TNCC TRAUMA NURSING PROCESS EXAM QUESTIONS

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TNCC TRAUMA NURSING PROCESS EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -19 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Double starred criteria ** is to be done in order - assessments and

interventions must be completed prior to moving to the next step, what are they? (5)

Answer:

Alertness and airway (And c-spine motion restriction)** Breathing** Circulation** Disability** Exposure**

Question 2: What do you assess for in the head to toe section?

Answer:

Inspect AND palpate head for injuries Inspect AND palpate face for injuries Inspect AND palpate neck for injuries (demonstrate removal AND reapplication of cervical collar for assessment (if indicated) Inspect AND palpate chest for injuries Auscultate breath sounds Auscultate heart sounds Inspect the abdomen for injuries Auscultate bowel sounds Palpate all 4 quadrants of the abdo for injuries Inspect and palpate the flanks for injuries Inspect pelvis for injuries Apply gentle pressure over iliac crests downward and medially Apply gentle pressure on the symphysis pubis (if iliac crests are stable) Inspect the perineum for injuries

Consider how to measure urinary output -assess for contraindications for a urinary catheter -use an external catheter -weigh diapers (peds and adults) Inspect and palpate all 4 extremities for neurovascular status and injuries

Question 3: What does SAMPLE stand for?

Answer:

Signs and symptoms, allergies, medications, past medical history, last meal, events lead to current state.Question 4: What do you assess for in the Circulation and Control of Hemorrhage portion? (2)

Answer:

MUST IDENTIFY BOTH

• Inspect AND palpate the skin for color, temperature, and moisture

• Palpate a pulse

May include but not limited to the following:

-Anticipate goal-directed therapy for shock -Apply a cardiac monitor -Apply pelvic binder -Apply traction splint -Assess patency of prehospital IVs -Compare central and peripheral pulses -Consider sources of internal hemorrhage -Control external hemorrhage -Draw labs -Facilitate FAST and/or radiographs to identify source of internal hemorrhage -Initiate CPR/ACLS -Obtain IV/IO access (Two sites) -Palpate central pulse if peripheral pulse is absent -Tilt pregnant patient or manually displace uterus

Question 5: What do you assess in the HISTORY portion?

Answer:

1. Obtain pertinent history (identifies at least one):

-medical records/documents -SAMPLE -Prehospital report

Question 6: What do you assess for in the Exposure and Environmental Control portion? (2)

Answer:

• Remove all clothing AND inspect for obvious injuries

-if transport device is in place, it may be removed as soon as possible -if there is no contraindications, the patient may be turned quickly to assess the posterior. The is deferred until after the head to toe assessment and imaging if needed to evaluate spinal and pelvic stability

2. Provide warmth (identifies at least ONE):

-Blankets -Increase room temp -Warmed fluids -Warming lights Question 7: Single starred criteria to be done - sequence is not critical, what are they? (4)

Answer:

Reassessment of primary survey interventions* Blood glucose if any alterations noted in disability* Pain assessment using an appropriate pain scale* Inspect posterior surfaces (unless contraindicated by suspected spine or pelvis injury)* Question 8: What do you assess for in the Full set of Vital Signs and Family Presence portion?(2)

Answer:

Obtain a Full set of vital signs Facilitate Family presence

Question 9: What is contained in the secondary survey?

Answer:

History and Head to Toe Assessment Inspect Posterior Surfaces Question 10: What do you assess for in the Get adjuncts and Give comfort portion?

Answer:

Use the LMNOP acronym:

L: Laboratory analysis

-blood gas -blood cross/type and screen -coagulation studies -CBC -Lactate -metabolic panel -pregnancy -toxicology screen

M: attach patient to cardiac Monitor

-set to frequent BPs -consider need for ECG

N: nasogastric or orogastric tube?

O: assess Oxygenation and continuous ETCO2

-increase or decrease the rate of assisted ventilation

-wean O2 (consider other ways to monitor if hypothermic/vasoconstricted/skin colors impact on pulse ox measurements)

P: assess Pain using an appropriate pain scale

-give appropriate nonpharmacologic comfort measures (identifies at least ONE): -distraction -family presence -places padding over bony prominence -repositioning -splinting -verbal reassurance Consider obtaining order for analgesia

Question 11: What is contained in the General Impression?

Answer:

Assess for obvious uncontrolled external hemorrhage or unresponsiveness/apnea and the need to re-prioritize to C-ABC When alterations are identified, intervene as appropriate and reassess.

May include but not limited to the following:

-Assess for a pulse -Control external hemorrhage -Initiate chest compressions -Initiate IV resuscitation for significant blood loss with signs of very poor perfusion

Question 12: What do you assess for in the Airway and Alertness portion? (3)

Answer:

SIMULTANEOUS CERVICAL SPINAL STABILIZATION

• Assess LOC using AVPU

• Open the airway

May include but not limited to the following:

-If cervical spinal injury is suspected, state the need for a 2nd person to provide manual cervical spinal stabilization AND demonstrate manual opening of the airway using the jaw-thrust maneuver -When the patients is alert and can cooperate, it is acceptable to ask the patient to open their mouth to assess the airway.

3. Assess the patency and protection of the airway (identifies at least FOUR):

-bony deformity - burns -edema -fluids(blood/vomit/secretions) -foreign objects -inhalation injury(burns, singed nasal or facial hair, soot) -loose or missing teeth -sounds(snoring, gurgling, or stridor) -tongue obstruction -vocalization When alterations are identified, intervene as appropriate and reassess

May include but not limited to the following:

-anticipate the need for intubation -insert an OPA or NPA -remove any loose teeth or foreign objects -suction the airway