TNCC 9TH EDITION 100 EXAM REVIEW
SOLVED QUESTIONS WITH ACCURATE
ANSWERS
◉ -Four of these must be identified to assess breathing effectiveness:
Answer: Breath sounds, depth/pattern/rate, spontaneous breathing,
subcutaneous emphysema, increased work of breathing,
symmetrical chest rise and fall, tracheal deviation/JVD, open
wounds/deformities, skin color
◉ -What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
Answer: cardiac monitor
◉ -When should 2 IV sites be established?
Answer: During "Circulation" assessment
◉ -If the patient is intubated and you've already assessed ETT
placement, what else needs to be done with the ETT? (step 10)
Answer: assess ETT position by noting the number at teeth/gums
AND secure ETT
◉ -What should you verbalize after completing all ETT assessments?
,Answer: moving patient from assisted ventilation to mechanical
◉ -During which part of the primary survey would you anticipate
the need for a chest tube, intubation, decompression of
pneumothorax, oxygen, or BVMs?
Answer: "Breathing and Ventilation"
◉ -Four of these must be identified to assess patency and protection
of the airway:
Answer: bony deformity, loose teeth, edema, inhalation injury,
sounds, tongue obstruction, burns, fluids, foreign objects,
vocalization
◉ -During which part of the primary survey would there be
anticipation for intubation, insertion of OPA/NPA, removal of any
loose teeth or foreign objects, or suctioning?
Answer: Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal
Stabilization"
◉ If c-spine stabilization is necessary, what need should be stated?
Answer: the need for a second person to provide manual c-spine
stabilization
,◉ *An adult patient who sustained a severe head trauma has been
intubated and is being manually ventilated via a bag-mask device at
a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry
is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
Answer: A.Decrease the rate of manual ventilation.
◉ 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?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome
Answer: post-concussive syndrome
◉ A patient with a lower extremity fracture complains of severe pain
and tightness in his calf, minimally relieved by pain medications.
Which of the following is the priority nursing intervention?
, A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg
Answer: C.Elevating the leg to the level of the heart
◉ 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
A ruptured diaphragm is a potentially life-threatening injury. The
patient will most likely have decreased breath sounds on the
affected side along with pain, which may radiate to the left shoulder.
However, these signs do not specifically implicate an injury to the
diaphragm. Auscultation of bowel sounds in the chest indicates that
abdominal contents have herniated up into the chest through a
defect in the diaphragm.
◉ *A patient has been in the emergency department for several
hours waiting to be admitted. They sustained multiple rib fractures
and a femur fracture after a fall. The patient has been awake, alert,
and complaining of leg pain. Their spouse reported that the patient
SOLVED QUESTIONS WITH ACCURATE
ANSWERS
◉ -Four of these must be identified to assess breathing effectiveness:
Answer: Breath sounds, depth/pattern/rate, spontaneous breathing,
subcutaneous emphysema, increased work of breathing,
symmetrical chest rise and fall, tracheal deviation/JVD, open
wounds/deformities, skin color
◉ -What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
Answer: cardiac monitor
◉ -When should 2 IV sites be established?
Answer: During "Circulation" assessment
◉ -If the patient is intubated and you've already assessed ETT
placement, what else needs to be done with the ETT? (step 10)
Answer: assess ETT position by noting the number at teeth/gums
AND secure ETT
◉ -What should you verbalize after completing all ETT assessments?
,Answer: moving patient from assisted ventilation to mechanical
◉ -During which part of the primary survey would you anticipate
the need for a chest tube, intubation, decompression of
pneumothorax, oxygen, or BVMs?
Answer: "Breathing and Ventilation"
◉ -Four of these must be identified to assess patency and protection
of the airway:
Answer: bony deformity, loose teeth, edema, inhalation injury,
sounds, tongue obstruction, burns, fluids, foreign objects,
vocalization
◉ -During which part of the primary survey would there be
anticipation for intubation, insertion of OPA/NPA, removal of any
loose teeth or foreign objects, or suctioning?
Answer: Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal
Stabilization"
◉ If c-spine stabilization is necessary, what need should be stated?
Answer: the need for a second person to provide manual c-spine
stabilization
,◉ *An adult patient who sustained a severe head trauma has been
intubated and is being manually ventilated via a bag-mask device at
a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry
is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
Answer: A.Decrease the rate of manual ventilation.
◉ 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?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome
Answer: post-concussive syndrome
◉ A patient with a lower extremity fracture complains of severe pain
and tightness in his calf, minimally relieved by pain medications.
Which of the following is the priority nursing intervention?
, A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg
Answer: C.Elevating the leg to the level of the heart
◉ 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
A ruptured diaphragm is a potentially life-threatening injury. The
patient will most likely have decreased breath sounds on the
affected side along with pain, which may radiate to the left shoulder.
However, these signs do not specifically implicate an injury to the
diaphragm. Auscultation of bowel sounds in the chest indicates that
abdominal contents have herniated up into the chest through a
defect in the diaphragm.
◉ *A patient has been in the emergency department for several
hours waiting to be admitted. They sustained multiple rib fractures
and a femur fracture after a fall. The patient has been awake, alert,
and complaining of leg pain. Their spouse reported that the patient
