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Skill Demonstration, Tncc, TNCC, TNCC EXAM, TNCC Written
Exam, TNCC Written Exam, Tncc, TNCC, Trauma Nursing II,
TNCC
Primary concern when a person cannot stop coughing/clearing their throat following house fire/smoke?
Correct Answer: Airway/Intubate
Lab evidence of cellular perfusion Correct Answer: Base Excess (Less than -6 is BAD)
Multiple people are in the ER of different ages who all go to the same church. They all have the same
symptoms. What is the most likely cause? Correct Answer: Biologic
Suspected shock type with a spinal cord injury Correct Answer: Distributive Shock (Includes neurogenic)
Patient has GCS of 3, unequal pupils (one sluggish, one blown), and is posturing. What is the cause?
Correct Answer: Herniation
Middle Meningeal Artery Correct Answer: Epidural Hematoma (results from collection of blood that
forms between dura mater and skull)
Prior to having a concussion (TBI), the patient had a brain injury that was not fully healed. What is the
cause? Correct Answer: 2nd Impact Syndrome
Bowel sounds heard in the L chest. What is this a symptom of? Correct Answer: Ruptured diaphragm
Symptoms of __________________: include muffled heart sounds and hypotension Correct Answer:
Pericardiocentesis
How should you dress a severed limb? Correct Answer: Sterile gauze with normal saline THEN put ice
on it
Amylase level looks at _____________ Correct Answer: Pancreas
What should you do if your patient has hyphema (collection of blood inside the front part of the eye?)
Correct Answer: Sit HOB up to 30 degrees
Principle that people have to take action after suffering a loss in order to decrease severity, seriousness, or
painfulness Correct Answer: Mitigation
What organ is most at risk following a gunshot Correct Answer: Liver
8 year old child with longitudinal thigh lacerations Correct Answer: Sign of child abuse
Bleeding around belly button Correct Answer: Cullen's Sign
,What would cause an inaccurate reading from an 02 saturation probe? Correct Answer:
Carboxyhemoglobin (increase FiO2 to 100%)
General study of forces and their effects on living tissue and the human body Correct Answer:
Biomechanics
Study of energy transfer as it applies to identifying actual or potential injuries Correct Answer:
Kinematics
Refers to the separation of tissue resulting from a sound and/or hydraulic wave force- the effect is a
crushing pressure wave which creates a temporary cavity, followed by a rapid and violent closing of the
cavity. Correct Answer: Cavitation
This rapid motion can lead to crushing, tearing, and shearing forces on tissue Correct Answer: Cavitation
Used in OR; does not provide protection against aspiration and not recommended in patients who have
eaten recently. It is a supraglottic airway. Correct Answer: Laryngeal Mask Airway
Single tube retroglottic device inserted into the esophagus and traps the glottis opening between an
esophageal cuff and an oropharyngeal cuff. Designed with 2 ports/lumens each with a separate cuff. Does
NOT provide protection against aspiration and is not indicated in children. It is a retroglottic airway.
Correct Answer: King Tube
Types of Shock (4) Correct Answer: Hypovolemic, Obstructive, Cardiogenic, Distributive
Hemorrhage is the leading cause. Can result from vomiting, diarrhea, and burn trauma. Decreased
circulating volume --> decreased preload. Therapy includes replacing the type of volume that was lost.
Correct Answer: Hypovolemic Shock
Results from hypo perfusion of tissue due to an obstruction in either the vasculature or heart. Therapy
aimed at relieving the obstruction and improving perfusion. Correct Answer: Obstructive Shock
Two classic examples of obstructive shock Correct Answer: Cardiac tamponade and tension
pneumothorax
Results from pump failure in the presence of adequate intravascular volume. Lack of CO and end-organ
perfusion secondary to a decrease in myocardial contractility and/or valvular insufficiency. Therapy
includes inotropic support, antidysrhythmic medications, and correction or treatment of underlying cause.
Correct Answer: Cardiogenic Shock
Results from the misdistribution of an adequate circulating blood volume with the loss of vascular tone or
increased permeability. Treatment is to provide volume replacement, increase systemic vascular
resistance with medications (pressors) and possible antibiotics. Correct Answer: Distributive Shock
Examples that can cause distributive shock Correct Answer: Anaphylactic shock, septic shock,
neurogenic shock
___________________: Impairs thrombin production and platelet function
_____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through hemodilution and the
impaired ability to produce clotting factors. Correct Answer: Trauma Triad of Death
Stages of Shock (3) Correct Answer: 1. Compensated
2. Decompensated vs Progressive
3. Irreversible
Complete craniofacial separation involving maxilla, zygoma, orbits, and bones of the cranial base.
Assessment findings include: massive facial edema, mobility and depression of zygomatic bones,
ecchymoses, diplopia, and open bite or malocclusion. Correct Answer: LeFort III
Transverse maxillary bone fracture that occurs above the level of the teeth from the maxilla. Assessment
findings include: independent moment of the maxilla from the rest of the face, slight swelling of the
maxillary area, lip laceration or fractured teeth, malocclusion. Correct Answer: LeFort I
Pyramidal maxillary bone fracture involving the mid-face area. The apex of the fracture transverses the
bridge of the nose. Assessment findings include: massive facial edema, nasal swelling with obvious
fracture of the nasal bones, malocclusion, CSF rhinorrhea Correct Answer: LeFort II
Can be caused by blunt trauma. Air escapes from the injured lung into the pleural space, and negative
intrapleural pressure is lost resulting in partial or complete collapse of the lung. S & S: dyspnea,
tachypnea, decreased/absent breath sounds on injured side, chest pain. Treatment: based on size,
symptoms, and stability. Chest tube may be placed to evacuate pleural air and maintain lung expansion
Correct Answer: Pneumothorax
Air enters the intrapleural space but cannot escape on expiration. The increasing intrathoracic pressure
causes the lung on the injured side to collapse. If pressure is not relieved, the mediastinum can shift
toward the uninjured side compressing the heart/great vessels/and opposite lung. S & S: anxiety, severe
restlessness, severe respiratory distress, significantly diminished or absent breath sounds on injured side,
hypotension, distended neck/head/upper extremity veins, tracheal deviation, or a shift toward uninjured
side. Treatment: Needle thoracentesis and chest tube insertion Correct Answer: Tension Pneumothorax
Collection of blood in pericardial sac. Mechanism of injury is typically penetrating trauma. Compresses
the heart and decreases ability of the ventricles to fill causing decreased SV and CO. S & S: hypotension,
muffled heart sounds, distended neck veins, tachycardia or PEA, dyspnea, cyanosis, chest pain. Surgical
evacuation will be needed. Correct Answer: Cardiac Tamponade
__________________ Shock: Spinal cord injury at T6 or above. Temporary loss of vasomotor tone and
sympathetic innervation. Temporary duration usually <72 hours. S & S: hypotension, bradycardia, loss of
ability to sweat below level of injury. Correct Answer: Neurogenic
______________ Shock: Spinal cord injury at any level. Transient loss of reflex below the level of injury.
Variable duration. S & S: flaccidity, loss of reflexes, bowel/bladder dysfunction. Correct Answer: Spinal
Significant muscle damage and cellular destruction releases myoglobin: a muscle protein; into the
bloodstream. Classic symptoms: muscle pain/numbness/changes in sensation, muscle weakness/paralysis,
dark red/brown urine. Correct Answer: Rhabdomyolysis
What does MIST mnemonic mean? Correct Answer: M: Mechanism of Injury
I: Injuries sustained
, S: S&S in the field
T: Treatment in the field
Older adults are harder to intubate due to ______________ ____________ Correct Answer: cervical
arthritis
Leading cause of preventable death after injury Correct Answer: Hemorrhage
Most frequently injured organ Correct Answer: Liver
Most frequently injured organ from BLUNT trauma Correct Answer: Spleen
Pain Ladder:
Step 1: Non-opioids for mild pain
Step 2: Weak opioids for mild to moderate pain
Step 3: Strong opioids for moderate to severe pain Correct Answer: 1: Tylenol, Ibuprofen, Ketorolac
2: Codeine
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