TNCC Trauma Nursing Core Course 18th
Edition ENA Test Bank |Graded A+ pass
1. Which of the following requires you to develop a plan of action,
initiate the plan, reassess the plan as care for the patient moves
forward, and adjust the plan as the patient's condition or circumstances
change?
A. Principles of
PHTLS B. The
Golden Period
C. The XABCDE assessment
D. Critical thinking process - ansQuestion 1: D
To help achieve the PHTLS goals, you will apply your critical thinking skills in
the field. Critical thinking in medicine is a process in which the healthcare
practitioner assesses the situation, the patient, and the resources available
and uses the information to decide on and provide the best care for the
patient.
1. You and your partner are responding to a call for a 2-year-old patient
with a burn injury to the hand. He has a visible burn to the left hand,
ending at the level above the wrist, red color, and wet in appearance.
What type of burn do you suspect the patient has sustained?
A. Superficial (first degree)
B. Partial thickness (second
degree) C. Full thickness (third
degree)
D. Subdermal (fourth degree) - ansQuestion 1: B
Scald burns are the most common burns seen in the pediatric population
ages 1 to 5 years. Scalds are partial thickness burns. The dermal layer is
damaged, and blisters are present or popped. It is also the most painful type
of burn.
1. You are called to the scene of a possible mass casualty motor vehicle
collision on the highway. Once you arrive on scene, what is your first
priority?
A. Immediately begin triaging patients.
B. Treat the patient with the most visible
blood loss. C. Determine the need for
additional resources.
D. Assess the scene and ensure it is safe. - ansQuestion 1: D
Ensure safety for responders, bystanders, and patient(s). The first
consideration when approaching any scene is the safety of all emergency
responders. When EMS personnel become victims, they not only can no
longer assist others, but also add to the number of patients.
1. You are called to the scene of an explosion and fire at a chemical plant
where you find multiple casualties.Triage has begun. Your first patient is
a 40-year-old man who was near the source of the explosion. He is
,TNCC Trauma Nursing Core Course 18th
Edition ENA Test Bank |Graded A+ pass
unconscious and has extensive injuries. You note gurgling respirations.
Why should you use the trauma jaw thrust maneuver first when dealing
with a trauma patient?
A. It's an easy technique that always works to open the airway.
,TNCC Trauma Nursing Core Course 18th
Edition ENA Test Bank |Graded A+ pass
B. It allows you to open the airway with little or no movement of the head
and cervical spine.
C. Other techniques and interventions don't work as well.
D. It can relieve a variety of anatomic airway obstructions in patients who
are breathing spontaneously. - ansQuestion 1: B
Manual maneuvers like the trauma jaw thrust or chin lift are always the first
airway maneuver you should make when treating a trauma patient. In
patients with suspected head, neck, orfacial trauma, the cervical spine is
maintained in a neutral in-line position.The trauma jaw thrust maneuver
allows you to open the airway with little or no movement of the head and
cervical spine.
1. You are responding to a call for 25-year-old, fit and healthy female who
fell off a mountain bike. Upon arrival, you find the patient walking around.
She is alert but complaining of pain in her clavicle and on her right side
when she inhales. You notice that her helmet is split in two. What is the
first thing you need to do?
A. Complete a review of the ABCs.
B. Check motor and sensory
function. C. Perform manual in-
line stabilization.
D. Place her on a backboard. - ansQuestion 1: C
Because there's a possibility of spinal injury, you should bring the patient's
head into a neutral in-line position.
1. You have been performing ongoing management on a 35-year-old female
patient who sustained thoracic trauma when a car hit her as she crossed
the street. Originally, your electronic monitoring devices all produce results
consistent with your patient's clinical condition. However, en route the
trauma center, the monitors start to differ from your patient's current
clinical condition each time you reassess. How should you handle this
situation?
A. Treat the patient's condition, not the monitor results.
B. Continue to reassess the patient and record the results for the
trauma center. C. Treat your patient based on the test results.
D. Stop testing and wait until you arrive at the trauma center for them to
perform an assessment. - ansQuestion 1: A
If there are inconsistent data from electronic monitoring devices, reassess
to be sure the monitor matches the patient's current clinical condition.
However, it is most important to treat the patient, not the monitor, so use
other signs and symptoms of potential patient deterioration.
1. You're called out to an assisted living facility for a 72-year-old woman
complaining of a severe headache and experiencing increased confusion.
Staff reports she fell out of her wheelchair earlier in the week but didn't
appear to be hurt; however, she's become increasingly disoriented over the
last day or so. Vital signs show: BP 110/90; heartrate 118 and irregularly
regular; ventilation rate 20 and slightly labored; SpO2 93% on room
, TNCC Trauma Nursing Core Course 18th
Edition ENA Test Bank |Graded A+ pass
air. She is taking warfarin for a clotting issue. Which of the following
should you suspect?
A. Cerebral
contusion B.
Epidural
hematoma
C. Subarachnoid hemorrhage
D. Subdural hematoma - ansQuestion 1: D
The patient's age, use of a blood thinner, and the fact she fell recently point
to a subdural hematoma.
1. Your partner is compressing the bleeding site of a male patient who was
stabbed multiple times in the left chest. The bleeding seems to be
controlled, yet the patient becomes combative. He is pale and is
breathing rapidly, yet states that he "can't breathe" and feels that he is
about to die. Your next step in patient management is to: A. start assisted
ventilation.
B. give high-flow oxygen.
C. decompress the left chest.
D. give a 250-mL fluid bolus. - ansQuestion 1: C
After X come A and B. You can quickly auscultate the lungs
(pneumothorax is almost certain with multiple stabs in the chest) and
decompress the chest. Decompressing a tension pneumothorax is the
quickest way to treat shock.
1. Your patient is experiencing severe pain after sustaining a femur
fracture in a motorcycle crash. You have a 20 minute transport to the
nearest trauma center. There are no other injuries noted on your primary
and secondary assessments. Which of the following medications would be
the best pain management choice?
A. NSAIDs
B. Acetaminoph
en C. Fentanyl
D. Morphine - ansQuestion 1: C
Fentanyl is often a first-line agent due to speed of onset, short duration of
action, and minimal effect on hemodynamics. Fentanyl can beadministered
IN, IM, IO, or IV. The IV route provides effects instantly whereasthe IN and IM
route have an onset of <10 minutes. The duration of fentanyl is short at 30
minutes to an hour. This will provide enough time to ease pain during
transport and let the traumacenter decide pain management upon arrival.
2. A trauma patient from the highway incident is holding her right arm,
and you note a significant amount of blood steadily flowing from a long
gash. This is an example of what type of hemorrhage?
A. Capillary
bleeding B.
Venous bleeding
C. Arterial