{"id":117266,"date":"2023-08-28T11:26:21","date_gmt":"2023-08-28T11:26:21","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=117266"},"modified":"2023-08-28T11:26:26","modified_gmt":"2023-08-28T11:26:26","slug":"tncc-full-solution-packall-tncc-exams-and-study-questions-are-here-all-answered-correctly","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/28\/tncc-full-solution-packall-tncc-exams-and-study-questions-are-here-all-answered-correctly\/","title":{"rendered":"TNCC FULL SOLUTION PACK(ALL TNCC EXAMS AND STUDY QUESTIONS ARE HERE ,ALL ANSWERED CORRECTLY)"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">TNCC Physical Assessments<br>What is the Trauma Assessment Mnemonic? Correct answer- A = Airway with<br>simultaneous cervical spine stabilization\/immobilization<br>B = Breathing<br>C = Circulation<br>D = Disability (neurologic status)<br>E = Expose patient\/Environmental Control<br>F = Full set of VS\/Focused Adjuncts\/Facilitate Family Presence<br>G = Give comfort measures<br>H = History\/Head-to-toe assessment<br>I = Inspect posterior surfaces<br>What is assessed in Airway while simultaneously protecting the cervical spine? Correct<br>answer- Assess:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Vocalization<\/li>\n\n\n\n<li>Tongue obstructing airway<\/li>\n\n\n\n<li>Loose teeth, foreign objects<\/li>\n\n\n\n<li>Blood, vomitus, other secretions<\/li>\n\n\n\n<li>Edema<br>Interventions:<\/li>\n\n\n\n<li>Position pt<\/li>\n\n\n\n<li>Jaw thrust\/Chin lift<\/li>\n\n\n\n<li>Remove foreign objects<\/li>\n\n\n\n<li>Suction blood, vomitus, secretions<\/li>\n\n\n\n<li>Insert oropharyngeal or nasopharyngeal airway<\/li>\n\n\n\n<li>Needle or surgical cricothyrotomy<br>What is assessed in Breathing? Correct answer- Assess:<\/li>\n\n\n\n<li>Spontaneous breathing<\/li>\n\n\n\n<li>Rise and fall of chest<\/li>\n\n\n\n<li>Rate and pattern of breathing<\/li>\n\n\n\n<li>Use of accessory muscles\/Diaphragmatic breathing<\/li>\n\n\n\n<li>Skin color<\/li>\n\n\n\n<li>Integrity of soft tissue and bony structures of chest wall<\/li>\n\n\n\n<li>Bilateral breath sounds<br>Interventions:<\/li>\n\n\n\n<li>Supplemental oxygen<\/li>\n\n\n\n<li>Bag-Mask ventilation<\/li>\n\n\n\n<li>Needle thoracentesis\/Decompression<\/li>\n\n\n\n<li>Chest tube<\/li>\n\n\n\n<li>Nonporous dsg taped on 3 sides<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">What is assessed in Circulation? Correct answer- Assess:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Palpates central pulse for rate and quality<\/li>\n\n\n\n<li>Skin color, temperature and moisture<\/li>\n\n\n\n<li>External bleeding<br>Interventions:<\/li>\n\n\n\n<li>Direct pressure over uncontrolled bleeding sites<\/li>\n\n\n\n<li>Insert 2 large caliber IV&#8217;s with warmed isotonic crystalloid solution<\/li>\n\n\n\n<li>Infuses fluid rapidly with blood tubing<\/li>\n\n\n\n<li>Blood sampling for typing<\/li>\n\n\n\n<li>Blood administration<\/li>\n\n\n\n<li>Pericardiocentesis<\/li>\n\n\n\n<li>Emergency thoracotomy<\/li>\n\n\n\n<li>Surgery<\/li>\n\n\n\n<li>Cardiopulmonary resuscitation and advanced life support measures<br>What is assessed in Disability? Correct answer- Assess:<\/li>\n\n\n\n<li>AVPU (LOC)<\/li>\n\n\n\n<li>Pupils (PERRL)<br>Interventions:<\/li>\n\n\n\n<li>Perform further investigation<\/li>\n\n\n\n<li>Hyperventilation, if indicated<br>What is assessed in Trauma Mnemonic under &#8220;E?&#8221; Correct answer- EXPOSE PATIENT<br>AND ENVIRONMENTAL CONTROL (remove clothing and keep patient warm)<br>Assess:<\/li>\n\n\n\n<li>Obvious wounds\/Deformities<\/li>\n\n\n\n<li>Temperature Control<br>Interventions:<\/li>\n\n\n\n<li>Remove clothing<\/li>\n\n\n\n<li>Preserve clothing for evidence if indicated (don&#8217;t cut through bullet wounds, use paper<br>bags)<\/li>\n\n\n\n<li>Cover with blankets<\/li>\n\n\n\n<li>Warming lights<\/li>\n\n\n\n<li>Increase ambient temperature<br>What is assessed in Trauma Mnemonic under &#8220;F?&#8221; Correct answer- FULL SET OF<br>VS\/FOCUSED ADJUNCTS\/FACILITATE FAMILY PRESENCE<br>Assess:<\/li>\n\n\n\n<li>Obtain a complete set of vital signs<\/li>\n\n\n\n<li>Consider the focused adjuncts<\/li>\n\n\n\n<li>Cardiac Monitor<\/li>\n\n\n\n<li>Pulse Oximeter<\/li>\n\n\n\n<li>Urinary catheter if not contraindicated<\/li>\n\n\n\n<li>Gastric tube<\/li>\n\n\n\n<li>Laboratory studies<\/li>\n\n\n\n<li>Facilitate family presence<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC test prepA, TNCC Notes for<br>Written Exam, TNCC Notes for Written<br>Exam, TNCC Prep, TNCC EXAM, TNCC<br>8th Edition<br>Expedite transfer to the closest trauma center Correct answer- A 56 y\/o M pt involved in<br>a motor vehicle crash is brought to the ED of a rural critical access facility. He<br>complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98\/71,<br>HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is<br>the priority intervention for this patient?<br>a pertinent medical hx is crucial Correct answer- Which of the following considerations<br>is the most important when caring for a geriatric trauma pt?<br>Mitigation Correct answer- Following a review of recent drills and a real disaster event,<br>a hospital has identified deficiencies and is taking steps to minimize the impact of a<br>future disaster . Which phase of the disaster life cycle does this describe?<br>Multiple requests for water Correct answer- EMS brings a pt who fell while riding his<br>bicycle. Using the American College of Surgeobs screening guidelines, which<br>assessment finding would prompt the RN to prepare the pt for a radiologic spine<br>clearance?<br>hemoglobin does not readily release O2 for use by the tissues Correct answer- What is<br>the effect of hypothermia on the oxyhemoglobin dissociation curve?<br>acidosis Correct answer- Which of the following is a component of the trauma triad of<br>death?<br>Complete Correct answer- EMS brings a pt from MVC. VS: BP 90\/49, HR 48, RR 12,<br>temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These<br>assessment findings are most consistent with which of the following types of spinal cord<br>injury?<br>flucuation in the water seal chamber Correct answer- Which of the following is an<br>expected finding in a pt with a tube thoracstomy connected to a chest drainage system?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">insert an oropharyngeal airway if there is no gag reflex Correct answer- During the<br>primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring<br>respirations. What priority nursing interventions should be preformed next?<br>globe rupture Correct answer- A 35 y\/o M presents with facial trauma after being struck<br>in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of<br>injury is suspected?<br>compensated Correct answer- A trauma pt is restless and repeatedly asking &#8220;where am<br>i?&#8221; VS upon arrival: BP 110\/60, HR96, RR 24. Her skin is cool and dry. Current VS are<br>BP 104\/84, HR 108, RR 28. The pt is demonstrating s\/sx of which stage of shock?<br>ventilate with a bag mask device Correct answer- An unresponsive trauma pt has an<br>oropharygeal airway in place, shallow and labored respirations, and dusky skin. The<br>trauma team has administered medications for drug-assisted intubation and attempted<br>intubation but was unsuccessful. What is the most appropriate immediate next step?<br>within 24 hrs of trauma Correct answer- When is the tertiary survey completed fora<br>trauma pt?<br>pressure Correct answer- An intubated and sedated pt in the ED has multiple extremity<br>injuries with the potential for causing compartment syndrome. What is the most reliable<br>indication of compartment syndrome in a patient who is unconscious?<br>worsening pneumothorax Correct answer- Which of the following is possible<br>complication of positive-pressure ventilation?<br>pelvic stability Correct answer- the most reassuring finding for a male pt with hip pain<br>after a fall is which of the following?<br>narrowed Correct answer- Which of the following pulse pressures indicate early<br>hypovolemic shock?<br>dysrhythmias Correct answer- Patients with a crush injury should be monitored for<br>which of the following conditions?<br>subdural hematoma Correct answer- Tearing of the bridging veins is most frequently<br>associated with which brain injury?<br>straight cath for urine sample Correct answer- A 20 y\/o M presents to the ED<br>complaining of severe lower abd pain after landing hard on the bicycle cross bars while<br>preforming an aerial BMX maneuver. Secondary assessment reveals lower abd<br>tenderness and scrotal ecchymosis. Which of the following orders would the RN<br>question?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">placental abruption Correct answer- You are caring for a pt who was involved in a MVC<br>and is 32 weeks pregnant. Findings of your secondary survey include abd pain on<br>palpation, fundal ht at the costal margin, and some dark bloody show. Varying<br>accelerations and decelerations are noted on cariocgraphy. These findings are most<br>consistent with which of the following?<br>it can worsen cord damage from an unstable spinal injury Correct answer- Which of the<br>following is true about the log-roll?<br>defusings Correct answer- All of these are considered a critical communication point in<br>trauma care EXCEPT which of the following?<br>pulse oximetry and capnography Correct answer- What bedside monitoring parameters<br>are used to assess for adequacy of O2 and effectiveness of ventilation?<br>padding the upper back while stabilizing the cervical spine Correct answer- Caregivers<br>carry in a 2 y\/o into the ED who fell out of a second-story window. The pt is awake and<br>crying with increased work of breathing and pale skin. Which of the following<br>interventions has the highest priority?<br>bowel Correct answer- Which of the following injuries is LEAST likely to be promptly<br>identified?<br>Initiate transfer to a trauma center Correct answer- A pt is brought to the ED of a rural<br>hospital following a high-speed MVC. When significant abd and pelvic injuries are noted<br>in the primary survey, which of the following is the priority interventions?<br>bardycardia and absent motor function below the level of injury Correct answer- A pt<br>with a complete spinal cord injury in neurogenic shock will demonstrate hypotension<br>and which other clinical signs?<br>apply splint and elevate above the level of the heart Correct answer- a 37 y\/o F has a<br>deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which<br>of the following is the most appropriate intervention?<br>the aorta is torn at its attachment with the ligamentum arteriosum Correct answer- which<br>of the following occurs during the third impact of a motor vehicle crash?<br>Report your suspicion of maltreatment in accordance with local regulations Correct<br>answer- a 5 y\/o child presents to the ED with bruises to the upper arm and buttocks in<br>various stages of healing and multiple small, clean, round burns to the back. There are<br>no abnormalities found based on the pediatric assessment triangle or primary survey.<br>Which of the following is the priority survey. Which of the following is the priority nursing<br>intervention?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">to guage end-organ perfusion and tissue hypoxia Correct answer- Why is a measure of<br>serum lactate obtained in the initial assessment of a trauma patient?<br>elevating the extremity to the level of the heart Correct answer- A pt with a lower<br>extremity fracture complains of severe pain and tightness in his calf, minimally by pain<br>medications. Which of the following is the priority nursing intervention?<br>velocity Correct answer- What factor contributes most to the kinetic energy of a body in<br>motion?<br>subdural hematoma Correct answer- An elderly patient with a history of anticoagulant<br>use presents after a fall at home today. She denies any loss of consciousness. She has<br>a hematoma to her forehead and complains of headache, dizziness, and nausea. What<br>is the most likely cause of her symptoms?<br>fat embolism Correct answer- a pt has been in the ED for several hrs waiting to be<br>admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has<br>been awake, alert, and complaining of leg pain. His wife reported that he suddenly<br>became anxious and confused. Upon reassessment, the pt is restless with respiratory<br>distress and petechiae to his neck. The pt is exhibiting s\/sx most commonly associated<br>with which of the following conditions?<br>nausea and vomiting Correct answer- Which of the following is a late sign of increased<br>intracranial pressure?<br>serial FAST exams Correct answer- a 49 y\/o restrained driver involved in a MVC<br>presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity<br>pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam<br>EXCEPT which of the following?<br>pericardiocentesis Correct answer- Which of the following is NOT considered goaldirected therapy for cardiogenic shock?<br>endotracheal tube Correct answer- The trauma nurse knows that placing a bariatric<br>patient in a ramped position providers better visualization during the insertion of which<br>device?<br>increased work of breathing? Correct answer- which of the following assessment<br>findings differentiates a tension pneumothorax from a simple pneumothorax?<br>calcium Correct answer- if a pt has received multiple transfusions of banked blood<br>preserved with citrate, which electrolyte is most likely to drop and require<br>supplementation?<br>identifying individuals who made mistakes during the traumatic event Correct answerWhich of the following is NOT considered a benefit of debriefings?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC EXAM<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Preparation and Triage<\/li>\n\n\n\n<li>Primary Survery (ABCDE) with resuscitation adjuncts (F,G)<\/li>\n\n\n\n<li>Reevaluation (consideration of transfer)<\/li>\n\n\n\n<li>Secondary Survey (HI) with reevaluation adjuncts<\/li>\n\n\n\n<li>Reevaluation and post resuscitation care<\/li>\n\n\n\n<li>Definitive care of transfer to an appropriate trauma nurseAns &#8211; Initial Assessment<\/li>\n\n\n\n<li>A- airway and Alertness with simultaneous cervical spinal stabilization<\/li>\n\n\n\n<li>B- breathing and Ventilation<\/li>\n\n\n\n<li>circulation and control of hemorrhage<\/li>\n\n\n\n<li>D &#8211; disability (neurologic status)<\/li>\n\n\n\n<li>F &#8211; full set of vitals and Family presence<\/li>\n\n\n\n<li>G &#8211; Get resuscitation adjuncts<br>L- Lab results (arterial gases, blood type and crossmatch)<br>M- monitor for continuous cardiac rhythm and rate assessment<br>N- naso or orogastric tube consideration<br>O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide<br>(ETC02) monitoring and capnopgraphy<br>H- History and head to toe assessment<br>I- Inspect posterior surfacesAns &#8211; ABCDEFGHI<br>Before the arrival of the ptAns &#8211; When should PPE be placed:<br>Pt is at hospital in the right amount of time, right care, right trauma facility, right<br>resourcesAns &#8211; Safe Care:<br>Uncontrolled HemorrhageAns &#8211; Major cause of preventable death:<br>reorganize care to C-ABCAns &#8211; If uncontrolled hemorrhage ..<br>Used at the beginning of the initial assessment<\/li>\n\n\n\n<li>A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is<br>clear.<\/li>\n\n\n\n<li>V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation<br>to respond, an airway adjunct may be needed to keep the tongue from obstructing the<br>airway.<\/li>\n\n\n\n<li>P responds to pain. If the pt. responds only to pain, he or she may not be able to<br>maintain his or her airway adjunct may need to be placed while further assessment is<br>made to determine the need for intubation.<\/li>\n\n\n\n<li>U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct<br>someone to chk in the pt is pulseless while assessing if the cause of the problem is the<br>airway.Ans &#8211; Airway and AVPU:<br>ask pt to pen his or her mouthAns &#8211; While assessing airway the patient is alert and<br>responds to verbal stimuli you should..<br>jaw thrust maneuver to open airway and assess for obstruction. If pt has a suspected<br>csi, the jaw thrust procedure should be done by two providers. One provider can<br>maintain c-spine and the other can perform the jaw thrust maneuver.Ans &#8211; While<br>assessing airway pt is unable to open mouth, responds only to pain, or is unresponsive<br>you should..<\/li>\n\n\n\n<li>The tongue obstructing the airway<\/li>\n\n\n\n<li>loose or missing teeth<\/li>\n\n\n\n<li>foreign objects<\/li>\n\n\n\n<li>blood, vomit, or secretions&#8217;<\/li>\n\n\n\n<li>edema<\/li>\n\n\n\n<li>burns or evidence of inhalation injury<br>Auscultiate or listen for:<\/li>\n\n\n\n<li>Obstructive airway sounds such as snoring or gurgling<\/li>\n\n\n\n<li>Possible occlusive maxillofacial bony deformity<\/li>\n\n\n\n<li>Subcutaneous emphysemaAns &#8211; Inspect the mouth for:<\/li>\n\n\n\n<li>Check the presence of adequate rise and fall of the chest with assisted ventilation<\/li>\n\n\n\n<li>Absence of gurgling on auscultation over the epigastrium<\/li>\n\n\n\n<li>Bilateral breath sounds present on auscultation<\/li>\n\n\n\n<li>Presence of carbon dioxide (CO2) verified by a CO2 device or monitorAns &#8211; If the pt<br>has a definitive airway in what should you do?<\/li>\n\n\n\n<li>Suction the airway<br>2, Use care to avoid stimulating the gag reflex<\/li>\n\n\n\n<li>If the airway is obstructed by blood or vomitus secretions, use a rigid suction device<br>If foreign body is noted, remove it carefully with forceps or another appropriate<br>methodAns &#8211; If Airway is not patent<\/li>\n\n\n\n<li>Apnea<\/li>\n\n\n\n<li>GCS 8 or less<\/li>\n\n\n\n<li>Maxillary fractures<\/li>\n\n\n\n<li>Evidence of inhalation injury (facial burns)<\/li>\n\n\n\n<li>Laryngeal or tracheal injury or neck hematoma<\/li>\n\n\n\n<li>High risk of aspiration and patients inability to protect the airway<\/li>\n\n\n\n<li>Compromised or ineffective ventilationAns &#8211; Following conditions might require a<br>definitive airway<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC Written Exam 2022<br>What is the best measure of the adequacy of cellular perfusion and helps predict the<br>outcome of resuscitation? Correct answer- Base deficit used in conjunction with serum<br>lactate<br>Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral<br>vasculature? Correct answer- Vasoconstriction<br>What results from tissue hypo perfusion and oxygen deficit? Correct answer- Metabolic<br>acidosis<br>What type of shock results in generalized vasodilation? Correct answer- Neurogenic<br>shock<br>Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what?<br>Correct answer- Phrenic nerve; paralyzed diaphragm and inability to breath<br>Extremity elevation AT the level of the heart is beneficial for what type of injury? Correct<br>answer- Compartment Syndrome<br>What is a high risk of frostbite? Correct answer- Thrombus formation<br>What two medications can be administered to maintain perfusion after a frostbite injury<br>along with rewarming? Correct answer- Tissue plasminogen activator or non steroidal<br>anti-inflammatory medication (NSAIDS)<br>An rise in diastolic blood pressures is a sign of increasing what? Correct answerPeripheral resistance<br>What position will benefit the airway and work of breathing for the bariatric patient?<br>Correct answer- Reverse Trendelenburg<br>Which phase of a blast results from flying debris, projectiles, and bomb fragments<br>causing lacerations or penetrating injuries? Correct answer- Secondary Phase<br>What phase of a blast results from any explosion-related illness or injury including<br>hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? Correct answerQuaternary Phase<br>What phase of a blast results from individuals being thrown by the blast and impacting<br>walls, ground, or any hard object? Correct answer- Tertiary Phase<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What phase of a blast results from impact of the over and under pressurization wave<br>with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal<br>hemorrhage, globe rupture, and mild traumatic brain injury? Correct answer- Primary<br>Phase<br>Signs of what include muscle pain or weakness, dark red or brown urine, general<br>weakness or malaise, and elevated creatinine kinase levels? Correct answerRhabdomyolosis<br>Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis,<br>cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein<br>distention, or hypotension? Correct answer- Pulmonary Embolus<br>Signs of what include headache, nausea and vomiting, amnesia, behavioral changes,<br>altered level of consciousness? Correct answer- Increased intracranial pressure<br>Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse<br>pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort?<br>Correct answer- Late signs of increased ICP with Herniation Syndrome<br>What is caused by the tear of the bridging veins or middle meningeal artery? Correct<br>answer- Subdural and Epidural Hematoma<br>Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness<br>and nausea. Correct answer- Postconcussive Syndrome\/ Mild Traumatic Brain Injury<br>Signs and symptoms similar to early signs of increased ICP but do not worsen. Correct<br>answer- Postconcussive Syndrome\/ Mild Traumatic Brain Injury<br>Cerebral Perfusion Pressure = <strong><em><strong><em>&#8211;<\/em><\/strong><\/em><\/strong> Correct answer- MAP &#8211; ICP<br>What is the range for CO2 to maximize perfusion? Correct answer- 35-45<br>Does hypoventilation cause dilation or constriction? Increase or decrease ICP? Correct<br>answer- Dilation and increase in ICP due to high CO2<br>Hyperventilation cause dilation or constriction? Correct answer- Constriction d\/t low<br>CO2<br>Pupils with pressure on cranial nerve Correct answer- Fixed and dilated<br>Pupils with opiates vs stimulants Correct answer- small; large<br>Pupils with anticholinergics such as atropine, ipratropium, and scopolamine Correct<br>answer- large<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC 8th edition exam<br>The major cause of preventable death after injury Answer- Uncontrolled hemorrhage<br>The best measure of the adequacy of cellular perfusion and helps to predict the<br>outcome of resuscitation Answer- Base deficit<br>Examples of primary blast injuries Answer- Blast lung, ruptured tympanic membrane,<br>TBI, abdominal hemorrhage<br>Examples of secondary blast injuries Answer- Wounds from debris and bomb fragments<br>Examples of tertiary blast injuries Answer- Blunt or penetrating trauma from the body<br>being thrown by the blast<br>Examples of quaternary blast injuries Answer- Injuries or illness related to explosion:<br>burns, toxic injury from chemicals<br>Examples of quinary blast injuries Answer- Injuries associated with exposure to<br>hazardous materials from the components of the blast<br>Questions to ask for airway assessment (need 4) Answer- Is the tongue obstructing?<br>Are there any foreign objects?<br>Is there any edema?<br>Are there loose or missing teeth?<br>Is there snoring, gurgling, or stridor?<br>Is there bony deformity?<br>Is there blood, vomit, or secretions?<br>Questions to ask during breathing assessment. (Need 4) Answer- Is there symmetrical<br>chest rise?<br>Is there spontaneous breathing?<br>Is there tracheal deviation or JVD?<br>What is their skin color?<br>Are there open wounds or deformities in the chest?<br>What&#8217;s the depth, pattern, and rate of respirations?<br>Is there increased work of breathing?<br>Are breath sounds present and equal?<br>3 ways to assess ETT placement Answer- 1. Apply end tidal, assess CO2 after 5-6<br>breaths<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>Assess for symmetrical chest wall rise and fall<\/li>\n\n\n\n<li>Auscultation over the epigastrium for gurgling and bilateral breath sounds.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC test prepA, TNCC Notes for<br>Written Exam, TNCC Notes for Written<br>Exam, TNCC Prep, TNCC EXAM, TNCC<br>8th Edition<br>Expedite transfer to the closest trauma center Correct answer- A 56 y\/o M pt involved in<br>a motor vehicle crash is brought to the ED of a rural critical access facility. He<br>complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98\/71,<br>HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the following is<br>the priority intervention for this patient?<br>a pertinent medical hx is crucial Correct answer- Which of the following considerations<br>is the most important when caring for a geriatric trauma pt?<br>Mitigation Correct answer- Following a review of recent drills and a real disaster event,<br>a hospital has identified deficiencies and is taking steps to minimize the impact of a<br>future disaster . Which phase of the disaster life cycle does this describe?<br>Multiple requests for water Correct answer- EMS brings a pt who fell while riding his<br>bicycle. Using the American College of Surgeobs screening guidelines, which<br>assessment finding would prompt the RN to prepare the pt for a radiologic spine<br>clearance?<br>hemoglobin does not readily release O2 for use by the tissues Correct answer- What is<br>the effect of hypothermia on the oxyhemoglobin dissociation curve?<br>acidosis Correct answer- Which of the following is a component of the trauma triad of<br>death?<br>Complete Correct answer- EMS brings a pt from MVC. VS: BP 90\/49, HR 48, RR 12,<br>temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These<br>assessment findings are most consistent with which of the following types of spinal cord<br>injury?<br>flucuation in the water seal chamber Correct answer- Which of the following is an<br>expected finding in a pt with a tube thoracstomy connected to a chest drainage system?<br>insert an oropharyngeal airway if there is no gag reflex Correct answer- During the<br>primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring<br>respirations. What priority nursing interventions should be preformed next?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">globe rupture Correct answer- A 35 y\/o M presents with facial trauma after being struck<br>in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of<br>injury is suspected?<br>compensated Correct answer- A trauma pt is restless and repeatedly asking &#8220;where am<br>i?&#8221; VS upon arrival: BP 110\/60, HR96, RR 24. Her skin is cool and dry. Current VS are<br>BP 104\/84, HR 108, RR 28. The pt is demonstrating s\/sx of which stage of shock?<br>ventilate with a bag mask device Correct answer- An unresponsive trauma pt has an<br>oropharygeal airway in place, shallow and labored respirations, and dusky skin. The<br>trauma team has administered medications for drug-assisted intubation and attempted<br>intubation but was unsuccessful. What is the most appropriate immediate next step?<br>within 24 hrs of trauma Correct answer- When is the tertiary survey completed fora<br>trauma pt?<br>pressure Correct answer- An intubated and sedated pt in the ED has multiple extremity<br>injuries with the potential for causing compartment syndrome. What is the most reliable<br>indication of compartment syndrome in a patient who is unconscious?<br>worsening pneumothorax Correct answer- Which of the following is possible<br>complication of positive-pressure ventilation?<br>pelvic stability Correct answer- the most reassuring finding for a male pt with hip pain<br>after a fall is which of the following?<br>narrowed Correct answer- Which of the following pulse pressures indicate early<br>hypovolemic shock?<br>dysrhythmias Correct answer- Patients with a crush injury should be monitored for<br>which of the following conditions?<br>subdural hematoma Correct answer- Tearing of the bridging veins is most frequently<br>associated with which brain injury?<br>straight cath for urine sample Correct answer- A 20 y\/o M presents to the ED<br>complaining of severe lower abd pain after landing hard on the bicycle cross bars while<br>preforming an aerial BMX maneuver. Secondary assessment reveals lower abd<br>tenderness and scrotal ecchymosis. Which of the following orders would the RN<br>question?<br>placental abruption Correct answer- You are caring for a pt who was involved in a MVC<br>and is 32 weeks pregnant. Findings of your secondary survey include abd pain on<br>palpation, fundal ht at the costal margin, and some dark bloody show. Varying<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">accelerations and decelerations are noted on cariocgraphy. These findings are most<br>consistent with which of the following?<br>it can worsen cord damage from an unstable spinal injury Correct answer- Which of the<br>following is true about the log-roll?<br>defusings Correct answer- All of these are considered a critical communication point in<br>trauma care EXCEPT which of the following?<br>pulse oximetry and capnography Correct answer- What bedside monitoring parameters<br>are used to assess for adequacy of O2 and effectiveness of ventilation?<br>padding the upper back while stabilizing the cervical spine Correct answer- Caregivers<br>carry in a 2 y\/o into the ED who fell out of a second-story window. The pt is awake and<br>crying with increased work of breathing and pale skin. Which of the following<br>interventions has the highest priority?<br>bowel Correct answer- Which of the following injuries is LEAST likely to be promptly<br>identified?<br>Initiate transfer to a trauma center Correct answer- A pt is brought to the ED of a rural<br>hospital following a high-speed MVC. When significant abd and pelvic injuries are noted<br>in the primary survey, which of the following is the priority interventions?<br>bardycardia and absent motor function below the level of injury Correct answer- A pt<br>with a complete spinal cord injury in neurogenic shock will demonstrate hypotension<br>and which other clinical signs?<br>apply splint and elevate above the level of the heart Correct answer- a 37 y\/o F has a<br>deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which<br>of the following is the most appropriate intervention?<br>the aorta is torn at its attachment with the ligamentum arteriosum Correct answer- which<br>of the following occurs during the third impact of a motor vehicle crash?<br>Report your suspicion of maltreatment in accordance with local regulations Correct<br>answer- a 5 y\/o child presents to the ED with bruises to the upper arm and buttocks in<br>various stages of healing and multiple small, clean, round burns to the back. There are<br>no abnormalities found based on the pediatric assessment triangle or primary survey.<br>Which of the following is the priority survey. Which of the following is the priority nursing<br>intervention?<br>to guage end-organ perfusion and tissue hypoxia Correct answer- Why is a measure of<br>serum lactate obtained in the initial assessment of a trauma patient?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">elevating the extremity to the level of the heart Correct answer- A pt with a lower<br>extremity fracture complains of severe pain and tightness in his calf, minimally by pain<br>medications. Which of the following is the priority nursing intervention?<br>velocity Correct answer- What factor contributes most to the kinetic energy of a body in<br>motion?<br>subdural hematoma Correct answer- An elderly patient with a history of anticoagulant<br>use presents after a fall at home today. She denies any loss of consciousness. She has<br>a hematoma to her forehead and complains of headache, dizziness, and nausea. What<br>is the most likely cause of her symptoms?<br>fat embolism Correct answer- a pt has been in the ED for several hrs waiting to be<br>admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has<br>been awake, alert, and complaining of leg pain. His wife reported that he suddenly<br>became anxious and confused. Upon reassessment, the pt is restless with respiratory<br>distress and petechiae to his neck. The pt is exhibiting s\/sx most commonly associated<br>with which of the following conditions?<br>nausea and vomiting Correct answer- Which of the following is a late sign of increased<br>intracranial pressure?<br>serial FAST exams Correct answer- a 49 y\/o restrained driver involved in a MVC<br>presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity<br>pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam<br>EXCEPT which of the following?<br>pericardiocentesis Correct answer- Which of the following is NOT considered goaldirected therapy for cardiogenic shock?<br>endotracheal tube Correct answer- The trauma nurse knows that placing a bariatric<br>patient in a ramped position providers better visualization during the insertion of which<br>device?<br>increased work of breathing? Correct answer- which of the following assessment<br>findings differentiates a tension pneumothorax from a simple pneumothorax?<br>calcium Correct answer- if a pt has received multiple transfusions of banked blood<br>preserved with citrate, which electrolyte is most likely to drop and require<br>supplementation?<br>identifying individuals who made mistakes during the traumatic event Correct answerWhich of the following is NOT considered a benefit of debriefings?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC 8th Edition Questions and Answers(2022 edition)<br>What are the greatest risks for transport?Answer- Loss of airway patency, displaced<br>obstructive tubes lines or catheters, dislodge splinting devices, need to replace or<br>reinforce dressings, deterioration in patient status change in vital signs or level of<br>consciousness, injury to the patient and\/or team members<br>According to newtons law which of these two force is greater: size or force?AnswerNeither. For each force there is an equal and opposite reaction.<br>What is the relationship between mass and velocity to kinetic energy?Answer- Kinetic<br>energy is equal to 1\/2 the mass multiplied the square of its velocity therefore when<br>mass is doubled so is the net energy, however, when velocity is doubled energy is<br>quadrupled.<br>What is tension?Answer- stretching force by pulling at opposite ends<br>What is compression?Answer- Crushing by squeezing together<br>What is bending?Answer- Loading about an axis. Bending causes compression on the<br>side the person is bending toward intention to the opposite side<br>What is shearing?Answer- Damage by tearing or bending by exerting faucet different<br>parts in opposite directions at the same time.<br>What is torsion?Answer- Torsion forces twist ends in opposite directions.<br>What is combined loading?Answer- Any combination of tension compression torsion<br>bending and\/or shear.<br>What are the four types of trauma related injuries?Answer- Blunt, penetrating, thermal,<br>or blast.<br>What are contributing factors to injuries related to blunt traumas?Answer- The point of<br>impact on the patient&#8217;s body, the type of surface that is hit, the tissues ability to resist<br>(bone versus soft tissue, air-filled versus solid organs), and the trajectory of force.<br>What are the seven patterns of pathway injuries related to motor vehicle accidents?<br>Answer- Up and over, down and under, lateral, rotational, rear, roll over, and ejection.<br>Differentiate between the three impacts of motor vehicle impact sequence.Answer- The<br>first impact occurs when the vehicle collided with another object. The second impact<br>occurs after the initial impact when the occupant continues to move in the original<br>direction of travel until they collide with the interior of the vehicle or meet resistance.<br>The third impact occurs when internal structures collide within the body cavity.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What are the three factors that contribute to the damage caused by penetrating<br>trauma&#8217;s?Answer- The point of impact, the velocity and speed of impact, and the<br>proximity to the object.<br>What causes the primary effects of blast traumas?Answer- The direct blast effects.<br>Types of injuries include last long, tympanic membrane rupture and middle ear damage,<br>abdominal hemorrhage and perforation, global rupture, mild Trumatic brain injury.<br>What causes the secondary effects of blast traumas?Answer- Projectiles propelled by<br>the explosion. Injuries include penetrating or blunt injuries or I penetration.<br>What causes the tertiary effects of blast traumas?Answer- Results from individuals<br>being thrown by the blast wind. Injuries include hole or partial body translocation from<br>being thrown against a hard service: blunt or penetrating trauma&#8217;s, fractures, traumatic<br>amputations.<br>What causes quarternary effects of blast traumas?Answer- All explosion related injuries,<br>illnesses, or diseases not due to the first three mechanisms. Injuries include external<br>and internal burns, crush injuries, closed and open brain injuries, asthmatic or breathing<br>problems from dust smoke or toxic fumes, angina, or hyper glycemia and hypertension.<br>What causes quinary effects of blasts traumas?Answer- Those associated with<br>exposure to hazardous materials from radioactive, biologic, or chemical components of<br>a blast. Injuries include a variety of health effects depending on agent.<br>What are the three processes that transfer oxygen from the air to the lungs and blood<br>streamAnswer- Ventilation: the active mechanical movement of air into and out of the<br>lungs; diffusion: the passive movement of gases from an area of higher concentration to<br>an area of lower concentration; and perfusion: the movement of blood to and from the<br>lungs as a delivery medium of oxygen to the entire body.<br>When would you use a nasopharyngeal airway versus an oral pharyngeal airway?<br>Answer- Nasopharyngeal airways is contraindicated in patients with facial trauma or a<br>suspected basilar skull fracture. Oral pharyngeal airways is used in unresponsive<br>patients unable to maintain their airway, without a gag reflex as a temporary measure to<br>facilitate ventilation with a bag mask device or spontaneous ventilation until the patient<br>can be intubated.<br>Describe the measurement of an NPAAnswer- Measure from the tip of the patient&#8217;s<br>nose to the tip of the patients earlobe.<br>Measurement of an OPAAnswer- Place the proximal end or flange of the airway adjunct<br>at the corner of the mouth to the tip of the mandibular angle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">TNCC final exam test 2022 open book<br>Why is a measure of serum lactate obtained in the initial assessment of the trauma<br>patient?<br>Answer: c &#8211; a) to measure oxygenation and ventilation<br>b) to quantify the base deficit for the adequacy of cellular perfusion<br>c) *to gauge end-organ perfusion and tissue hypoxia **<br>d) to determine the underlying cause of shock<br>A trauma patient is restless and repeatedly asking &#8220;where am I?&#8221; vital signs upon arrival<br>were BP 100\/60 mm Hg, HR 96 beats\/min, and RR 24 breaths\/min. Her skin is cool and<br>dry. Current vital signs are BP 104\/84mm Hg, HR 108, RR 28 breaths\/min. The patient<br>is demonstrating signs and symptoms of which stage of shock?<br>Answer: A &#8211; A) compensated **<br>B) Progressive<br>C) irreversible<br>D) decompensated<br>An elderly patient with a history of anticoagulant use presents after a fall at home that<br>day. she denies any loss of consciousness. She has a hematoma to her forehead and<br>complains of headache, dizziness, and nausea. Which is a most likely cause of her<br>symptoms?<br>Answer: D &#8211; A) epidural hematoma<br>B) diffuse axonal injury<br>C) post-concussive syndrome<br>D) subdural hematoma ***<br>EMS brings a patient who fell riding his bicycle. Using the American College of<br>Surgeons screening guidelines, which assessment finding would prompt the nurse to<br>prepare the patient for radiologic spine clearance?<br>Answer: D &#8211; A) Alert with no neurologic deficits<br>B) Multiple abrasions to the extremities<br>C) Multiple requests of water<br>D) Smell of alcohol on breath ***<br>Which of the following occurs during the third impact of a motor vehicle crash?<br>Answer: C &#8211; A) The driver of the vehicle collides with the steering wheel<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B) the vehicle collides with a tree<br>C) the aorta is torn at its attachment with the ligamentum arteriosum<br>D) the airbag deploys and strikes the front seat passenger ***<br>A passenger is brought to the emergency department of a rural hospital following a<br>high-speed MVC. When significant abdominal and pelvic injuries are noted in the<br>primary survey, which of the following is the priority interventions?<br>Answer: A &#8211; A) initiate transfer to a trauma center **<br>B) provide report to the operating room nurse<br>C) Obtained imaging studies<br>D) Place a gastric tube<br>Which of the following injuries is LEAST likely to be promptly identified?<br>Answer: C &#8211; A) spleen<br>B) lung<br>C) bowel ***<br>D) brain<br>Patients with a crush injury should be monitored for which of the following conditions?<br>Answer: C &#8211; A) Hypernatremia<br>B) Hypercalcemia<br>C) Dysrhthmias **<br>D) polyuria<br>What finding raises suspicion of complete spinal cord injury?<br>Answer: B &#8211; A) Weakness in the lower extremities<br>B) Priapism ***<br>C) voluntary anal sphincter tone<br>D) intact reflexes distal to the injury<br>A patient with a complete spinal cord injury in neurogenic shock will demonstrate<br>hypotension and which other clinical signs?<br>Answer: D &#8211; A) Bradycardia and ipsilateral absences of motor function<br>B) Tachycardia and respiratory depression<br>C) Tachycardia and absent motor function below the level of injury<br>D) Bradycardia and absent motor function below the level of the injury ***<br>A 5-year old child presents to the ED with bruises to the upper arms and buttocks in<br>various stages of healing and multiple small, clean, round burns to the back. There are<br>no abnormalities found based on the pediatric assessment triangle or primary survey.<br>Which of the following is the priority nursing intervention?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>TNCC Physical AssessmentsWhat is the Trauma Assessment Mnemonic? Correct answer- A = Airway withsimultaneous cervical spine stabilization\/immobilizationB = BreathingC = CirculationD = Disability (neurologic status)E = Expose patient\/Environmental ControlF = Full set of VS\/Focused Adjuncts\/Facilitate Family PresenceG = Give comfort measuresH = History\/Head-to-toe assessmentI = Inspect posterior surfacesWhat is assessed in Airway while simultaneously protecting [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117266","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117266","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117266"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117266\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117266"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117266"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}