TNCC Final Exam Test Open Book
A 35-year old male presents with facial trauma after being struck in the face with a
baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is
suspected?
Answer: B
A) Oculomotor nerve palsy
B) Globe rupture ***
C) Uncal herniation
D) Retinal detachment
Which of the following is true about the log roll maneuver?
Answer: C
A) It causes less spinal motion than the lift and slide maneuver
B) It is recommended for patients with unstable pelvic fractures
C) It can worsen cord damage from an unstable spinal injury ***
D) It does not increases the risk of life threatening hemorrhage from unstable
injuries
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports
significant damage to the driver’s side of the car. The patient is asking to have the
cervical color removed. when is it appropriate to remove the cervical collar?
Answer: A
A) After a physical examination if the patient has no radiologic abnormalities on a
computed tomography scan ***
B) After physician evaluation if the patient has not neurologic abnormalities on
exam
C) After palpation of the spine if the patient has no point tenderness the the
vertebral column
D) After physical examination if the patient has not neck pain with movement
Tearing of the bridging veins is most frequently associated with which brain injury?
Answer: B
A) Epidural hematoma
B) Subdural hematoma ***
C) Diffuse axonal injury
D) Intracerebral hematoma
If a patient has received multiple transfusions of banked blood preserved with
citrate, which electrolyte is most likely to drop and require supplementation?
Answer: D
A) Potassium
B) Magnesium
C) Sodium
D) Calcium ***
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that
the CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
Answer: D
A) Brief
B) Loop
C) Debrief
D) Huddle ***
Which of the following considerations is most important when caring for a geriatric
trauma patient?
Answer: B
A) Head to exam
B) Medical history **
C) Incontinence
D) Falls
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?
(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
4560 / 2 (half of fluids given in first 8 hours) = 2280 mL
Answer: A
A) 2280 mL ***
B) 3840 mL
C) 4560 mL
D) 7680 mL
Which of the following assessment findings differentiates a tension PTX from a
simple PTX?
Answer: D
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.
A) Increased work of breathing
B) Unilaterally diminished breath sounds
C) Pleuritic chest pain
D) Hypotension that worsens with inspiration ***