TNCC Notes for Written ExaM 2023 Defined
terms and Q&A/Trauma Nursing Core Course 7th Edition (2015)
What is kinematics? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- Energy can neither
be created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? -{ANSW}- Force equals mass multiplied
by acceleration of deceleration.
What is kinetic energy (KE)? -{ANSW}- KE equals 1/2 the mass (M)
multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- - Tracheal
deviation
- JVD
What are signs of ineffective breathing? -{ANSW}- - 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? -{ANSW}- A tight-fitting nonrebreather mask at 12-
15 lpm.
What intervention should be done if a pt presents with effective circulation?
-{ANSW}- - Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? -{ANSW}- - 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? -{ANSW}- -
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"? -{ANSW}- 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? -{ANSW}- - 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? -
{ANSW}- - Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
- Keep clothing for evidence
terms and Q&A/Trauma Nursing Core Course 7th Edition (2015)
What is kinematics? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- Energy can neither
be created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? -{ANSW}- Force equals mass multiplied
by acceleration of deceleration.
What is kinetic energy (KE)? -{ANSW}- KE equals 1/2 the mass (M)
multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- 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? -{ANSW}- - Tracheal
deviation
- JVD
What are signs of ineffective breathing? -{ANSW}- - 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? -{ANSW}- A tight-fitting nonrebreather mask at 12-
15 lpm.
What intervention should be done if a pt presents with effective circulation?
-{ANSW}- - Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? -{ANSW}- - 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? -{ANSW}- -
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"? -{ANSW}- 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? -{ANSW}- - 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? -
{ANSW}- - Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
- Keep clothing for evidence
