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TNCC Notes for Written Exam
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TNCC Notes for Written Exam QUESTIONS WITH COMPLETE ANSWERS
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TNCC Notes for Written ExamWhat is kinematics? Correct Answer: A branch of mechanics (energy transfer) that refers to motion and
does not consider the concepts of force and mass of the object or body.
What is Newton's First Law? Correct Answer: A body at rest will remain at rest. A body in motion will
remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? Correct Answer: Energy can neither be created nor
destroyed. It is only changed from one form to another.
What is Newton's Second Law? Correct Answer: Force equals mass multiplied by acceleration of
deceleration.
What is kinetic energy (KE)? Correct Answer: KE equals 1/2 the mass (M) multiplied by the velocity
squared.
What is the Mnemonic for the Initial Assessment? Correct Answer: A = Airway with simultaneous
cervical spine protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient warm)
What is the Mnemonic for the Secondary Assessment? Correct Answer: F = Full set of VS/Focused
adjuncts (includes cardiac monitor, urinary catheter, and gastric tube)/Family presence
G = Give comfort measures (verbal reassurance, touch, and pharmacologic and nonpharmacologic
management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds? Correct Answer: Auscultate the lungs bilaterally at
the second intercostal space midclavicular line and at the fifth intercostal space at the anterior axillary
line.
What are the late signs of breathing compromise? Correct Answer: - Tracheal deviation
- JVD
What are signs of ineffective breathing? Correct Answer: - AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
,- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing effectively? Correct
Answer: A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? Correct Answer: - Insert 2
large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? Correct Answer: - Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? Correct Answer: - Control any
uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? Correct Answer: DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
, What are the interventions for Disability? Correct Answer: - If assessment indicates a decreased LOC,
conduct further investigation during secondary focused assessments
- If pt is not alert or verbal, continue to monitor for any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration, consider hyperventilation.
What is assessed and intervened for Expose/Environmental Controls? Correct Answer: - Remove
clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
- Keep clothing for evidence
What is the first thing assessed under the Secondary Assessment? Correct Answer: FULL SET VS /
FOCUSED ADJUNCTS / FAMILY PRESENCE
- ABCDE should be completed
- Labs, X-rays, CT, Foley,
- Family Presence
What is the second thing assessed under the Secondary Assessment? Correct Answer: GIVE COMFORT
MEASURES
- Talking to pt
- Pharmacologic/Nonpharmacologic pain management
- Observe for physical signs of pain
What is assessed under the Mnemonic "H"? Correct Answer: HISTORY / HEAD-TO-TOE ASSESSMENT
- MIVT
- M = Mechanism of injury
- I = Injuries sustained
- V = Vital Signs
- T = Treatment
- Pt generated information
- PMH
- Head-to-toe assessment
What is assessed under the Mnemonic "I"? Correct Answer: INSPECT POSTERIOR SURFACES
- While maintaining C-spine, logroll pt with assistance to inspect back, flanks, buttocks and posterior
thighs.
- Palpate vertebral column for deformity and areas of tenderness
- Assess rectum for presence/absence of tone, presence of blood
What she be done after the Secondary Assessment? Correct Answer: Reassess:
- Primary survey,
- VS
- Pain
- Any injuries
What are factors that contribute to ineffective ventilation? Correct Answer: - AMS
- LOC
- Neurologic injury
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