TNCC PRACTICE EXAM - -Guaranteed passing score -20 Questions and Ans...

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TNCC PRACTICE EXAM

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -20 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: A patient with a knife injury to the neck has an intact airway and is hemodynamically stable. He complains of difficulty swallowing and speaking. Further assessment is indicated next for which of the following conditions?

• Damage to the spinal cord
• An expanding pneumothorax
• Laceration of the carotid artery
• Injury to the thyroid gland

Answer:

• Damage to the spinal cord Rationale: Penetrating neck trauma may include concurrent injuries to the

spinal cord, airway, or vascular neck structures. With an intact airway and hemodynamic stability, the other common concurrent injury is to the spinal cord (pp. 124, 126).Question 2: A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg 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?

• Decompensated shock
• Normal vital signs in pregnancy
• Abruptio placentae

• Supine hypotension syndrome

Answer:

• Normal vital signs in pregnancy Rationale: In pregnancy, the resting heart rate increases by 10 to 20

beats/minute and a small decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in peripheral resistance (p. 294). Normal fetal heart rate is between 120 and 160 beats/minute (p. 297).Question 3: Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment are examples of which phase of injury?

• Primary
• Secondary
• Tertiary
• Quaternary

Answer:

• Secondary Rationale: The secondary phase of a blast results from flying debris, projectiles, and bomb

fragments causing lacerations or penetrating injuries (p. 20).Question 4: When obtaining a history for an injured patient, understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the

trauma provider in:

• Evaluating and anticipating the types of injury that may be present
• Deciding whether law enforcement should be notified
• Determining needed laboratory tests
• Predicting the need for a surgical procedure

Answer:

• Evaluating and anticipating the types of injury that may be present Rationale: Mechanism of injury

and energy transfer can assist the provider in evaluating and anticipating damage (p. 23).

Question 5: A patient fell two weeks ago, striking his head. He came to the emergency department with a persistent headache and nausea. He was diagnosed with a small subdural hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports that he has been anxious, restless, and shaky. He vomited twice during the night. He tells the day shift nurse that he couldn't sleep because a young child kept coming into his room.What is a likely cause for these signs and symptoms?

• Increased intracranial pressure
• Alcohol withdrawal
• Rhabdomyolysis
• Pulmonary embolus

Answer:

• Alcohol withdrawal Rationale: Alcohol withdrawal is a common delayed condition because symptoms

are difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting, psychomotor agitation, anxiety, insomnia, hallucinations, or seizures (p. 397).Question 6: The major preventable cause of death in the trauma patient is:

• Airway compromise
• Ineffective ventilation
• Secondary head injury
• Uncontrolled hemorrhage

Answer:

• Uncontrolled hemorrhage Rationale: Uncontrolled hemorrhage is the major cause of preventable

death after injury, so assessment to identify uncontrolled hemorrhage is key to the initial assessment process (p. 29).Question 7: What is the best position for maintaining an open airway in the bariatric patient?

• Prone
• Supine
• Reverse Trendelenburg
• Right lateral recumbent

Answer:

• Reverse Trendelenburg Rationale: The reverse Trendelenburg position will benefit both airway

maintenance and work of breathing in the bariatric patient (p. 285).Question 8: While performing an assessment on a 13-month-old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a potential sign of mental status changes?

• Sunken fontanel
• Crying, but consolable
• Hyperglycemia
• Cooperation with the assessment

Answer:

• Cooperation with the assessment Rationale: An alert older infant or toddler will recognize his or her

caregiver, be cautious of strangers, and may not respond to commands, which is a normal response (p.235).Question 9: The across-the-room observation step in the initial assessment provides the

opportunity to:

• Assess for uncontrolled internal hemorrhage
• Accurately triage the patient
• Reprioritize circulation before airway or breathing
• Activate the trauma team

Answer:

• Reprioritize circulation before airway or breathing. Rationale: The across-the-room observation is

done 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 (p. 28).Question 10: The nurse is obtaining a history for a patient who presents following sexual assault. This history is completed using which of the following techniques?

• Bring the family in to the interview room
• Use direct quotes to record information