QUESTIONS AND CORRET DETAILED ANSWERS WITH

TNCC TEST -

QUESTIONS AND CORRET DETAILED ANSWERS WITH

RATIONALES (VERIFIED ANSWERS) AGRADE

Name the 3 types of Disruptive shock. - ANSWER>> 1) Anaphylactic shock 2) Septic Shock 3) Neurogenic Shock Name the 3 stages of shock. - ANSWER>> 1) Compensated shock 2) Decompensated or Progressive shock 3) Irreversible shock What are signs of Compensated shock? - ANSWER>> Anxiety as blood is shunted from areas responsible for higher brain function, normal systolic BP, elevated diastolic BP, increased RR, bounding pulse, decreased urinary output.What are signs of Decompensated or Progressive shock? - ANSWER>> Decreased LOC, decreased systolic BP, narrowing pulse pressure, tachycardia, weak pulses, rapid shallow respirations, cool and cyanotic skin, increased lactic acid levels.What are signs of Irreversible shock? - ANSWER>> Obtunded, marked hypotension and heart failure, bradycardia, bradypnea, organ failure, acidosis.What pain scale is used for the infant and pediatric patients and what does it stand for?

• ANSWER>> F- Facial expression

L- Leg position A- Activity C- Crying C- Consolability 1 / 3

Which patient population is the Critical care Pain observation tool used in? - ANSWER>> Intubated or nonverbal patients unable to self report.Which patient population is the Behavior Pain scale used for and what are the 3 components? - ANSWER>> Intubated patients, facial expression, upper limb movement, compliance with ventilation.Where does the Olfactory cranial nerve run? - ANSWER>> Nasal mucosa to the olfactory bulb.Where does the Optic cranial nerve run? - ANSWER>> Retina to occipital and temporal lobes.What is the point of origin for cranial nerves III - X and XII? - ANSWER>> Brainstem exiting through foramen magnum.CO2 is a primary regulator of blood flow to the brain and a strong vasoconstrictor or vasodilator? - ANSWER>> Vasodilator What is a normal ICP level? - ANSWER>> 0-15 mmHg A sustained ICP over what level is considered abnormal? - ANSWER>> 20 mmHg Cerebral autoregulation maintains a constant cerebral vascular blood flow as long as the MAP is in what range? - ANSWER>> 50-150 mmHg Normal cerebral perfusion pressure is what? - ANSWER>> 60-100 mmHg *** - *** = ICP - ANSWER>> MAP - ICP Autoregulation maintains a steady state when the CPP is between what? - ANSWER>> 50 - 160 mmHg When cerebral autoregulation fails, perfusion is dependent on what and what conditions would complicate this? - ANSWER>> MAP, hemorrhage and hypovolemia 2 / 3

Early assessment findings of ICP include. - ANSWER>> Headache, N&V, amnesia, behavior changes, altered loc Late assessment findings of ICP include. - ANSWER>> Dilated nonreactive pupils, unresponsive to stimuli, abnormal posturing, widening pulse pressure, reflex bradycardia, decreased respiratory effort.A unilaterally fixed and dilated pupil may indicate what? - ANSWER>> Oculomotor nerve compression from increased ICP.Bilaterally fixed and pinpoint pupils may indicate an injury where? - ANSWER>> At the pons.A moderately dilated pupil with sluggish response may be an early sign of what? - ANSWER>> Herniation syndrome.What test provides greater neurologic detail than the GCS and what does it include? - ANSWER>> FOUR Score, eye response, motor response, brainstem reflexes, respiration Assessment findings of an Intracerebral Hematoma include. - ANSWER>> Progressive and often rapid decline in LOC, headache, signs of increasing ICP, pupil abnormalities, himiparesis or hemiplegia.Assessment findings of an Epidural Hematoma include. - ANSWER>> Transient LOC followed by a lucid period, headache, dizziness, N&V, hemiparesis, hemiplegia.Assessment findings of an Coup/Contracoup injury include. - ANSWER>> Altered loc, behavioral motor or speech deficit, abnormal posturing, signs of increased ICP Assessment findings of acute subdural hematoma include. - ANSWER>> Severe headache, changes in LOC, ipsilateral dilated or nonreactive pupil, contralateral hemiparesis

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