a 56 yo m pt involved in a motor vehicle crash is brought to the e
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TNCC test prepA, TNCC Notes for
Written Exam, TNCC Notes for Written
Exam, TNCC Prep, TNCC EXAM, TNCC
8th Edition
Expedite transfer to the closest trauma center - A 56 y/o M pt involved in a motor
vehicle crash is brought to the ED of a rural critical access facility. He complains of neck
pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26,
SpO2 94% on high-flow O2 via NRB mask. Which of the following is the priority
intervention for this patient?
a pertinent medical hx is crucial - Which of the following considerations is the most
important when caring for a geriatric trauma pt?
Mitigation - Following a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future disaster .
Which phase of the disaster life cycle does this describe?
Multiple requests for water - EMS brings a pt who fell while riding his bicycle. Using the
American College of Surgeobs screening guidelines, which assessment finding would
prompt the RN to prepare the pt for a radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - What is the effect of
hypothermia on the oxyhemoglobin dissociation curve?
acidosis - Which of the following is a component of the trauma triad of death?
Complete - EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2
C). The pt exhibits urinary incontinence and priapism. These assessment findings are
most consistent with which of the following types of spinal cord injury?
flucuation in the water seal chamber - Which of the following is an expected finding in a
pt with a tube thoracstomy connected to a chest drainage system?
insert an oropharyngeal airway if there is no gag reflex - During the primary survey of an
unconscious pt with multi-system trauma, the nurse notes snoring respirations. What
priority nursing interventions should be preformed next?
globe rupture - A 35 y/o M presents with facial trauma after being struck in the face with
a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected?
,compensated - A trauma pt is restless and repeatedly asking "where am i?" VS upon
arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84,
HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock?
ventilate with a bag mask device - An unresponsive trauma pt has an oropharygeal
airway in place, shallow and labored respirations, 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?
within 24 hrs of trauma - When is the tertiary survey completed fora trauma pt?
pressure - An intubated and sedated pt in the ED has multiple extremity injuries with the
potential for causing compartment syndrome. What is the most reliable indication of
compartment syndrome in a patient who is unconscious?
worsening pneumothorax - Which of the following is possible complication of positive-
pressure ventilation?
pelvic stability - the most reassuring finding for a male pt with hip pain after a fall is
which of the following?
narrowed - Which of the following pulse pressures indicate early hypovolemic shock?
dysrhythmias - Patients with a crush injury should be monitored for which of the
following conditions?
subdural hematoma - Tearing of the bridging veins is most frequently associated with
which brain injury?
straight cath for urine sample - A 20 y/o M presents to the ED complaining of severe
lower abd pain after landing hard on the bicycle cross bars while preforming an aerial
BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal
ecchymosis. Which of the following orders would the RN question?
placental abruption - You are caring for a pt who was involved in a MVC and is 32
weeks pregnant. Findings of your secondary survey include abd pain on palpation,
fundal ht at the costal margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cariocgraphy. These findings are most consistent with which
of the following?
it can worsen cord damage from an unstable spinal injury - Which of the following is true
about the log-roll?
defusings - All of these are considered a critical communication point in trauma care
EXCEPT which of the following?
,pulse oximetry and capnography - What bedside monitoring parameters are used to
assess for adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - Caregivers carry in a 2 y/o
into the ED who fell out of a second-story window. The pt is awake and crying with
increased work of breathing and pale skin. Which of the following interventions has the
highest priority?
bowel - Which of the following injuries is LEAST likely to be promptly identified?
Initiate transfer to a trauma center - A pt is brought to the ED of a rural hospital following
a high-speed MVC. When significant abd and pelvic injuries are noted in the primary
survey, which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury - A pt with a complete
spinal cord injury in neurogenic shock will demonstrate hypotension and which other
clinical signs?
apply splint and elevate above the level of the heart - a 37 y/o F has a deformity of the L
wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is
the most appropriate intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - which of the
following occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - a 5 y/o
child presents to the ED with bruises to the upper arm 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 survey. Which of the following is the priority nursing intervention?
to guage end-organ perfusion and tissue hypoxia - Why is a measure of serum lactate
obtained in the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - A pt with a lower extremity fracture
complains of severe pain and tightness in his calf, minimally by pain medications. Which
of the following is the priority nursing intervention?
velocity - What factor contributes most to the kinetic energy of a body in motion?
subdural hematoma - An elderly patient with a history of anticoagulant use presents
after a fall at home today. She denies any loss of consciousness. She has a hematoma
to her forehead and complains of headache, dizziness, and nausea. What is the most
likely cause of her symptoms?
, fat embolism - a pt has been in the ED for several hrs waiting to be admitted. He
sustained multiple rib fractures and a femur fracture after a fall. He has been awake,
alert, and complaining of leg pain. His wife reported that he suddenly became anxious
and confused. Upon reassessment, the pt is restless with respiratory distress and
petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of
the following conditions?
nausea and vomiting - Which of the following is a late sign of increased intracranial
pressure?
serial FAST exams - a 49 y/o restrained driver involved in a MVC presents to the
trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are
stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT
which of the following?
pericardiocentesis - Which of the following is NOT considered goal-directed therapy for
cardiogenic shock?
endotracheal tube - The trauma nurse knows that placing a bariatric patient in a ramped
position providers better visualization during the insertion of which device?
increased work of breathing? - which of the following assessment findings differentiates
a tension pneumothorax from a simple pneumothorax?
calcium - if a pt has received multiple transfusions of banked blood preserved with
citrate, which electrolyte is most likely to drop and require supplementation?
identifying individuals who made mistakes during the traumatic event - Which of the
following is NOT considered a benefit of debriefings?
500 mL/hr - You are treating a 27 y/o M in respiratory distress who was involved in a
house fire. Calculating TBSA burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
advanced age - Which of the following is most likely to contribute to inadequate
oxygenation and ventilation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - Which of the
following patients warrants referral to a burn center?
dressing removal - 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 taped it on three 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 immediate intervention?
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