TNCC 9TH EDITION EXAM

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TNCC 9TH EDITION EXAM

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -50 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step?

Answer:

Notify the physician Question 2: A patient is brought to the emergency department with chest pain and shortness of breath following a high-speed motor vehicle collision in which they were the unrestrained driver. There is crepitus to the left chest with clear and equal breath sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40 breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular contractions. These findings are most consistent with which type of shock?

Answer:

Cardiogenic Question 3: An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of their symptoms?

Answer:

Post-concussive syndrome

Question 4: A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would indicate sacral sparing?

Answer:

Voluntary anal sphincter tone Question 5: Three adults present at different times during a one-hour period with a high fever, fatigue, and headache. All three patients have a rash which started on their mouth, face, and arms with progression to the chest and abdomen. They all visited the same grocery store within the last week. What is the most appropriate intervention from triage for these patients?

Answer:

Immediately initiate isolation precautions Question 6: An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2 hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 mL/hour. The urine output over the last hour was 15mL. What intervention should the nurse anticipate?

Answer:

Increase isotonic crystalloid infusion rate Question 7: Which findings are most consistent with a complete transection of the spinal cord?

Answer:

Absence of sensory and motor function below the level of injury Question 8: An adult was thrown against a concrete wall during a factory explosion and sustained a femur fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred during what level of blast trauma?

Answer:

Tertiary

Question 9: Which of the following situations could cause functional grief?

Answer:

Amputation of a limb Question 10: An adult trauma patient has received 1 liter of isotonic crystalloid solution, 6 units of packed red blood cells, 6 units of fresh frozen plasma, and 1 combined unit of platelets during the initial fluid resuscitation phase. Re-assessment includes: BP 104/66 mm Hg, HR 112 beats/minute, intermittent ventricular bigeminy on the cardiac monitor, and the presence of muscle tremors. What should the nurse anticipate administering based on these findings?

Answer:

Calcium gluconate Question 11: You are speaking with the family of a critically injured patient. The spouse is crying loudly and the daughter is angry and yelling at the staff. Which of the following nursing interventions is most appropriate?

Answer:

Ask if the family would like spiritual support

Question 12: What finding is consistent with the irreversible stage of shock?

Answer:

Bradycardia Question 13: An adult patient is brought to the emergency department following a motor vehicle collision with complaints of neck pain. They have identified as a person in the process of transitioning from male to female. What effect of hormone therapy should be considered when planning care for this patient?

Answer:

Testosterone therapy may decrease blood pressure Correct rationale: A person who is in the process of transitioning from male to female will usually be taking female hormones such as estrogen/estradiol to assist with the transition. This can cause a decrease in muscle mass, increased risk of thromboembolism, and possibly increased bone density.These patients would not be taking testosterone.Question 14: What type of wound closure is used with infection-prone wounds where the edges are difficult to approximate?

Answer:

Secondary Question 15: A trauma patient who is 30-weeks pregnant arrives at the emergency department following a motor vehicle collision. Which normal physiologic change should be considered when assessing ventilatory status?

Answer:

Increased oxygen consumption

Question 16: A patient is brought to the emergency department following a motor vehicle rollover and is complaining of left upper abdominal pain and left shoulder pain. This presentation is most consistent with an injury to which organ?

Answer:

Spleen Question 17: A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most consistent with an injury to the diaphragm?

Answer:

Bowel sounds heard in the left lower chest Question 18: A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the water seal chamber during inspiration and expiration. What is the best action for the nurse to take?

Answer:

Continue to the intensive care unit Question 19: Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing intervention?

Answer:

Notify the provider of the change Question 20: A patient presents to the emergency department after jumping from a third story and landing on their right foot then falling to the ground. There is pain and crepitus to the right hip when applying gentle downward and medial pressure to the iliac crests. This mechanism of injury is most consistent with what type of pelvic fracture?

Answer:

Vertical shear fracture Question 21: A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right lower chest and complaints of shortness of breath. What is the priority intervention?

Answer:

Airway and ventilation support