TNCC test prepA, 8th Edition Study Guide 2022/2023
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Course
TNCC
Institution
TNCC
Expedite transfer to the closest trauma center
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 mask. Whic...
a 56 yo m pt involved in a motor vehicle crash is brought to the ed of a rural critical access facility he complains of neck pain
and diffuse abd pain his gcs is
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TNCC test prepA, 8th Edition
Expedite transfer to the closest trauma center - correct 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 mask. Which of the following is
the priority intervention for this patient?
a pertinent medical hx is crucial - correct answer Which of the following considerations
is the most important when caring for a geriatric trauma pt?
Mitigation - correct answer Following a review of recent drills and a real disaster event,
a hospital has identified deficiencies and is taking steps to minimize the impact of a
future disaster . Which phase of the disaster life cycle does this describe?
Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of
any substances, and without neurologic abnormalities - correct answer EMS brings a pt
who fell while riding his bicycle. Using the American College of Surgeons screening
guidelines, which assessment finding would prompt the RN to prepare the pt for a
radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - correct answer What is
the effect of hypothermia on the oxyhemoglobin dissociation curve?
acidosis - correct answer Which of the following is a component of the trauma triad of
death?
Complete - correct answer EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12,
temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These
assessment findings are most consistent with which of the following types of spinal cord
injury?
flucuation in the water seal chamber - correct answer Which of the following is an
expected finding in a pt with a tube thoracstomy connected to a chest drainage system?
insert an oropharyngeal airway if there is no gag reflex - correct answer During the
primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring
respirations. What priority nursing interventions should be preformed next?
,globe rupture - correct answer A 35 y/o M presents with facial trauma after being struck
in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of
injury is suspected?
compensated - correct answer A trauma pt is restless and repeatedly asking "where am
i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are
BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of shock?
ventilate with a bag mask device - correct answer An unresponsive trauma pt has an
oropharygeal airway in place, shallow and labored respirations, and dusky skin. The
trauma team has administered medications for drug-assisted intubation and attempted
intubation but was unsuccessful. What is the most appropriate immediate next step?
within 24 hrs of trauma - correct answer When is the tertiary survey completed fora
trauma pt?
pressure - correct answer An intubated and sedated pt in the ED has multiple extremity
injuries with the potential for causing compartment syndrome. What is the most reliable
indication of compartment syndrome in a patient who is unconscious?
worsening pneumothorax - correct answer Which of the following is possible
complication of positive-pressure ventilation?
pelvic stability - correct answer the most reassuring finding for a male pt with hip pain
after a fall is which of the following?
narrowed - correct answer Which of the following pulse pressures indicate early
hypovolemic shock?
dysrhythmias - correct answer Patients with a crush injury should be monitored for
which of the following conditions?
subdural hematoma - correct answer Tearing of the bridging veins is most frequently
associated with which brain injury?
straight cath for urine sample - correct answer A 20 y/o M presents to the ED
complaining of severe lower abd pain after landing hard on the bicycle cross bars while
preforming an aerial BMX maneuver. Secondary assessment reveals lower abd
tenderness and scrotal ecchymosis. Which of the following orders would the RN
question?
placental abruption - correct answer You are caring for a pt who was involved in a MVC
and is 32 weeks pregnant. Findings of your secondary survey include abd pain on
palpation, fundal ht at the costal margin, and some dark bloody show. Varying
accelerations and decelerations are noted on cariocgraphy. These findings are most
consistent with which of the following?
,it can worsen cord damage from an unstable spinal injury - correct answer Which of the
following is true about the log-roll?
defusings - correct answer All of these are considered a critical communication point in
trauma care EXCEPT which of the following?
pulse oximetry and capnography - correct answer What bedside monitoring parameters
are used to assess for adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - correct answer Caregivers
carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and
crying with increased work of breathing and pale skin. Which of the following
interventions has the highest priority?
bowel - correct answer Which of the following injuries is LEAST likely to be promptly
identified?
Initiate transfer to a trauma center - correct answer A pt is brought to the ED of a rural
hospital following a high-speed MVC. When significant abd and pelvic injuries are noted
in the primary survey, which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury - correct answer A pt
with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs?
apply splint and elevate above the level of the heart - correct answer a 37 y/o F has a
deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which
of the following is the most appropriate intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - correct answer
which of the following occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - correct
answer a 5 y/o child presents to the ED with bruises to the upper arm 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 survey. Which of the following is the priority nursing
intervention?
to guage end-organ perfusion and tissue hypoxia - correct answer Why is a measure of
serum lactate obtained in the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - correct answer A pt with a lower
extremity fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention?
, velocity - correct answer What factor contributes most to the kinetic energy of a body in
motion?
subdural hematoma - correct answer An elderly patient with a history of anticoagulant
use presents after a fall at home today. She denies any loss of consciousness. She has
a hematoma to her forehead and complains of headache, dizziness, and nausea. What
is the most likely cause of her symptoms?
fat embolism - correct answer a pt has been in the ED for several hrs waiting to be
admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has
been awake, alert, and complaining of leg pain. His wife reported that he suddenly
became anxious and confused. Upon reassessment, the pt is restless with respiratory
distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated
with which of the following conditions?
Late signs of increased intracranial pressure include: dilated nonreactive pupils,
unresponsive to verbal or painful stimuli, abnormal motor posturing, and Cushing
response (widening pulse pressure, reflex bradycardia, decreased respiratory effort) -
correct answer Which of the following is a late sign of increased intracranial pressure?
serial FAST exams - correct answer a 49 y/o restrained driver involved in a MVC
presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity
pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam
EXCEPT which of the following?
pericardiocentesis - correct answer Which of the following is NOT considered goal-
directed therapy for cardiogenic shock?
endotracheal tube - correct answer The trauma nurse knows that placing a bariatric
patient in a ramped position providers better visualization during the insertion of which
device?
increased work of breathing
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side
- correct answer which of the following assessment findings differentiates a tension
pneumothorax from a simple pneumothorax?
calcium - correct answer if a pt has received multiple transfusions of banked blood
preserved with citrate, which electrolyte is most likely to drop and require
supplementation?
identifying individuals who made mistakes during the traumatic event - correct answer
Which of the following is NOT considered a benefit of debriefings?
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