodynamic stability, the other common concurrent injury is to the cervical spine. The general impression step in the initail assessment provides the opportunity to do which of the following? a. assess for uncontrolled internal hemorrhage b. accurately triage the patient c.Reprioritize circulation before airway and breathing d. activate the trauma team - CORRECT ANSWER c. reprioritize circulation before airway and breathing the general impression is formed in the beginning of the primary survey to rapidly assess the need to reprioritize before airway or breathing. This is done id uncontolled external hemorrhage is identified. A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick for a couple of days and is now back working on the team. Which of the following behaviors indicate the nurse is coll. a. they are talking about taking the emergency nurse certification exam b. they keep requesting to be assigned to the walk-in ambulatory area c.they are impaiient and snap at thier coworkers. d. they are thinking about transferring out of the department - CORRECT ANSWER a. this is an indication that the nurse is taking positive steps ti advance thier own practice, a sign of resilience. Treatment for frostbite can include which of the following interventions? a. warm the affected part over 30-60 minutes b. use gentle friction to improve circulation c.administer tissue plasminogen activator d. drainage of all large and small blisters - CORRECT ANSWER c. admin tpa- with frostbite thrombus formation is a risk. TPA has been effective in maintaining perfusion and decreasing the need for amputation when administered within 24 hours of rewarming. what is the leading cause of preventable death for the trauma patient in the prehospital environment. a. airway compromise b. ineffective ventilation c. secondary head injury d. uncontrolled external hemmorage - CORRECT ANSWER d. uncontrolled external hemmorage c. determining the need for lab tests d. predicting the need for a surgical procedure - CORRECT ANSWER a. anticipating the types of injuries that may be present mechanism of injury and energy transfer can assist the provider in anticipating the types of injuries that may be present and their severity In a patient with severe traumatic brain injury, hypocapnia causes which condition? a. respiratory acidosis b. metabolic acidosis c. neurogenic shock d. cerebral vasoconstriction - CORRECT ANSWER ***d. hypocapnia, cause vasoconstriction especially in the cerebral vasculature a. hypercapnia from inadequate ventilation causes respiratory acidosis, not hypocapnia b. metabolic acidosis results from tissue hypoperfusion and oxygen deficit, not hypocapnia c. neurogenic shock is associated with spinal cord injuries and results in generalized vasodilation. Hypocapnia causes vasoconstriction. Which of the following describes ventilation principles associated with use of a bag-mask device for an adult? a. compress the bag-mask device at a rate of one breath every six seconds b. delivers 100 % oxygen c. squeeze the bag completely for each breath d. maintain - CORRECT ANSWER a. compress the bag-mask at a rate of one breath every six seconds What is the best measure of the adequacy of cellular perfusion and can help predict the outcome of resuscitation? a. end tidal CO2 b. Hematocrit level c. Base deficit d. Oxygen saturation - CORRECT ANSWER c. base deficit- serves as an endpoint measurement of the adequacy of cellular perfusion and, when used in conjunction with serum lactate, helps predict the success of resuscitation. a. End tidal CO2-end product of ventilation and a reflection of metabolism and pulmonary fxn. What technique is most appropriate when obtaining a history? a. sitting next to the patient b. ensuring the patient answers all questions c. asking for information only related to the assault d. applying active listening - CORRECT ANSWER d. applying active listening While performing an assessment on a 13-month old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a sign of possible altered mental status? a. sunken fontanel b. crying, but consolable c. spontaneous movement of arms and legs d. cooperation with the assessment - CORRECT ANSWER d. cooperation with the assessment A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn't sleep because a young child kept coming into the room. What is the most likely cause for these signs and symptoms? - CORRECT ANSWER B: Alcohol withdrawal is a common delayed condition because symptoms are difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting, psychomotor agitation, anxiety, insomnia, transient hallucinations, or seizures A: Signs of increased intracranial pressure include headache, nausea and vomiting, amnesia, behavioral changes, and altered level of consciousness.. C: Signs of rhabdomyolysis include muscle pain or weakness, dark red or brown urine, general weakness or malaise, and elevated creatinine kinase levels. D: Signs of pulmonary embolus include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distension, or hypotension. Why is alertness included in the airway assessment? - CORRECT ANSWER Including this helps evaluate the patient's ability to protect their own airway What pneumonic is used to assess a patient level of alertness? - CORRECT ANSWER A: Alert V: Responds to verbal stimuli P: Responds to pain U: Unresponsive Why is AVPU beneficial to use at the beginning of the initial patient assessment? - CORRECT ANSWER Will help determine appropriate airway intervention In a patient who is unable to open their mouth or unresponsive, how do we assess the airway? - CORRECT ANSWER Jaw- thrust maneuver is performed to open airway and mouth to assess for obstruction What inspecting the airway, what are we inspecting for? - CORRECT ANSWER Vocalization Tongue Obstruction Loose or missing teeth Foreign objects Fluids (blood, vomit, secretions) Edema Burns/ evidence of inhalation injury If an airway is patent, what is the goal? - CORRECT ANSWER Focusing efforts at maintaining and supporting a patent airway (Pt may be allowed to assume position that facilitates better air exchange so long as no CSI is suspected)