TNCC Exam Bundle Questions And Answers Graded A+

What roles are vital to a trauma team? - ANSWER-1. Patient 2. Team leader 3. Core team 4. Contingency and support services What are the characteristics of an effective team? - ANSWER-1. Clear roles and responsibilities 2. Shared mental model 3. Optimize resources 4. Strong team leadership...

Energy forces: Tension - ANSWER-forces stretch by pulling at opposite ends. Example: Tensile strength describes the tissues ability to resist pulling apart when stretched. Tendons, ligaments, and muscles can tear when they are overstretched (Achilles tendon) Energy Forces: Compression - ANSWE...

Expedite transfer to the closest trauma center - ANSWER-A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mas...

Prepare and triage - ANSWER-I will need to activate the triage team I will need to prepare the trauma room - this may not include and is not limited to 1) fluid warmer 2) peds equipment 3) bariatric equipment 4) difficult airway 5) IV equipment I will need to don PPE and consider the p...

The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following? A. Decompensa...

States the need to activate the trauma team - ANSWER-The trauma team is activated States the need to prepare the trauma room - ANSWER-Preparation is complete States the need to don personal protective equipment (PPE) - ANSWER-PPE has been donned by the team Assesses for obvious uncontrolled...

What does the Primary survey begin with in the TNP? - ANSWER-Across the room observation What is the main goal of primary survey during a trauma? - ANSWER-to immediately identify all life threatening conditions that can cause death within a few minutes of presentation What is the major cause o...

A 56 y/o M involved in a MVC is brought to the ED. He complains of neck pain, SOB, and diffuse abdominal pain. His GCS is 15, VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which is the priority intervention for this patient? - ANSWER-Expedite transfer to the closest trauma cent...

A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, r...

1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ANSWER-Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxyg...

1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ANSWER-Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxyg...

what is TNCC? - ANSWER-Trauma Nursing Core Course what forms of energy are there? - ANSWER-chemical, electrical, mechanical, radiant, thermal What is kinetic energy? - ANSWER-the energy of a body in motion amount of KE depends on what? - ANSWER-mass and velocity rollover collisions with ...

Normal levels of intracranial pressure - ANSWER-0-15 What is CPP and what is the normal range? - ANSWER-Cerebral perfusion pressure- measure of how much blood is getting to the brain Range for brain to auto regulate: 50-160 Role of MAP in TBI - ANSWER-if CPP isn't in normal range than MAP ...

An adult patient who sustained a severe head trauma has been intubated and has been manually ventilated via a bag mask device at a rate of 18 breaths per minute. The patient has received one intravenous fluid bolus of 500 ML of warmed isotonic crystalloid solution. The PaCO2 is 30 and a pulse ox sym...

1 - Trauma Activation - ANSWER-State need for trauma activation 2 - Is there any specific equipment that you would prepare? - ANSWER-State need to prepare trauma room Don PPE 3 - The patient has just arrived - ANSWER-Across the room observation. Is there any uncontrolled bleeding? If so, cont...

KE - ANSWER-Speed increases energy by the square of the velocity and can influence the extent of injury. However, the action of stopping must also be considered. Speed increases the risk of injury, but energy transfer occurs during the "stop," when energy is exerted and applied to the tissues upon...

Confirm ETT placement - ANSWER-An intubated trauma pt 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. What is the priority intervention? Apply a splint and elevate the extremity above the level of t...

A patient arrives at the emergency department by private vehicle after sustaining an injury to the right lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant bleeding. What is the priority intervention? A. Elevate the extremity to the level of th...

Primary survey - ANSWER-ABCDE with resuscitation adjuncts FG What does ABCDE/FG stand for - ANSWER-A airway/alertness/w simultaneous cervical spinal stabilization B-breathing/ventilation C-circ/control of hemorrhage D-disability (neuro status) E-exposure/environment control F-full VS/family ...

Biomechanics - ANSWER-is the general study of forces and their effects kinematics - ANSWER-the study of energy transfer as it applies to identifying actual or potential injuries Mechanism of Injury (MOI) - ANSWER-is how external forces are transferred to the body, resulting in injury Newton...

PPH - ANSWER-Activate, prepare, ppe, hemorrhage A - ANSWER-AVPU & Airway (tongue, teeth, edema, blood) B - ANSWER-Breathing (work, sym, rate, color) C - ANSWER-Circulation (hem, pulse, color, temp, moisture) D - ANSWER-Disability (GCS, pupils) E - ANSWER-Exposure (remove clothes, hem,...

What is kinetic energy (KE)? - ANSWER-KE equals 1/2 the mass (M) multiplied by the velocity squared. What is the Mnemonic for the Initial Assessment? - ANSWER-A = Airway with simultaneous cervical spine protection B = Breathing C = Circulation D = Disability (neurologic status) E = Expose/Env...

After report - ANSWER-Activate trauma team Get room ready -suction -chest tube? -IV kit Don PPE Across Room - ANSWER-Check for active hemorrhage A - ANSWER-Alert (AVPU) Airway (with c spine) 4 -tongue -secretions -edema -snoring

Patient report is given - ANSWER-"I'll activate the trauma team" The trauma team is activated - ANSWER-"I'll prepare the trauma room with a rapid infuser and chest trauma equipment." Preparation is complete - ANSWER-"I'll don a led jacket and yellow gown" PPE has been donned by the...

Prep & Triage - ANSWER-1. Activate trauma team and assign roles 2. Prepare the room and equipment 3. Don PPE General Impression - ANSWER-Assess for uncontrolled hemorrhage or unresponsiveness / apnea and the need to re-prioritize C-ABC Gen. Impression interventions - ANSWER-Interventions to ...

A - ANSWER-- Across the room observation for uncontrolled hemorrhage - Airway and alertness (w/ simultaneous c-spine stabilization) B - ANSWER-Breathing and ventilation C - ANSWER-- Circulation - Control of hemorrhage D - ANSWER-Disability E - ANSWER-Exposure and environmental control...

All of these are considered a critical communication point in trauma care EXCEPT which of the following? - ANSWER-Defusings A defusing is part of critical incident stress management but is not considered a critical communication point in trauma care. .During the primary survey of an unconscious p...

Primary concern when a person cannot stop coughing/clearing their throat following house fire/smoke? - ANSWER-Airway/Intubate Lab evidence of cellular perfusion - ANSWER-Base Excess (Less than -6 is BAD) Multiple people are in the ER of different ages who all go to the same church. They all ha...

RESPOND - ANSWER-Reassure Establish rapport Support patient Plan care, manage Pain Offer hope Never deliver news alone Determine patient needs MIST - ANSWER-Mechanism of injury Injuries sustained Signs and symptoms in the field Treatment in the field Primary Survey - ANSWER-Airway and...

What are the guidelines for field triage of injured patients? - ANSWER-Transport patients with the greatest degree of injury to highest level of care. Examples of physiologic derangements. - ANSWER-GCS <13 SBP <90 RR <10 or >29 Need for ventilatory support Examples of anatomical...

CSI - ANSWER-Cervical spinal Injury Manual stabilization - ANSWER-Two hands holding head and neck in alignment Immobilization (Neck) - ANSWER-Semi-rigid cervical collar securely fastened ( Miami j ) AVPU - ANSWER-Alert Verbal stimuli Pain Unresponsive Alert - ANSWER-May maintain air...

A - ANSWER-Airway--edema, vomit/blood, loose teeth, tongue obstruction, vocalization. Look in mouth, clear all/suction, maintain c-spine, cricothyrotomy or intubate as needed. B - ANSWER-Breathing--chest rise (symmetrical), rate and depth, accessory muscles, breath sounds, skin color. Do suppleme...

what organs tolerate pressure wave energy better? - ANSWER-solid organs (heart, liver, spleen, kidneys, pancreas, uterus) Highest rate of TBI related hospitalizations and death occurs in... - ANSWER-males ages 0 to 4 What organs resist shearing forces better? - ANSWER-air filled organs (lungs,...

Preparation & Triage - ANSWER-Safe Practice, Safe Care Right time Right resources Activate trauma team & prepare Trauma Room Across-the-room Observation - ANSWER-Uncontrolled hemorrhage? - Reprioritize to <C>ABC A- Airway & Alertness (C-Spine stabilization) - ANSWER-- *Assess LOC via...

A. (Know at least 4) - ANSWER-Airway & Alertness: the three Ts - Talk/vocalization/AVPU - Tongue obstruction - Loose teeth - Blood, vomitus, secretions, edema B. (Know at least 3) - ANSWER-Breathing & Ventilation: BRRO - Breathing spontaneously? - Rise & fall of chest/symmetry - Rate and...

1. Pre-Hospital MIST Report - ANSWER--Age -Sex -Mechanism and Details of Injury -Mental Status -Vitals (BP, HR, RR, O2) -C Spine or Backboard? -IV Access? -Meds given (including fluids and Oxygen) 2. Preparation and Triage - ANSWER-1. State need to activate Trauma Team ("Trauma Team Activ...

Airway Obstructions - ANSWER--Tongue obstruction -Altered LOC -Maxillofacial trauma -Vomiting -Injury to neck and larynx Causes of Ineffective Ventilation - ANSWER--Altered mental status -Prolonged loss of consciousness -Increased ICP -Hypoxia -High cervical spinal trauma -Blunt or penet...

Able to assess what is needed in the Trauma Room - ANSWER-Ex: Fluid warmer, pediatric/bariatric equipment, difficult airway or IV equipment If there is obvious uncontrolled external hemorrhage, where do you start? - ANSWER-Start with "C" Circulation. Initiate IV fluid and blood replacement befo...

Prepare for trauma: equipment - ANSWER-PPE IS there uncontrolled bleeding? - ANSWER-Go straight to circulation A: alertness and airway - ANSWER-Jaw and thrust (make sure to keep c-spine) Foreign object? Blood, vomit, secretions? Edema? Bony deformities of face? Tongue obstruction? AVPU...

What is kinetic energy (KE)? - ANSWER-KE equals 1/2 the mass (M) multiplied by the velocity squared. What is the Mnemonic for the Initial Assessment? - ANSWER-A = Airway with simultaneous cervical spine protection B = Breathing C = Circulation D = Disability (neurologic status) E = Expose/Env...

*Must Identify ALL 3* •Inspects for any uncontrolled external hemorrhage • Palpates a central pulse • Inspects AND palpates the skin for color, temperature, and moisture - ANSWER-(TNP) Circulation and Control of Hemorrhage

what roles are vital to a trauma team? - ANSWER-The Pt, team leader, care team, support services (anesthesia, RT, paramedics) what are the characteristics of an effective team? - ANSWER-Dynamic, interdependent, adaptive What are the key foundations to successful teamwork in the care of the tra...

MARCH mneumonic - ANSWER-Massive Hemorrhage: Control with combat gauze, celox gauze, or chito gauze; replacement of blood loss with whole blood or 1:1:1 ratio of plasma, RBC, and platelets to achieve SBP of 80-90mmHg. Airway: Establish and maintain patent airway Respiration: Decompress suspected ...

What is the key to a high performing trauma team? - ANSWER-Effective communication When obtaining a history for an injured patient, determining energy transfer through biochemical data help the nurse to: - ANSWER-prepare for and anticipate injuries The major preventable cause of death in the t...

What kind of approach is used by all members of the trauma team to provide optimal care for the trauma patient? - ANSWER-A systematic, organized approach. What is the minimum acceptable urinary output? - ANSWER-0.5mL/kg/hr What does SCIWORA stand for? - ANSWER-Spinal Cord Injury With Out Radio...

What is the key to a high-performance trauma team? A. Individual goals B. Use of TeamSTEPPS C. Identification of a single decision maker D. Effective communication - ANSWER-D. Effective communication When obtaining a history for an injured patient, understanding the kinematic concepts assoc...

The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patients fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to c...

After getting your MIST report, what 3 things should you do? - ANSWER-1. Activate Trauma Team 2. Prepare the room and equiptment 3. Don PPE What needs to happen as soon as the patient arrives? - ANSWER-The across-the-room assessment. Assess for any uncontrolled bleeding or hemorrhage. If b...

TNP Trauma Nursing Process - ANSWER-Rienforces a systemic and standardized approach to trauma nursing care and skills using an intergeated approach to trauma teamwork, communication and collabration Trauma - ANSWER-Leading cause of death ages 1-44 approx one person every 3 min brief - ANSWER-P...

EMS brings a patient who fell while riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? - ANSWER-Alert with no neurological deficits The trauma nurse knows that plac...

Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a) to measure oxygenation and ventilation b) to quantify the base deficit for the adequacy of cellular perfusion c) to gauge end-organ perfusion and tissue hypoxia d) to determine the underlying cause ...

EMS brings a patient who fell while riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? - ANSWER-Alert with no neurological deficits The trauma nurse knows that plac...

Why is alertness included in the airway assessment? - ANSWER-Including this helps evaluate the patient's ability to protect their own airway What pneumonic is used to assess a patient level of alertness? - ANSWER-A: Alert V: Responds to verbal stimuli P: Responds to pain U: Unresponsive Wh...

What do you do to prepare for the trauma after EMS report? - ANSWER-- activate code trauma - prepare team, assign roles - gather supplies - PPE - safety/ decontamination What is the first thing you do when the pt arrives? - ANSWER-General impression/ across the room assessment Is pt uncont...

What is the key to a high-performance trauma team? a. Individual goals b. Use of TeamSTEPPS c. Identification of a single decision maker d. Effective communication - ANSWER-d. Effective communication Rationale: Skilled communication, cooperation, and coordination are the cornerstones of high-...

Primary concern when a person cannot stop coughing/clearing their throat following house fire/smoke? - ANSWER-Airway/Intubate Lab evidence of cellular perfusion - ANSWER-Base Excess (Less than -6 is BAD) Multiple people are in the ER of different ages who all go to the same church. They all ha...

A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, r...

What is the key to a high performing trauma team? - ANSWER-Consistent communication (Communication, cooperation, and coordination are the foundations of successful teamwork in trauma care p.6) When obtaining a history for an injured patient, determining energy transfer through biomechanical data...

Expedite transfer to the closest trauma center - ANSWER-A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mas...

Primary concern when a person cannot stop coughing/clearing their throat following house fire/smoke? - ANSWER-Airway/Intubate Lab evidence of cellular perfusion - ANSWER-Base Excess (Less than -6 is BAD) Multiple people are in the ER of different ages who all go to the same church. They all ha...

1 - Trauma Activation - ANSWER-State need for trauma activation 2 - Is there any specific equipment that you would prepare? - ANSWER-State need to prepare trauma room Don PPE 3 - The patient has just arrived - ANSWER-Across the room observation. Is there any uncontrolled bleeding? If so, cont...

Major cause of death 1-44 - ANSWER-Trauma: major cause of death for people ages 1-44 years Epidemiology: Unintentional injury is a leading cause of death across all age groups in the US - ANSWER-• 65+ falls are the leading cause of injury-related deaths • 25-64: poisoning is the leading caus...

What roles are vital to a trauma team? - ANSWER--The patient -The team leader -Core team -Contigency and support services What are the characteristics of an effective team? - ANSWER-- Clear roles and responsibilities - Shared mental model - Optimize resources - Strong team leadership - E...

Spinal shock - ANSWER-At and below the level of spinal injury normal activity ceases, flaccidity, incontinence Spinal shock cause - ANSWER-Injury to spinal cord at any level Injury between T1 and T11 - ANSWER-Hypoventillation Central cord syndrome - ANSWER-Decreased function of upper extrem...

Initial - ANSWER-Activate Trauma, special equp, PPE REprior CABC? Across the room assessment AVPU, cervical stabilization A - ANSWER-Check airway for patency Tongue, Blood, secreations, teeth, trash, swelling/edema Interventions OPA, NPA, Tube REassess B - ANSWER-Breathing Spontaneous Che...

A - ANSWER-Airway and Alertness with simultaneous cervical spinal stabilization B - ANSWER-Breathing and Ventilation C - ANSWER-Circulation and Control of Hemorrhage D - ANSWER-Disability (neurologic status) E - ANSWER-Exposure and Environmental control F - ANSWER-Full set of Vital Si...

C What are the primary benefits of a team approach to trauma care - ANSWER-it provides a systemic approach to care and organizes care A In the primary survey AVPU is performed to determine if the patient can: - ANSWER-Protect their aiway B WHich may lead to unreliable pulse ox reading - ANSWER...

Shock - ANSWER-Inadequate tissue perfusion Hypovolemic Shock - ANSWER--Loss of circulating blood volume -Loss of plasma from intravascular space -Decreased preload -Decreased cardiac output -Replace lost volumer Obstructive Shock - ANSWER--Obstruction and prevention of function of vasculat...

PRIMARY - ANSWER-Blast lung primary - ANSWER-rupture of tympanic membranes/middle ear damage primary - ANSWER-abdominal hemorrhage and perforation primary - ANSWER-eye rupture primary - ANSWER-TBI, concussion secondary - ANSWER-wounds from flying debris secondary - ANSWER-eye penet...

Frostbite treatment - ANSWER-Rewarm area over 15 to 30 minutes in controlled temperature water (98.6-102.2) Give pain medicine Avoid friction or rubbing carbon monoxide poisoning - ANSWER-CO replaces oxygen and hemoglobin creating carboxyhemoglobin s/s headache, confusion, nausea or vomiting...

C What are the primary benefits of a team approach to trauma care - ANSWER-it provides a systemic approach to care and organizes care A In the primary survey AVPU is performed to determine if the patient can: - ANSWER-Protect their aiway B WHich may lead to unreliable pulse ox reading - ANSWER...