TNCC FINAL EXAM PRACTICE EXAM AND STUDY

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TNCC FINAL EXAM PRACTICE EXAM AND STUDY

GUIDE NEWEST ACTUAL EXAM 300 QUESTIONS

AND CORRECT DETAILED ANSWERS (VERIFIED

ANSWERS) |ALREADY GRADED A+

What are factors that contribute to ineffective ventilation? - ANSWER- - AMS

• LOC
• Neurologic injury
• Spinal Cord Injury
• Intracranial Injury
• Blunt trauma
• Pain caused by rib fractures
• Penetrating Trauma
• Preexisting hx of respiratory diseases
• Increased age

What medications are used during intubation? - ANSWER- LOAD

Mnemonic:

L = Lidocaine O = Opioids A = Atropine D = Defasiculating agents

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What are the Rapid Sequence Intubation Steps? - ANSWER-

PREPARATION:

• gather equipment, staffing, etc.

PREOXYGENATION:

• Use 100% O2 (prevent risk of aspiration).

PRETREATMENT:

• Decrease S/E's of intubation

PARALYSIS WITH INDUCTION:

• Pt has LOC, then administer neuromuscular blocking agent

PROTECTION AND POSITIONING:

• Apply pressure over cricoid cartilage (minimizes likelihood of

vomiting and aspiration

PLACEMENT WITH PROOF

• Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate

pt 30-60 seconds between attempts.

• After intubation, inflate the cuff
• Confirm tube placement w/exhaled CO2 detector.

POSTINTUBATION MANAGEMENT:

• Secure ET tube
• Set ventilator settings
• Obtain Chest x-ray
• Continue to medicate
• Recheck VS and pulse oxtimetry
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What is a Combitube? - ANSWER- A dual-lumen, dual-cuff airway that can be placed blindly into the esophagus to establish an airway. If inadvertently placed into trachea, it can be used as a temporary ET tube.

There are only two sizes: small adult and larger adult.

What is a Laryngeal Mask Airway? - ANSWER- Looks like an ET tube but is equipped with an inflatable, elliptical, silicone rubber collar at the distal end. It is designed to cover the supraglottic area.

ILMA, does not require laryngoscopy and visualization of the chords.

What is Needle Cricothyrotomy - ANSWER- Percutaneous transtracheal ventilation. (temporary)

Complications include:

• inadequate ventilation causing hypoxia
• hematoma formation
• esophageal perforation
• aspiration
• thyroid perforation
• subcutaneous emphysema

What is Surgical Cricothyrotomy? - ANSWER- Making an incision in cricothyroid membrane and placing a cuffed endo or trach tube into trachea. This is indicated when other methods of airway management have failed and pt cannot be adequately ventilated and oxygenated. 3 / 4

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Complications include:

• Aspiration
• Hemorrhage or hematoma formation or both
• Lac to trachea or esophagus
• Creation of a false passage
• Laryngeal stenosis

How do you confirm ET Tube/Alternative Airway Placement? - ANSWER- - Visualization of the chords

• Using bronchoscope to confirm placement
• Listening to breath sounds over the epigastrum and chest walls while

ventilating the pt

• CO2 detector
• Esophageal detection device
• Chest x-ray

How do you inspect the chest for adequate ventilation? - ANSWER-

Observe:

• mental status
• RR and pattern
• chest wall symmetry
• any injuries
• patient's skin color (cyanosis?)
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