TNCC 9th Edition final exam - 80 questions with correct and verified answers, Exams of Nursing

Download TNCC 9th Edition final exam - 80 questions with correct and verified answers and more Exams Nursing in PDF only on Docsity! TNCC 9th Edition final exam test 80 questions with correct and verified answers. Graded A+ 1. "A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? A) apply a sling and elevate the extremity to the level of the heart. B) apply a splint and elevate above the level of the heart C) Apply a sling and elevate the extremity above the level of the heart D) apply a splint and elevate the extremity to the level of the heart. - Correct answer B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART" 2. "A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principle? A) initiate two large bore intravenous lines for Ringers lactate solution administration B) Administer Dilaudid for pain control and provide comfort care C) Place the patient in an observation area for care within the next few hours D) Contact the command center for the personnel to notify next of kin. - Correct answer A) initiate two large bore intravenous lines for Ringers lactate solution administration" 3. "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 patient is asking to have the cervical color removed. when is it appropriate to remove the cervical collar? A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan B) after physician evaluation if the patient has not neurologic abnormalities on exam C) after palpation of the spine if the patient has no point tenderness the the vertebral column D) after physical examination if the patient has not neck pain with movement - Correct answer A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan" 4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - Correct answer C. Notify the physician" 5. "A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what is the priority intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - Correct answer A. Initiate transfer to a trauma center" 6. "An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respiratory, and dusky skin. the trauma team has administered medications for drug assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? A) Ventilate with a BVM B) Prepare for cricothyroidotomy C) administer reversal medications D) contact anesthesia for assistance - Correct answer A) Ventilate with a BVM" 7. "An adult who fell from a second story roof is brought to the emergency department by private vehicle. The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an open wound in proximity to an obvious deformity of the left lower extremity. What is the priority intervention? A. Initiate cervical spine stabilization B. Apply a splint to the lower extremity C. Put the patient on portable oxygen. D. Log roll the patient onto a spine board - Correct answer A. Initiate cervical spine stabilization" 8. "An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the cerebral blood flow? A. Decrease the rate of manual ventilation. B. Initiate another fluid bolus. C. Recheck endotracheal tube placement. D. Increase the amount of oxygen delivered. - Correct answer A. Decrease the rate of manual ventilation." a) to measure oxygenation and ventilation b) to quantify the base deficit for the adequacy of cellular perfusion c) to gauge end-organ perfusion and tissue hypoxia d) to determine the underlying cause of shock - Correct answer c) to gauge end-organ perfusion and tissue hypoxia" 21. "EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? A) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath - Correct answer D) Smell of alcohol on breath" 22. "Which of the following occurs during the third impact of a motor vehicle crash? A) The driver of the vehicle collides with the steering wheel B) the vehicle collides with a tree C) the aorta is torn at its attachment with the ligamentum arteriosum D) the airbag deploys and strikes the front seat passenger - Correct answer C) the aorta is torn at its attachment with the ligamentum arteriosum" 23. "A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority interventions? A) initiate transfer to a trauma center B) provide report to the operating room nurse C) Obtained imaging studies D) Place a gastric tube - Correct answer A) initiate transfer to a trauma center" 24. "Which of the following injuries is LEAST likely to be promptly identified? A) spleen B) lung C) bowel D) brain - Correct answer C) bowel" 25. "Patients with a crush injury should be monitored for which of the following conditions? A) Hypernatremia B) Hypercalcemia C) Dysrhythmias D) polyuria - Correct answer C) Dysrhythmias" 26. "What finding raises suspicion of complete spinal cord injury? A) Weakness in the lower extremities B) Priapism C) voluntary anal sphincter tone D) intact reflexes distal to the injury - Correct answer B) Priapism" 27. "A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? A) Bradycardia and ipsilateral absences of motor function B) Tachycardia and respiratory depression C) Tachycardia and absent motor function below the level of injury D) Bradycardia and absent motor function below the level of the injury - Correct answer D) Bradycardia and absent motor function below the level of the injury" 28. "A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? A) report your suspicion of the maltreatment in accordance with local regulations B) apply ice to the bruises and consult wound care C) engage in therapeutic communication to determine the MOI D) provide the family with injury prevention recourses - Correct answer A) report your suspicion of the maltreatment in accordance with local regulations" 29. "A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A) elevating the extremity above the level of the heart B) repositioning and apply ice C) Elevating the extremity to the level of the heart D) Preparing the patient for ultrasound - Correct answer C) Elevating the extremity to the level of the heart" 30. "Which of the following is a late sign of increased intracranial pressure? A) Restlessness or drowsiness B) Nausea and vomiting C) Decreased respiratory effort D) Amnesia and anxiety - Correct answer C) Decreased respiratory effort" 31. "Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? A) ABC B) MARCH C) AVPU D) VIPP - Correct answer B) MARCH" 32. "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 tapes it on 3 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 interventions? A) needle decompression B) tube thoracostomy C) dressing removal D) surgical repair - Correct answer C) dressing removal" 33. "A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values is expected with a musculoskeletal complication associated with this presentation? A) elevated creatine kinase B) decreased potassium level C) decreased WBC D) elevated GFR - Correct answer A) elevated creatine kinase" 34. "Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? A) padding the upper back while stabilizing the cervical spine B) applying a tight-fitting NRB mask with an attached resevior C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation - Correct answer A) padding the upper back while stabilizing the cervical spine" 35. "A 35-year old male presents with facial trauma after bring struck in the face with a baseball. a tear- drop shaped left pupil is noted on exam. What type of injury is suspected? A) oculomotor nerve palsy B) globe rupture C) Uncal herniation D) retinal detachment - Correct answer B) globe rupture" 36. "Which of the following is true about the log roll maneuver? A) it causes less spinal motion than the lift and slide maneuver B) it is recommended for patients with unstable pelvic fractures C) it can worsen cord damage from an unstable spinal injury D) it does not increases the risk of life threatening hemorrhage from unstable injuries - Correct answer C) it can worsen cord damage from an unstable spinal injury" 37. "If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? D) Hemoglobin molecule saturation (SaO2) decreases - Correct answer A) Hemoglobin does not readily release oxygen for use by the tissues" 49. "A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycle cross bars which performing an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurse questions? A) Fast exam B) CT scan C) straight cath for urine sample D) ice and elevation of the scrotum - Correct answer C) straight cath for urine sample" 50. "Which of the following is possible complication of positive-pressure ventilation? A) worsening pneumothorax B) worsening flail chest C) reabsorption of pleural air D) negative intrapleural pressure - Correct answer A) worsening pneumothorax" 51. "Which of the following is NOT considered goal-directed therapy of cardiogenic shock? A) controlled fluid boluses B) antidysrhythmic administration C) pericardiocentesis D) cardiac cath - Correct answer C) pericardiocentesis" 52. "What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? A) pulse oximetry and capnogaphy B) respiratory rate and capnography C) pulse oximetry and respiratory rate D) capnography and capnometry - Correct answer A) pulse oximetry and capnogaphy" 53. "Which of the following values indicates the need for alcohol withdrawal interventions? A) CIWA-Ar of 36 B) GCS 13 C) ETCo2 of 48 mm Hg D) heart rate of 45 beats/min - Correct answer A) CIWA-Ar of 36" 54. "The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? A) Intraosseous line B) orogastric tube C) ET tube D) urinary catheter - Correct answer C) ET tube" 55. "You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are most consistent with which of the following? A) placental abruption B) preterm labor C) uterine rupture D) fetal demise - Correct answer A) placental abruption" 56. 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? a. increase intracranial pressure b. alcohol withdrawal c. rhabdomyolysis d. pulmonary embolus - Correct answer b. alcohol withdrawal" 57. "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. leave all of the blisters intact - Correct answer c. administer tissue plasminogen activator" 58. "A patient with a spinal cord injury 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 resuscitation fluid c. perform serial assessments of neurologic function d. maintain core temperature - Correct answer a. maintain adequate respiratory status" 59. "Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment are examples of which phase of injury? a. primary b. secondary c. tertiary d. quaternary - Correct answer b. secondary" 60. "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 would indicate this nurse is coping well? a. They are talking about taking the emergency nursing certification examination. b. They keep requesting to be assigned to the walk-in/ambulatory area c. They are impatient and snap at their coworkers. d. They are thinking about transferring out of the emergency department. - Correct answer a. They are talking about taking the emergency nursing certification examination." 61. "Which of the following accurately 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 6 seconds. b. Delivers 100% oxygen. c. Squeeze the bag-mask device completely for each breath. d. Maintain the oxygen saturation levels between 92% and 94%. - Correct answer a. Compress the bag-mask device at a rate of one breath every 6 seconds." 62. "The general impression step in the initial 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 or breathing. d. Activate the trauma team - Correct answer c. Reprioritize circulation before airway or breathing." 63. "The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following? a. Decompensated shock b. Normal vital signs in pregnancy c. Compensated shock d. Supine hypotension syndrome - Correct answer b. Normal vital signs in pregnancy" 64. "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" 65. "A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest. Which concurrent injury is most commonly associated with this fracture? a. Blunt cardiac injury b. Brachial plexus injury c. Pneumothorax d. Hemothorax - Correct answer b. Brachial plexus injury" 66. "A patient arrives at the emergency department by private vehicle after sustaining an injury to the right lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant bleeding. What is the priority intervention? a. Elevate the extremity to the level of the heart b. Initiate direct pressure c. Apply a tourniquet d. Cover the open wound with sterile saline dressings - Correct answer b. Initiate direct pressure"