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TNCC Trauma Nursing Core Course 7th Edition ENA Exam Verified 2024
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TNCC Trauma Nursing Core Course 7th Edition ENA Exam Verified 2024
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TNCC Trauma Nursing Core Course 7thEdition ENA Exam Verified 2024
_________ therapy is now suggested for fluid resuscitation to replace patient losses,
including administering PRBCs, plasma, and platelets. - ANSWER-COMPONENT
THERAPY
ch. 5, p. 45
__________, which can occur in resuscitation, is a common IATROGENIC cause of
INCREASED intrathoracic pressure resulting in COMPRESSION of the heart and
DECREASED cardiac output. - ANSWER-HYPERVENTILATION
ch. 7, p. 74
55% of spinal injuries occur to which part of spine? - ANSWER-cervical
ch. 13, p. 179
A rapid, thready pulse may indicate (a. _______), and an irregular pulse may warn of
potential (b. _______). - ANSWER-a. HYPOVOLEMIA
b. CARDIAC DYSFUNCTION
ch. 5, p. 45
ABGs provide values of oxygen, CO2 and base excess, which are... - ANSWER-
Reflective endpoint measurements of the effectiveness of cellular perfusion, adequacy
of ventilation, and the success of the resuscitation.
An abnormal base deficit may indicate poor perfusion and tissue hypoxia, which results
in the generation of hydrogen ions and metabolic acidosis.
ch. 5, p. 46
Activation of the SYMPATHETIC NERVOUS SYSTEM causes the ADRENAL glands to
release TWO catecholamines - EPINEPHRINE and NOREPINEPHRINE. These
cause... - ANSWER-- HIGH levels of EPINEPHRINE cause smooth muscle relaxation in
the airways and causes arteriole smooth muscle contractility (potentiating inotrophic
effect). EPI also INCREASES heart rate (positive chronotrophic effect), peripheral
vasocontriction, and glycogenolysis (breakdown of glycogen stores in liver into glucose
for cellular use)
,- NOREPINEPHRINE increases heart rate, vascular tone through alpha-adrenergic
receptor activation, and blood flow to skeletal muscle and triggers the release of
glucose from energy stores.
ch. 7, p. 77
Additional history includes the following (MIST mnemonic) prehospital report: -
ANSWER-- MOI
- Injuries sustained
- Signs and Symptoms (in the field)
- Treatment (in the field)
ch. 5, p. 47
All open fractures are considered contaminated due to exposure to the environment and
are at risk for infection. These sites of injury have poor wound healing with a risk of.... -
ANSWER-OSTEOMYELITIS and SEPSIS
ch. 14, p. 197
Anterior cord syndrome - ANSWER-loss of pain and temperature sensation with
weakness, paresthesia, and urinary retention
ch. 13, p. 182
AORTIC DISRUPTION - ANSWER-Assessment findings
- Fractures of sternum, first or second rib or scapula
- CARDIAC MURMURS
- BACK, CHEST PAIN
- UNEQUAL EXTREMITY PULSE STRENGTH or BLOOD PRESSURE (Significantly
greater in upper extremities)
- HYPOTENSION
- TACHYCARDIA
- SKIN CHANGES: diaphoresis, pallor, cyanosis
- PHARAPLEGIA (due to disruption of spinal perfusion from aortic injury)
- Radiograph findings include- left hemothorax, right-sided tracheal deviation, widened
mediastinum
Interventions
- Prepare for surgery or angiography
- Consider massive transfusion protocol
ch. 11, p. 146
Are the lumen contents of the small bowel considered sterile? What is the pH? -
ANSWER-neutral pH, and sterile
,ch. 12, p. 164
As ICP rises, CPP ________, resulting in cerebral ischemia, hypoxemia, and lethal
secondary insult. - ANSWER-DECREASES
Ch. 9, p. 109
As shock progresses, primary goal of the body is to maintain perfusion to vital organs.
Sympathetic stimulation has little effect on the cerebral and coronary vessels since they
are capable of autoregulation. Cerebral autoregulation maintains a constant... -
ANSWER-cerebral vascular blood flow as long as the MAP is maintained between 50-
150... when autoregulation in the brain fails, perfusion becomes dependent solely on
pressure.
ch. 7, p. 78
Assess pupils for... - ANSWER-Equality, shape, and reactivity (PERRL)
ch. 5, p. 45
Assessment findings for MILD, MODERATE, and SEVERE TRAUMATIC BRAIN
INJURY INCLUDE: - ANSWER-MILD
- GCS 13-15
- Brief (<30 min) LOC
- POST-TRAUMATIC AMNESIA < 24 hours
- No change on neuron aging studies
MODERATE
- GCS score 9-12
- Wide variety of symptoms, including ALTERATIONS IN CONSCIOUSNESS,
CONFUSION, AMNESIA, and FOCAL NEUROLOGICAL DEFICITS
- May deteriorate to severe head injury over time
SEVERE
- GCS score <8
- Significant alterations in consciousness
- ABNORMAL PUPILLARY RESPONSE
- ABNORMAL POSTURING
Ch. 9, p. 115
Assessment findings for renal injuries include - ANSWER-- Turner sign (bruising by 11th
and 12th ribs)
- Hematuria
- Frank tenderness, costovertebral angle tenderness, palpable flank mass
, - Structural damage or leakage of contrast on intravenous pyelogram (IVP)
- If patient hemodyanmically unstable for CT, a single-infusion IVP can be performed at
bedside followed by complete study once patient is stable
- Positive urine dipstick for microscopic blood or leukocyte esterase
- Abnormal or elevated BUN and creatinine
90% of injuries are minor. Anticipate nephrology consultation in more severe injures;
surgical repair is required within 12 hours to salvage an ischemic kidney
ch. 12, p. 167
Assessment findings of a CHRONIC SUBDURAL HEMATOMA - ANSWER-- ALTERED
or STEADY DECLINE IN LOC
- HEADACHE
- LOSS OF MEMORY or ALTERED REASONING
- MOTOR DEFICIT: CONTRALATERAL HEMIPARESIS, HEMIPLEGIA, OR
ABNORMAL MOTOR POSTURING OR ATAXIA
- APHASIA
- IPSILATERAL UNILATERAL FIXED and DILATED PUPIL
- INCONTINENCE
- SEIZURES
Ch. 9, p. 114
Assessment findings of a DIFFUSE INJURY - ANSWER-Injuries that occur over a wide
spread area, not always identifiable on CT because damage involves contusions or
hearing and stretching of micro vascular, not a localized hematoma. These injuries
commonly follow a direct blow to the head and are often sports-related. Patients can
have varying degrees of symptoms that last minutes to hours. Assessment findings
include:
- TRANSIENT LOC
- HEADACHE, DIZZINESS
- NAUSEA, VOMITING
- CONFUSION, DISORIENTATION
- MEMORY LOSS and CONCENTRATION DIFFICULTY
- IRRITABILITY and FATIGUE
Ch. 9, p. 115
Assessment findings of a EPIDURAL HEMATOMA - ANSWER-- TRANSIENT LOC
followed by lucid period lasting minutes to hours
- HEADACHE, DIZZINESS
- NAUSEA, VOMITING
- CONTRALATERAL HEMIPARESIS
- HEMIPLEGIA
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