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TEST BANK; TNCC FULL SOLUTION PACK (ALL TNCC EXAMS AND STUDY QUESTIONS ARE HERE, ALL ANSWERED
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TEST BANK; TNCC FULL SOLUTION PACK (ALL TNCC EXAMS AND STUDY QUESTIONS ARE HERE, ALL ANSWERED
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An elderly patient with a history of anticoagulant use presents after a fall at home thatday. 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 - D) subdural hematoma
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 - A) compensated
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 of shock - c) to gauge end-organ perfusion and
tissue hypoxia
EMS brings a patient who fell 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?
A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath - D) Smell of alcohol on breath
Which of the following occurs during the third impact of a motor vehicle crash?
A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger - C) the aorta is torn at its
attachment with the ligamentum arteriosum
,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 - A) initiate transfer to a trauma center
Which of the following injuries is LEAST likely to be promptly identified?
A) spleen
B) lung
C) bowel
D) brain - C) bowel
Patients with a crush injury should be monitored for which of the following conditions?
A) Hypernatremia
B) Hypercalcemia
C) Dysrhythmias
D) polyuria - C) Dysrhythmias
You are treating a 27-year old male in respiratory distress who was involved in a house
fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what
rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr - B) 500 mL/hr
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 - B) fat embolism
,Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - B) narrowed
Which of the following considerations is most important when caring for a geriatric
trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls - B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from
a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration - D) hypotension that worsens with
inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side.
Hypotension due to compression of the heart and great vessels is consistent with
obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is
calculating the patient's 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 calculate the total BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL - A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
, A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis - A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
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 - C) expedite transfer to the closest trauma center
What finding raises suspicion of complete spinal cord injury?
A) Weakness in the lower extremities
B) Priapism
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury - B) Priapism
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 - D) Bradycardia
and absent motor function below the level of the injury
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
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