TNCC 8TH EDITION EXAM 2 LATEST VERSIONS
(VERSION A & B) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
According to newtons law which of these two force is greater: size or force? -
ANSNeither. For each force there is an equal and opposite reaction.
Define Cushing's triad - ANSBradycardia, progressive hypertension (widening pulse
pressure), and decreased respiratory effort
Define the characteristics of neurogenic shock - ANSDistributive shock with a T6 or
higher injury results and vasodilation, bradycardia, flushed warm dry skin. Risk for
temperature instability. Nursing interventions include maintaining warmth and spinal
stabilization.
Define the characteristics of spinal shock - ANSTransient loss of function can include
loss of reflexes and muscle tone below the level of industry with possible vascular
response.
Describe one fat embolism syndrome is most likely to occur in its characteristics -
ANSWith longform fractures. Tachycardia, Thrombocytopenia, and petechiae rash.
Describe the characteristics of cardiogenic shock - ANSCardiogenic shock results from
pump failure in the presence of adequate intravascular volume. Lack of cardiac output
and an organ perfusion occurs secondary to a decrease in myocardial contractility and
or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms
can include low blood pressure increase heart rate and respiratory rate chest pain
shortness of breath dysrhythmias increase troponin and pale cool moist skin
Describe the characteristics of distributive shock. - ANSDistributive shock occurs as a
result of Mel distribution of an adequate circulating blood volume with the loss of
vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis,
or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate
preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin
with a cool core temperature.
Describe the characteristics of hypovolemic shock - ANSHypovolemia is caused by a
decrease in the amount of circulating volume usually caused by massive bleeding, but
also can be from vomiting and diarrhea. Characteristics include low blood pressure and
preload, increase heart rate respiratory rate and afterload, with contractility unchanged.
Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin,
distended abdomen, pelvic fracture, or bruise swollen and deformed extremities
especially long bones.
,TNCC 8TH EDITION EXAM 2 LATEST VERSIONS
(VERSION A & B) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
Describe the characteristics of obstructive shock - ANSObstructive shock is it
mechanical problem that results from hypoperfusion of the tissue due to an obstruction
in either the vasculature or the heart resulting in decreased cardiac output. Some
causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on
the right side of the heart during systole in the pulmonary artery.Signs include anxiety,
muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses
paradoxes.
Describe the four types of spinal cord injury - ANSCentral cord injury results in greater
weakness distally, anterior injury includes motor loss or weakness below the cord level
of injury yet sensory is intact, Brown-Sequard (hemicord) is weak on one side with
sensory deficit on opposite side, posterior cord syndrome although rare is when the
patient is unable to use sense vibration in proprioception
Describe the measurement of an NPA - ANSMeasure from the tip of the patient's nose
to the tip of the patients earlobe.
Differentiate between the three impacts of motor vehicle impact sequence. - ANSThe
first impact occurs when the vehicle collided with another object. The second impact
occurs after the initial impact when the occupant continues to move in the original
direction of travel until they collide with the interior of the vehicle or meet resistance.
The third impact occurs when internal structures collide within the body cavity.
Measurement of an OPA - ANSPlace the proximal end or flange of the airway adjunct at
the corner of the mouth to the tip of the mandibular angle.
Name the three ways to confirm ETT placement - ANSPlacement of a CO2 monitoring
device, Assessing for equal chest rise and fall, and listening at the epigastrium and four
lung fields for equal breath sounds.
True or false: NPAs and OPAs are definitive airways. - ANSFalse. When placing one of
these? One should consider the potential need for a definitive airway.
What are contributing factors to injuries related to blunt traumas? - ANSThe point of
impact on the patient's body, the type of surface that is hit, the tissues ability to resist
(bone versus soft tissue, air-filled versus solid organs), and the trajectory of force.
What are the early signs of increased Intracranial pressure - ANSheadache, vomiting,
behavioral changes that begin with restlessness and may progress to confusion,
drowsiness, or impaired judgment
,TNCC 8TH EDITION EXAM 2 LATEST VERSIONS
(VERSION A & B) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
What are the four types of shock? - ANSHypovolemic, Cardiogenic, Obstructive, &
Distributive
What are the four types of trauma related injuries? - ANSBlunt, penetrating, thermal, or
blast.
What are the greatest risks for transport? - ANSLoss of airway patency, displaced
obstructive tubes lines or catheters, dislodge splinting devices, need to replace or
reinforce dressings, deterioration in patient status change in vital signs or level of
consciousness, injury to the patient and/or team members
What are the late signs of Increased intracranial pressure - ANSdilated, non-reactive
pupil(s); abnormal motor posturing (flexion, extension, flaccidity); Cushing's triad,
Unresponsive to per verbal and painful stimuli, bradycardia and decreased respiratory
effort
What are the seven patterns of pathway injuries related to motor vehicle accidents? -
ANSUp and over, down and under, lateral, rotational, rear, roll over, and ejection.
What are the signs and symptoms of decompensated shock? - ANSDecreased level of
consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses,
tachypnea, skin that is cool clammy and cyanotic, base access outside the normal
range, and serum lactate levels greater than two to 4MMOL/L.
What are the signs and symptoms of irreversible shock? - ANSObtunded stuporous or
comatose state, marked hypertension and heart failure, bradycardia with possible
dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin,
kidney liver and other organ failure, severe acidosis, elevated lactic acid levels,
worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding.
What are the signs of compensated shock? - ANSAnxiety, confusion, restlessness,
increased respiratory rate, narrowing pulse pressure were diastolic increases yet
systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary
output
What are the symptoms of a subdural hematoma? - ANSDecreased LOC, nausea
vomiting headache and ipsilateral pupillary changes
, TNCC 8TH EDITION EXAM 2 LATEST VERSIONS
(VERSION A & B) COMPLETE 200 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
What are the three factors that contribute to the damage caused by penetrating
trauma's? - ANSThe point of impact, the velocity and speed of impact, and the proximity
to the object.
What are the three processes that transfer oxygen from the air to the lungs and blood
stream - ANSVentilation: the active mechanical movement of air into and out of the
lungs; diffusion: the passive movement of gases from an area of higher concentration to
an area of lower concentration; and perfusion: the movement of blood to and from the
lungs as a delivery medium of oxygen to the entire body.
What are the three stages of shock - ANSCompensated, decompensated or
progressive, and irreversible.
What are the treatment goals for a TBI? - ANSO2 saturation > or equal to 95%, systolic
blood pressure > or equal to 100 MMHG, ICP < 15 MMHG, CPP > or equal to 60
MMHG, normal glycemia, hemoglobin > or equal to 7 g/DL, sodium 135-145, osmotic
diuretics, anti-emetics, sedatives, anticonvulsants, head of bed at 30°, and neck at
midline
What causes quarternary effects of blast traumas? - ANSAll explosion related injuries,
illnesses, or diseases not due to the first three mechanisms. Injuries include external
and internal burns, crush injuries, closed and open brain injuries, asthmatic or breathing
problems from dust smoke or toxic fumes, angina, or hyper glycemia and hypertension.
What causes quinary effects of blasts traumas? - ANSThose associated with exposure
to hazardous materials from radioactive, biologic, or chemical components of a blast.
Injuries include a variety of health effects depending on agent.
What causes the primary effects of blast traumas? - ANSThe direct blast effects. Types
of injuries include last long, tympanic membrane rupture and middle ear damage,
abdominal hemorrhage and perforation, global rupture, mild Trumatic brain injury.
What causes the secondary effects of blast traumas? - ANSProjectiles propelled by the
explosion. Injuries include penetrating or blunt injuries or I penetration.
What causes the tertiary effects of blast traumas? - ANSResults from individuals being
thrown by the blast wind. Injuries include hole or partial body translocation from being
thrown against a hard service: blunt or penetrating trauma's, fractures, traumatic
amputations.
