TNCC WRITTEN EXAM 2024/2025 NEWEST!! 200 COMPLETE ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS ) ALREADY GRADED
A/ 2024 TNCC WRITTEN PREP 103 EXAM QUESTIONS AND CORRECT ANSWERS.
What are the late signs of breathing compromise? - ANSWER--
Tracheal deviation
- JVD
What are signs of ineffective breathing? - 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? - ANSWER-A tight-fitting nonrebreather mask at
12-15 lpm.
,What intervention should be done if a pt presents with effective
circulation? - ANSWER-- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate
rate
What are signs of ineffective circulation? - 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? -
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)
What are factors that contribute to ineffective ventilation? - ANSWER-
- AMS
- LOC
- Neurologic injury
- Spinal Cord Injury
- Intracranial Injury
- Blunt trauma
- Pain caused by rib fractures
- Penetrating Trauma
- Preexisting hx of respiratory diseases
- Increased age
What medications are used during intubation? - ANSWER-LOAD
Mnemonic:
L = Lidocaine
O = Opioids
A = Atropine
D = Defasiculating agents
What are the Rapid Sequence Intubation Steps? – ANSWER-
PREPARATION:
- gather equipment, staffing, etc.
PREOXYGENATION:
, - Use 100% O2 (prevent risk of aspiration).
PRETREATMENT:
- Decrease S/E's of intubation
PARALYSIS WITH INDUCTION:
- Pt has LOC, then administer neuromuscular blocking agent
PROTECTION AND POSITIONING:
- Apply pressure over cricoid cartilage (minimizes likelihood of
vomiting and aspiration
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts.
Ventilate pt 30-60 seconds between attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
What is a Combitube? - ANSWER-A dual-lumen, dual-cuff airway that
can be placed blindly into the esophagus to establish an airway. If
inadvertently placed into trachea, it can be used as a temporary ET
tube. There are only two sizes: small adult and larger adult.
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