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TNCC ENA 9TH EDITION PRE TEST
Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -20 Questions and Answers
-Format: Multiple-choice / Flashcard
Question 1: A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest. Which concurrent injury is most commonly associated with this fracture?
- Blunt cardiac injury
- Brachial plexus injury
- Pneumothorax
- Hemothorax
Answer:
- Brachial plexus injury
- Warm the affected part over 30 to 60 minutes
- Use gentle friction to improve circulation
- Administer tissue plasminogen activator
- Drainage of all large and small blisters
Rationale: First and second rib fractures are most commonly associated with great vessel, head and spinal cord, and brachial plexus injuries.Question 2: Treatment for frostbite can include which of the following interventions?
Answer:
- Administer tissue plasminogen activator
- Decompensated shock
- Normal vital signs in pregnancy
- Compensated shock
- Supine hypotension syndrome
Rationale: With frostbite, thrombus formation is a risk. Tissue plasminogen activator, a thrombolytic medication, has been effective in maintaining perfusion and decreasing the need for amputation when administered within 24 hours of rewarming.Question 3: The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mmHg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following?
Answer:
- Normal vital signs in pregnancy
- They are talking about taking the emergency nursing certification exam
- They keep requesting to be assigned to the walk-in/ambulatory area
- They are impatient and snap at their coworkers
- They are thinking about transferring out of the emergency department
Rationale: In pregnancy, the resting heart rate increases by 10 to 20 beats/minute. This is also a small decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in peripheral resistance. Normal fetal heart rate is between 120 and 160 beats/minute.Question 4: A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick for a couple of days and is now back working on the team. Which of the following would indicate this nurse is coping well?
Answer:
- They are talking about taking the emergency nursing certification exam
Rationale: This is an indication the nurse is taking positive steps to advance their own practice, a sign of resilience. B indicates the nurse is still not ready to return to their previous level of engagement in their job. C shows signs of burnout, irritability and frustration. D shows decreased satisfaction with the job, a sign of burnout.
Question 5: A patient with a spinal cord injury at C5 is being cared for in the emergency department while awaiting transport to a trauma center. Which of the following represents the highest priority for ongoing assessment and management for this patient?
- Maintain adequate respiratory status
- Administer balanced resuscitation fluid
- Perform serial assessments of neurologic function
- Maintain core temperature
Answer:
- Maintain adequate respiratory status
- Apply gentle pressure over the iliac crests, downward and laterally
- Apply gentle pressure over the iliac crests, downward and medially
- Apply firm pressure over the iliac crests, downward and laterally
- Apply firm pressure over the iliac crests, downward and medially
Rationale: Spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function, resulting in a paralyzed diaphragm and inability to breathe. Maintenance of respiratory function is the highest priority.Question 6: What is the appropriate technique for palpating the pelvis for stability?
Answer:
- Apply gentle pressure over the iliac crests, downward and medially
- Damage to the cervical spine
- An expanding pneumothorax
- Laceration of the carotid artery
- Injury of the thyroid gland
Rationale: To assess for pelvic instability, gentle pressure is applied over the iliac crests, downward and medially.Question 7: An adult patient with a knife injury to the neck has an intact airway and is hemodynamically stable. They complain of difficulty swallowing and speaking. In the primary survey, further assessment is indicated next for which of the following conditions?
Answer:
- Damage to the cervical spine
- Assess for uncontrolled internal hemorrhage
- Accurately triage the patient
- Reprioritize circulation before airway or breathing
- Activate the trauma team
Rationale: Penetrating neck trauma may include concurrent injuries to the cervical spine and cord, airway, or vascular neck structures. With an intact airway and hemodynamic stability, the other common concurrent injury is to the cervical spine.Question 8: The general impression step in the initial assessment provides the opportunity to do which of the following?
Answer:
- Reprioritize circulation before airway or breathing
- End-tidal carbon dioxide
- Hematocrit
- Base deficit
- Oxygen saturation
Rationale: The general impression is formed at the beginning of the primary survey to rapidly assess the need to reprioritize circulation before airway or breathing. This is done if uncontrolled external hemorrhage is identified.Question 9: What is the best measure of the adequacy of the cellular perfusion and can help to predict the outcome of resuscitation?
Answer:
- Base deficit
- Prone
- Supine
Rationale: Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and, when used in conjunction with serum lactate, helps predict the success of the resuscitation.Question 10: What is the best position for maintaining an open airway in the obese patient?
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