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TNCC 9TH EDITION TNP QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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TNCC 9TH EDITION TNP QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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TNCC 9TH EDITION TNP QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
—What does the J stand for at the end of the secondary survery? - ANSWER just keep evaluating - vipp
—What does VIPP stand for? - ANSWER vital signs, injuries/interventions, primary survey, pain
—During the head-to-toe, where would you find Grey-Turner's sign? - ANSWER flank
—During the head-to-toe, where would you find Cullen's sign? - ANSWER umbilicus
-What is sometimes deferred at the end of the head-to-toe? - ANSWER inspecting posterior
-Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial support,
social services, splinting, tetanus, and wound care are all interventions that you do AFTER and before
WHAT? - ANSWER AFTER head-to-toe, BEFORE J (VIPP)
-What three items are obtained during the pertinent history assessment? - ANSWER Medical records,
prehospital report, SAMPLE
-What are examples of nonpharmacologic measures? (must identify at least one during testing) -
ANSWER Distraction, family presence, padding bony prominences, repositioning, splinting, verbal
reassurance
-For whom is capnography highly recommended? - ANSWER all patients
-In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? - ANSWER EKG
-In Step 16 of "Exposure and Environment", you must name at least one of these interventions: -
ANSWER blankets, room temp increase, warmed fluids, warming lights
-To assess circulation, you must do these two main tasks: - ANSWER 1. inspect AND palpate skin color,
temp, moisture and 2. palpate a pulse
-What do you do when alterations are identified in any of the steps in the primary survery? - ANSWER
intervene as appropriate and reassess
-What three assessments must be done if the patient is intubated? - ANSWER 1. attach CO2 detector and
assess for evidence of exhaled CO2; 2. observe for rise and fall of the chest w/ assisted ventilations; 3.
auscultate over epigastrium for gurgling AND lungs for bilateral breath sounds
-Four of these must be identified to assess breathing effectiveness: - ANSWER Breath sounds,
depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, increased work of breathing,
symmetrical chest rise and fall, tracheal deviation/JVD, open wounds/deformities, skin color
,-What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which credit is given in
the LMNOP section? - ANSWER cardiac monitor
-When should 2 IV sites be established? - ANSWER During "Circulation" assessment
-If the patient is intubated and you've already assessed ETT placement, what else needs to be done with
the ETT? (step 10) - ANSWER assess ETT position by noting the number at teeth/gums AND secure ETT
-What should you verbalize after completing all ETT assessments? - ANSWER moving patient from
assisted ventilation to mechanical
-During which part of the primary survey would you anticipate the need for a chest tube, intubation,
decompression of pneumothorax, oxygen, or BVMs? - ANSWER "Breathing and Ventilation"
-Four of these must be identified to assess patency and protection of the airway: - ANSWER bony
deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns, fluids, foreign
objects, vocalization
-During which part of the primary survey would there be anticipation for intubation, insertion of
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? - ANSWER Assessing patency and
protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - ANSWER the need for a second person
to provide manual c-spine stabilization
*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? - ANSWER A.Decrease the rate of manual ventilation.
An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - ANSWER post-concussive syndrome
A patient with a 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 leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
, D.Preparing the patient for ultrasound of the leg - ANSWER C.Elevating the leg to the level of the heart
A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a
small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most
consistent with an injury to the diaphragm? - ANSWER Bowel sounds heard in the left lower chest
A ruptured diaphragm is a potentially life-threatening injury. The patient will most likely have decreased
breath sounds on the affected side along with pain, which may radiate to the left shoulder. However,
these signs do not specifically implicate an injury to the diaphragm. Auscultation of bowel sounds in the
chest indicates that abdominal contents have herniated up into the chest through a defect in the
diaphragm.
*A patient has been in the emergency department for several hours waiting to be admitted. They
sustained multiple rib fractures and a femur fracture after a fall. The patient has been awake, alert, and
complaining of leg pain. Their spouse reported that the patient suddenly became anxious and confused.
Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The
patient is exhibiting signs and symptoms most commonly associated with which of the following
conditions?
A. Acute lung injury
B. Fat embolism
C. Pneumothorax
D. Pulmonary contusion - ANSWER B. Fat embolism
*Three adults present at different times during a one-hour period with a high fever, fatigue, and
headache. All three patients have a rash which started on their mouth, face, and arms with progression
to the chest and abdomen. They all visited the same grocery store within the last week. What is the most
appropriate intervention from triage for these patients?
A. Move them to a decontamination area
B. Mask the patients and send them to the waiting room
C. Immediately initiate isolation precautions
D. Send them to the waiting room without a mask - ANSWER C. Immediately initiate isolation
precautions
The fact that multiple people with different demographics are appearing with similar signs and
symptoms would alert the nurse to a possible biological exposure. These patients should be placed in
isolation to prevent possible spread until further determination can be made.
*A 35-year-old male 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?
A.Oculomotor nerve palsy
B.Globe rupture
C.Retrobulbar hematoma
D.Retinal detachment - ANSWER B.Globe rupture
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