https:\/\/learnexams.com\/search\/study?query=<\/a><\/p>\n\n\n\nWhat are the greatest risk for transport?
Loss of airway
patency, displaced obstructive tubes lines or catheters, dislodge splinting devices,
need to replace or reinforce dressings, deterioration in patient status change in vital
signs or level of consciousness, injury to the patient and\/or team members<\/p>\n\n\n\n
According to newton’s law which of these two force is greater: size or force?
neither, equal and opposite reaction<\/p>\n\n\n\n
What is the relationship between mass and velocity to kinetic energy?
Kinetic energy is equal to 1\/2 the mass multiplied the square of its velocity
therefore when mass is doubled so is the net energy, however, when velocity is
doubled energy is quadrupled.<\/p>\n\n\n\n
What is tension?
stretching force by pulling at opposite ends<\/p>\n\n\n\n
What is compression?
Crushing by squeezing together<\/p>\n\n\n\n
What is bending?
Loading about an axis. Bending causes
compression on the side the person is bending toward intention to the opposite side<\/p>\n\n\n\n
What is shearing?
Damage by tearing or bending by
exerting faucet different parts in opposite directions at the same time.<\/p>\n\n\n\n
What is torsion?
Torsion forces twist ends in
opposite directions.<\/p>\n\n\n\n
What is combined loading?
any combination of
tension compression torsion bending and\/or shear.<\/p>\n\n\n\n
What are the four types of trauma related injury?
Blunt, penetrating, thermal, or blast.<\/p>\n\n\n\n
What are the contributing factors to injuries related to blunt trauma?
the point of impact on the patient’s body, the type of surface that is hit,
the tissues ability to resist (bone versus soft tissue, air-filled versus solid organs),
and the trajectory of for<\/p>\n\n\n\n
What are the seven patterns of pathway injuries related to motor vehicle accidents?
Up and over, down and under, lateral,
rotational, rear, roll over, and ejection.<\/p>\n\n\n\n
Differentiate between the three impacts of motor vehicle impact sequence.
The first impact occurs when the vehicle collided with another
object. The second impact occurs after the initial impact when the occupant
continues to move in the original direction of travel until they collide with the interior
of the vehicle or meet resistance. The third impact occurs when internal structures
collide within the body cavity.<\/p>\n\n\n\n
What are the three factors that contribute to the damage caused by penetrating
trauma’s?
The point of impact, the velocity and speed of impact, and the proximity to the object<\/p>\n\n\n\n
What causes the primary effects of blast trauma?
The direct
blast effects. Types of injuries include last long, tympanic membrane rupture and
middle ear damage, abdominal hemorrhage and perforation, global rupture, mild
Trumatic brain injury.<\/p>\n\n\n\n
What causes the secondary effects of blast traumas?
Projectiles
propelled by the explosion. Injuries include penetrating or blunt injuries<\/p>\n\n\n\n
What causes the tertiary effects of blast traumas?
Results
from individuals being thrown by the blast wind. Injuries include hole or partial body
translocation from being thrown against a hard service: blunt or penetrating
trauma’s, fractures, traumatic amputations.<\/p>\n\n\n\n
What causes quarternary effects of blast traumas?
All
explosion related injuries, illnesses, or diseases not due to the first three
mechanisms. Injuries include external and internal burns, crush injuries, closed and
open brain injuries, asthmatic or breathing problems from dust smoke or toxic fumes,
angina, or hyper glycemia and hypertension.<\/p>\n\n\n\n
What causes quinary effects of blasts traumas?
Those
associated with exposure to hazardous materials from radioactive, biologic, or chemical
components of a blast. Injuries include a variety of health effects depending on agent<\/p>\n\n\n\n
What are the three processes that transfer oxygen from the air to the lungs and blood stream?
Ventilation: the active mechanical movement of air into and out of the lungs; diffusion: the passive movement of gases from an area of higher concentration to an area of lower concentration; and perfusion: the movement of blood to and from the lungs as a delivery medium of oxygen to the
entire body<\/p>\n\n\n\n
When would you use a nasopharyngeal airway (NPA) versus an oral pharyngeal airway(OPA)?
Nasopharyngeal airways is contraindicated in patients with
facial trauma or a suspected basilar skull fracture. Oral pharyngeal airways is used
in unresponsive patients unable to maintain their airway, without a gag reflex as a
temporary measure to facilitate ventilation with a bag mask device or spontaneous
ventilation until the patient can be intubated.<\/p>\n\n\n\n
Describe the measurement of an NPA?
Measure from the tip
of the patient’s nose to the tip of the patients earlobe.<\/p>\n\n\n\n
Measurement of OPA
Place the proximal end or flange of
the airway adjunct at the corner of the mouth to the tip of the mandibular angle<\/p>\n\n\n\n
True or False: NPAs and OPAs are definitive airways?
false, need to consider a definitive airway<\/p>\n\n\n\n
3 ways to confirm ETT placement?
Placement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at
the epigastrium and four lung fields for equal breath sounds.<\/p>\n\n\n\n
When capnography measurement reads greater than 45MMHG, the nurse
should consider increasing or decreasing the ventilation rate?
Increasing the ventilation rate. Doing so would allow the patient to
blow off retained CO2<\/p>\n\n\n\n
When capnography measurement reads less than 35MMHG, the nurse should
consider increasing or decreasing the ventilation rate?
Decreasing the ventilation rate. By doing so, the nurse allows the patient to retain
CO2<\/p>\n\n\n\n
What are the three stages of shock
Compensated, decompensated or progressive, and irreversible.<\/p>\n\n\n\n
What are the signs of compensated shock?
Anxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output<\/p>\n\n\n\n
What are the signs and symptoms of decompensated shock?
Decreased level of consciousness, hypertension, narrow pulse pressure,
tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic,
base access outside the normal range, and serum lactate levels greater than two to
4MMOL\/L.<\/p>\n\n\n\n
What are the signs and symptoms of irreversible shock?
Obtunded stuporous or comatose state, marked hypertension and heart failure,
bradycardia with possible dysrhythmias, decreased and shallow respiratory rate,
pale cool and clammy skin, kidney liver and other organ failure, severe acidosis,
elevated lactic acid levels, worsening base access on ABGs, coagulopathies with
petechiae purpura or bleeding<\/p>\n\n\n\n
What are the four types of shock?
ypovolemic,
Cardiogenic, Obstructive, & Distributive<\/p>\n\n\n\n
What is the trauma triad of death?
hypothermia,
acidosis, coagulopathy<\/p>\n\n\n\n
Describe the characteristics of obstructive shock
Obstructive shock is it mechanical problem that results from hypoperfusion of the
tissue due to an obstruction in either the vasculature or the heart resulting in
decreased cardiac output. Some causes include a tension pneumothorax, cardiac
tamponade, or venous air embolism on the right side of the heart during systole in
the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD,
hypertension, chest pain, difficulty breathing, or pulses paradoxes.<\/p>\n\n\n\n
Describe the characteristics of cardiogenic shock
Cardiogenic shock results from pump failure in the presence of adequate
intravascular volume. Lack of cardiac output and an organ perfusion occurs
secondary to a decrease in myocardial contractility and or valvular insufficiency. This
can happen with blunt cardiac trauma or an MI. Symptoms can include low blood
pressure increase heart rate and respiratory rate chest pain shortness of breath
dysrhythmias increase troponin and pale cool moist skin<\/p>\n\n\n\n
Describe the characteristics of distributive shock
Distributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature.<\/p>\n\n\n\n
Describe the characteristics of hypovolemic shock
Hypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones.<\/p>\n\n\n\n
What is the recommended fluid bolus for a trauma?
500 ML’s of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML’s should be given judiciously with constant reassessments after administration.<\/p>\n\n\n\n
What is the minimum permissive hypertension and a trauma patient?
A systolic of greater than or equal to 90 MMHG<\/p>\n\n\n\n
What is the minimum permissive oxygenation level of a trauma patient?
Greater than or equal to 94%<\/p>\n\n\n\n
What is Cullen’s sign and its significance?
Cullens sign
is periumbilical bruising and is indicative of intraperitoneal bleeding<\/p>\n\n\n\n
Define Cushing’s triad
Bradycardia, progressive
hypertension (widening pulse pressure), and decreased respiratory effort<\/p>\n\n\n\n
What are the early signs of increased Intracranial pressure
headache, vomiting, behavioral changes that begin with restlessness and may
progress to confusion, drowsiness, or impaired judgment<\/p>\n\n\n\n
Late signs of increased ICP
dilated, non-reactive pupil(s); abnormal motor posturing (flexion, extension,
flaccidity); Cushing’s triad, Unresponsive to per verbal and painful stimuli,
bradycardia and decreased respiratory effort<\/p>\n\n\n\n
What are the symptoms of a subdural hematoma?
Decreased LOC, nausea vomiting headache and ipsilateral pupillary changes<\/p>\n\n\n\n
What is a trademark symptom of an epidural hematoma
Loss
of consciousness then awake and alert then loss of consciousness<\/p>\n\n\n\n
Define the characteristics of neurogenic shock
Distributive shock with a T6 or higher injury results and vasodilation, bradycardia, flushed warm dry skin. Risk for temperature instability. Nursing interventions include maintaining warmth and spinal stabilization.<\/p>\n\n\n\n
Define the charateristics of spinal shock
transient loss
of function can include loss of reflexes and muscle tone below the level of
industry with possible vascular response.<\/p>\n\n\n\n
Describe the four types of spinal cord injury
Central cord injury results in greater weakness distally, anterior injury includes motor loss or weakness below the cord level of injury yet sensory is intact, Brown-Sequard (hemicord) is weak on one side with sensory deficit on opposite side, posterior cord syndrome although rare is when the patient is unable to use sense vibration in proprioception<\/p>\n\n\n\n
Describe one fat embolism syndrome is most likely to occur in its characteristics –
With longform fractures. Tachycardia, Thrombocytopenia,
and petechiae rash.<\/p>\n\n\n\n
What is the Munro-Kellie doctrine?
Within the skull 80% his brain, 10% is blood, and 10% is CSF. Any increase of any of the products results in increased intracranial pressure.<\/p>\n\n\n\n
What are the treatment goals for a TBI?
O2 saturation > or equal to 95%, systolic blood pressure > or equal to 100 MMHG, ICP < 15 MMHG, CPP > or equal to 60 MMHG, normal glycemia, hemoglobin > or equal to 7 g\/DL, sodium 135-145, osmotic diuretics, anti-emetics, sedatives, anticonvulsants, head of bed at 30\u00b0, and neck at midline<\/p>\n\n\n\n
What is the key to high performing trauma team?
effective communication<\/p>\n\n\n\n
When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the
trauma provider in:
evaluating and anticipating the types of injuries that may be present<\/p>\n\n\n\n
rationale: mechanism of injury and energy transfer can assist the provider in evaluating
and anticipating damage<\/p>\n\n\n\n
The major preventable cause of death in the traume patients is
uncontrolled hemorrage<\/p>\n\n\n\n
the across-the-room observation step in the initial assessment provides the opportunity
to
eprioritize circulation before airway or breathing<\/p>\n\n\n\n
rationale: the across-the-room observation is done at the beginning of the primary
survey to rapidly assess the need to reprioritize circulation before airway or
breathing. This is done if uncontrolled external hemorrhage is identified.<\/p>\n\n\n\n
Which of the following accurately describes ventilation prinicples associated with a bag-
mask device?
ventilate at a rate of 10-12 breaths\/min or every 5-6 sec<\/p>\n\n\n\n
Which of the following is the best measure of the adequacy of cellular perfusion
and helps to predict the outcome of resuscitation?
base deficit<\/p>\n\n\n\n
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular
perfusion and when used in conjunction with serum lactate helps predict the success
of resuciation<\/p>\n\n\n\n
What is the safe pharmacological alternative to opioids for rib fracture pain management
in the anticoagulated patient?
intercostal nerve block<\/p>\n\n\n\n
rationale: continuous intercostal nerve blocks use long-acting anesthetics and
can provide safe and effective pain management for the anticoagulated patient.<\/p>\n\n\n\n
In a patient with severe traumatic brain injury, hypocapnia causes:
cerebral vasoconstriction<\/p>\n\n\n\n
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction,
especially in the cerebra; vasculature<\/p>\n\n\n\n
A patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following?
damage to spinal cord<\/p>\n\n\n\n
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or vascular neck structures. With an intact airway and hemodynamic
stability, the other common concurrent injury is to the spinal cord<\/p>\n\n\n\n
What is the appropriate technique for palpating the pelvis for stability?
apply gentle pressure over the iliac downward and medially<\/p>\n\n\n\n
rationale: to assess for pelvic instability, gentle pressure is applied over the iliac crests
downward and medially<\/p>\n\n\n\n
a patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. which of the following represents the
highest priority for ongoing assessment and management?
maintain adequate respiratory status<\/p>\n\n\n\n
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function,
resulting in a paralyzed diaphragm and inability to breathe<\/p>\n\n\n\n
Based on proper bleeding control techniques, what is the first step to stop the bleeding
of a penetrating injury to the lower extremity?
initiate direct pressure<\/p>\n\n\n\n
rationale: the first step in controlling any bleeding is direct pressure. if that is not
adequate, the application of a tourniquet may be needed<\/p>\n\n\n\n
treatment for frostbite includes:
administer tissue plasminogen activator<\/p>\n\n\n\n
rationale: with frostbite, thrombus formation is a risk. tissue plasminogen or
nonsteroidal anti-inflammatory medication can be administered. The tissue
plasminogen activator has been effective in maintaining perfusion and decreasing the
need for amputation when administered within 24 hours of rewarming<\/p>\n\n\n\n
A 30-week pregnant trauma patient’s vital signs include a blood pressure of 94\/62 mm
Hg and a heart rate of 108 beats\/minute. Fetal heart tones are 124 beats\/minute. The
emergency nurse interprets the patient’s hemodynamic findings as an indication of
which of the following?
normal vital signs in pregnancy<\/p>\n\n\n\n
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small
decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in peripheral resistance. Normal fetal rate is between 120 and 160
bpm<\/p>\n\n\n\n
While performing an assessment on a 13-month old involved in a motor vehicle
collision, the nurse identifies which of the following findings from the patient as a
potential sign of mental status change?
cooperation with the assessment<\/p>\n\n\n\n
rationale: an alert older infant or toddler will recognize his or her caregiver, be cautious
of strangers, and may not respond to commands, which is a normal response<\/p>\n\n\n\n
What is the best position for maintaining an open airway in the bariatric
patient?
reverse trendelenburg<\/p>\n\n\n\n
rationale: the reverse trendelenburg position will benefit both airway maintenance
and work of breathing in the bariatric patient.<\/p>\n\n\n\n
The nurse is obtaining for a patient who presents following sexual assault. The history is
completed using which of the following techniques?
use direct quotes to record
information<\/p>\n\n\n\n
rationale: history includes a detailed description of the incident that is objective, using
direct quotes<\/p>\n\n\n\n
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in
sick for a couple of days and is now back working on the team. Which of the following
behaviors would indicate this nurse is coping well?
she is talking about taking the emergency nursing certification examination<\/p>\n\n\n\n
rationale: this is an indication she is taking positive steps to advance her own practice, a
sign of resilience<\/p>\n\n\n\n
Following a bomb explosion, fragmentation injuries from the bomb or objects in
the enviroment are examples of which phase of injury?
seconday<\/p>\n\n\n\n
rationale: the secondary phase of a blast results from flying debris, projectiles, and
bomb fragments causing lacerations or penetrating injuries<\/p>\n\n\n\n
A patient fell two weeks ago, striking his head. He came to the emergency department
with a persistent headache and nausea. He was diagnosed with a small subdural
hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night
shift nurse reports he has been anxious, restless, and shaky. he vomited twice during
the night. He tells the day shift nurse he couldn’t sleep because a young child kept
coming into his room. What is a likely cause for these signs and symptoms?
alcohol
withdrawal<\/p>\n\n\n\n
rationale: alcohol withdrawal is a common delayed condition because symptoms are
difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea
or vomiting, psychomotor agitation, anxiety, insomnia, hallucinations, or seizures.<\/p>\n\n\n\n
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
to measure oxygenation and ventilation<\/p>\n\n\n\n
A trauma patient is restless and repeatadly asking “where am I?” vital signs upon arrival were BP 100\/60, HR 96, and RR 24. Her skin is cool and dry. Current vital signs BP 104\/84, HR 108, RR 28. The patient is demonstrating signs and symptoms of what stage of shock?
compensated<\/p>\n\n\n\n
An elderly patient with a history of anticoagulation use presents after a fall at gome that day. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is mostly likely the cause of her symptoms?
epidural hematom<\/p>\n\n\n\n
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?
alert with no neurological deficits<\/p>\n\n\n\n
Which of the following occurs during the third impact of a MVC?
the vehicle collides with a tree<\/p>\n","protected":false},"excerpt":{"rendered":"
TNCC final exam test 2024 open book updated TNCC final exam test 2024 open bookWhy is a measure of serum lactate obtained in the initial assessment of the traumapatient?Answer: c – a) to measure oxygenation and ventilationb) to quantify the base deficit for the adequacy of cellular perfusionc) *to gauge end-organ perfusion and tissue hypoxia […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","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-131344","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131344","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=131344"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/131344\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=131344"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=131344"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=131344"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}