EDITION FINAL EXAM NEWEST

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TNCC 9

TH

EDITION FINAL EXAM NEWEST

ACTUAL EXAM 120 QUESTIONS AND CORRECT

DETAILED ANSWERS (VERIFIED ANSWERS)

|ALREADY GRADED A+

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?

• 2280 mL
• 3840 mL
• 4560 mL
• 7680 mL - ANSWER- A) 2280 mL

(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 1 / 4

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Which of the following is a component of the trauma triad of death?

• Acidosis
• hyperthermia
• hemorrhage
• sepsis - ANSWER- A) Acidosis

Rationale: hypothermia, metabolic acidosis, coagulopathy

A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck pain, SOB, and

diffuse abd pain. His GCS is 15. His vitals are as follows:

BP 98/71

HR 125 beats/min RR 26 breaths/min SpO2 94% on high flow O2 via NRB mask

which of the following is the priority intervention for this patient?

• Expedite transport to the CT scanner 2 / 4

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• prepare the patient for spinal radiographs
• expedite transfer to the closest trauma center
• notify the patients family - ANSWER- C) expedite transfer to

the closest trauma center

An elderly patient with a history of anticoagulant use presents after a fall at home that day. she denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?

• epidural hematoma
• diffuse axonal injury
• post-concussive syndrome
• subdural hematoma - ANSWER- D) subdural hematoma

A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry.Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock?

• compensated 3 / 4

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• Progressive
• irreversible
• decompensated - ANSWER- A) compensated

Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?

• to measure oxygenation and ventilation
• to quantify the base deficit for the adequacy of cellular

perfusion

• to gauge end-organ perfusion and tissue hypoxia
• to determine the underlying cause of shock - ANSWER- c) to

gauge end-organ perfusion and tissue hypoxia

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 neurologic deficits
• Multiple abrasions to the extremities
• Multiple requests of water
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