TNCC 9th Edition Practice Questions
And Answers
MARCH mneumonic - CORRECT 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: Establis...
TNCC 9th Edition Practice Questions And Answers MARCH mneumonic - CORRECT 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 maintai n patent airway Respiration: Decompress suspected tension pneumothorax, seal open chest wounds, and support ventilation and oxygenation as required. Circulation: Provide vascular access (IV/IO) and administer fluids as required to treat shock Head injury/H ypothermia: Prevent or treat hypotension and hypoxia to prevent worsening of TBI and prevent or treat hypothermia. AVPU - CORRECT ANSWER -Assessing Alertness A: Alert and oriented V: Responds to verbal stimuli P: Responds only to painful stimuli U: Unrespo nsive LACE - CORRECT ANSWER -Soft Tissue Injuries L: Lacerations A: Abrasions, Avulsions C: Contusions E: Edema, Ecchymosis Urinary Catheter Contraindications - CORRECT ANSWER -if urethral transsection is suspected: -blood at the urethral meatus -perineal ecchymosis -scrotal ecchymosis -high-riding or nonpalpable prostate Breathing Intervention Reassessment - CORRECT ANSWER -1. Attach CO2 detector 2. Listen over epigastrum 3. Bilateral breath sounds at midaxillary and midclavicular lines 4. Color change aft er 6 breaths 5. Monitor skin color; get xr Troubleshooting Ventilator Alarms - CORRECT ANSWER -D: Displaced Tube O: Obstructed or Kinked Tube P: Pneumothorax E: Equipment failure, such as the patient becoming detached from the equipment or loss of capnography Seven P's of RSI - CORRECT ANSWER --Preparation: ensure you have all necessary equipment and personnel. Verify IV sites -Preoxygenation: high flow oxygen for minimum of 3 minutes. Position is HOB elevated to 20 degrees. For spinal precautions, reverse Trendelenburg at 30 degrees. -Pre-intubation optimization: Lidocaine (may reduce risk of rise in ICP during intubation) or Fentanyl (mitigates sympathetic re sponse increased HR and BP during intubation) administration -Paralysis with induction -Protection: after neuromuscular blocking agent is administered, protect the airway from aspiration by avoiding BVM, which can result in regurgitation and aspiration. -Placement with proof: inflate ETT cuff, secure, use ETCO2 for confirmation -Post-intubation management: secure tube and note measurement; xr. Inductions Agents for RSI - CORRECT ANSWER -Etomidate Ketamine Midazolam Propofol Paralysis Agents for RSI - CORRE CT ANSWER -Succinylcholine Rocuronium Vecuronium Cerebral Perfusion Pressure (CPP) - CORRECT ANSWER -Normal: 60 -100 mm Hg Acceptable: 50 -70 mm Hg Hypercarbia - CORRECT ANSWER -PaCO2 > 45 mmHg Excess of Co2 in the blood, indicated by an elevated PaCO2 as de termined by blood gas analysis Intracranial Pressure (ICP) - CORRECT ANSWER -0-15mmHg The pressure of the CSF in the subarachnoid space Mean Arterial Pressure (MAP) - CORRECT ANSWER -50-150mmHg The average blood pressure in a single cardiac cycle, roughly calculated as the SBP + 2 x the DBP/3 Avoid hypoxemia in the patient with head trauma - CORRECT ANSWER -A single episode of hypoxemia (PaO2 <60mmHg) can be detrimental to the patient's outcome. Maintain pulse ox at 95% or greater and obtain ABG measurement asap for patient with severe TBI. Maintain ETCO2 between 35 -45 mmHg
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