TNCC EXAM 8TH EDITION STUDY QUESTIONS & Answers

  1. 1.What is the effect of hypothermia on the oxyhemoglobin dissociation
    curve: 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 oxygen.
  2. EMS arrives with the intoxicated driver of a car involved in a motor vehicle
    crash. EMS reports significant damage to the driver’s side of the car. The
    patient is asking to have the cervical collar removed. When it is appropriate
    to remove the cervical collar?: After a physical examination if the patient has no
    radiologic abnormalities on CT A CT is recommended for spinal clearance in an
    impaired patient.
  3. The nurse is caring for a 120 kg male 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 body surface area burned, how much IV fluid would be
    administered in the first 8 hours?: 2280 mL Both upper arms = 8%, both lower
    arms = 6%, and both hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total
    is equal to 2280 mL. Superficial burns are not included in the TBSA calculation for
    fluid resuscitation.
  4. Which of the following is an expected finding in a patient with a tube
    thoracostomy connected to a chest drainage system: Fluctuation in the water
    seal chamber Fluctuation in the water seal chamber indicates the tube is placed
    correctly in the pleural space.
  5. .A 35-year-old male 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?: Globe rupture A teardrop-shaped pupil suggests a
    globe rupture.
  6. .A patient with a complete spinal cord injury in neurogenic shock will
    demonstrate hypotension and which other clinical signs?: Bradycardia and
    absent motor function below the level of injury Patients with a complete spinal cord
    injury will have absent motor function below the level of the lesion. They become
    hypotensive and bradycardic due to loss of autonomic nervous system function.
  7. Which of the following patients warrants referral to a burn center?: A
    52-year-old diabetic male with a partial-thickness burn to the left lower leg This
    patient has a 7% TBSA burn with a preexisting medical history that could complicate management, prolong recovery, or affect mortality.
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  8. You are caring for a patient who was involved in a motor vehicle crash
    and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal margin, and some
    dark bloody show. Varying accelerations and decelerations are noted on
    cardiotocography. These findings are most consistent with which of the
    following?: Placental abruption The findings of abdominal pain, elevated fundal
    height, dark bloody show, and fetal distress are most consistent with placental
    abruption.
  9. A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing
    an aerial BMX maneuver. Secondary assessment reveals lower abdominal
    tenderness and scrotal ecchymosis. Which of the following orders would the
    nurse question?: Straight catheter for urine sample Insertion of a urinary catheter
    is contraindicated if urethral transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal ecchymosis, scrotal ecchymosis,
    and a high-riding or non-palpable prostate.
  10. Which of the following occurs during the third impact of a motor vehicle
    crash?: The aorta is torn at its attachment with the ligamentum arteriosum This
    occurs during the third impact.
  11. All of these are considered a critical communication point in trauma care
    EXCEPT which of the following?: Defusings A defusing is part of critical incident
    stress management but is not considered a critical communication point in trauma
    care.
  12. Which of the following mnemonics can help the nurse prioritize care
    for a trauma patient with massive uncontrolled hemorrhage?: MARCH The
    MARCH mnemonic stands for massive hemorrhage, airway, respiration, circulation, and head injury/hypothermia. The MARCH mnemonic recognizes uncontrolled hemorrhage as the major cause of preventable death after injury.
  13. You are treating a 27-year-old male in respiratory distress who was
    involved in a house fire. Calculating total body surface area (TBSA) burned
    is deferred due to the need for emergent intubation. At what rate should you
    begin fluid resuscitation?: 500 mL/hour Prior to calculating TBSA, this is the
    recommended starting point for fluid resuscitation for patients 14 years of age and
    older
  14. A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center complaining of abdominal, pelvic, and bilateral
    lower extremity pain. Vital signs are stable. The nurse can anticipate all of

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