TNCC Written Exam Questions Verified

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TNCC Written Exam Questions & Verified Answers Correctly 1.What are the late signs of breathing compromise Answer - Tracheal deviation -JVD 2.What are signs of ineffective breathing Answer - AMS -Cyanosis, especially around the mouth -Asymmetric expansion of chest wall -Paradoxical movement of the chest wall during inspiration and expiration -Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing -Sucking chest wounds -Absent or diminished breath sounds -Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated -Anticipate definitive airway management to support ventilation.

3.Upon initial assessment, what type of oxygen should be used for a pt breathing effectively Answer A tight-fitting nonrebreather mask at 12-15 lpm. 1 / 4

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4.What intervention should be done if a pt presents with effective circulation?-

: Answer - Insert 2 large caliber IV's

-Administer warmed isotonic crystalloid solution at an appropriate rate 5.What are signs of ineffective circulation Answer - Tachycardia -AMS -Uncontrolled external bleeding -Pale, cool, moist skin -Distended or abnormally flattened external jugular veins -Distant heart sounds 6.What are the interventions for Effective/Ineffective Circulation

Answer - Control any uncontrolled external bleeding by:

-Applying direct pressure over bleeding site -Elevating bleeding extremity -Applying pressure over arterial pressure points -Using tourniquet (last resort).-Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution -Use warmed solution -Use pressure bags to increase speed of IVF infusion -Use blood administration tubing for possible administration of blood -Use rapid infusion device based on protocol 2 / 4

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-Use NS 0.9% in same tubing as blood product -IV = surgical cut-down, central line, or both.-Blood sample to determine ABO and Rh group -IO in sternum, legs, arms or pelvis -Administer blood products -PASG (without interfering with fluid resuscitation) 7.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 8.What medications are used during intubation

Answer LOAD Mnemonic: L = Lidocaine

O = Opioids A = Atropine D = Defasiculating agents 3 / 4

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9.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 aspi- ration

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

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