TNCC FINAL EXAM TEST 2024 OPEN BOOK QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in
various stages of healing and multiple small, clean, round burns to the back. There are
no abnormalities found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
A) report your suspicion of the maltreatment in accordance with local regulations
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention recourses - ANSA) report your suspicion of
the maltreatment in accordance with local regulations
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on
the bicycle cross bars which performing an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the nurse questions?
A) Fast exam
B) CT scan
C) straight cath for urine sample
D) ice and elevation of the scrotum - ANSC) straight cath for urine sample
A 35-year old male presents with facial trauma after bring struck in the face with a
baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is
suspected?
A) oculomotor nerve palsy
B) globe rupture ***
C) Uncal herniation
D) retinal detachment - ANSB) globe rupture
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and elevate above the level of the heart
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart. - ANSB) apply a
splint and ELEVATE ABOVE THE LEVEL OF THE HEART
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all
of these negative fast exam except which of the following?
A. Diagnostic peritoneal lavage
B. Serial FAST exams
C. Abdominal and pelvic CT scans
,TNCC FINAL EXAM TEST 2024 OPEN BOOK QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
D. Serial abdominal assessments - ANSA) diagnostic peritoneal lavage
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma.
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - ANSC) expedite transfer to the closest trauma center
A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the
primary survey, which of the following is the priority interventions?
A) initiate transfer to a trauma center
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube - ANSA) initiate transfer to a trauma center
A patient arrives with a large open chest wound after being assaulted with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it
on 3 sides. He is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate interventions?
A) needle decompression
B) tube thoracostomy
C) dressing removal
D) surgical repair - ANSC) dressing removal
,TNCC FINAL EXAM TEST 2024 OPEN BOOK QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
A patient has been in the ED for several hours waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o
leg pain. His wife reported suddenly becoming anxious and confused. Upon
reassessment, the patient is restless, with respiratory distress and petechiae to his
neck. the patient is exhibiting signs of symptoms commonly associated with which of the
following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion - ANSB) fat embolism
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab
values is expected with a musculoskeletal complication associated with this
presentation?
A) elevated creatine kinase
B) decreased potassium level
C) decreased WBC
D) elevated GFR - ANSA) elevated creatine kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - ANSA) initiate
two large bore intravenous lines for Ringers lactate solution administration
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury - ANSD)
Bradycardia and absent motor function below the level of the injury
, TNCC FINAL EXAM TEST 2024 OPEN BOOK QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
A patient with 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 extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart
D) Preparing the patient for ultrasound - ANSC) Elevating the extremity to the level of
the heart
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the
CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
A) Brief
B) loop
C) debrief
D) huddle - ANSD) huddle
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival
were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and
dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient
is demonstrating signs and symptoms of which stage of shock?
A) compensated
B) Progressive
C) irreversible
D) decompensated - ANSA) compensated
An elderly patient with a history of anticoagulant use presents after a fall at home that
day. she denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma - ANSD) subdural hematoma
An intubated trauma patient is being transferred to a tertiary care center. After moving
the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which
of the following is the priority interventions?
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