TNCC NOTES FOR WRITTEN EXAM WITH
CORRECT ANSWERS
1. What is kinematics? - ANSWER-A branch of mechanics (energy
transfer) that refers to motion and does not consider the concepts of
force and mass of the object or body.
2. What is Newton's First Law? - ANSWER-A body at rest will remain at
rest. A body in motion will remain in motion until acted on by an
outside force.
3. What is the Law of Conservation of Energy? - ANSWER-Energy can
neither be created nor destroyed. It is only changed from one form to
another.
4. What is Newton's Second Law? - ANSWER-Force equals mass multiplied
by acceleration of deceleration.
5. What is kinetic energy (KE)? - ANSWER-KE equals 1/2 the mass (M)
multiplied by the velocity squared.
6. What is the Mnemonic for the Initial Assessment? - ANSWER-A = Airway
with simultaneous cervical spine protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the
patient warm)
7. What is the Mnemonic for the Secondary Assessment? - ANSWER-F =
Full set of VS/Focused adjuncts (includes cardiac monitor, urinary
catheter, and gastric tube)/Family presence
, G = Give comfort measures (verbal reassurance, touch, and
pharmacologic and nonpharmacologic management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
8. Where do you listen to auscultate breath sounds? - ANSWER-Auscultate
the lungs bilaterally at the second intercostal space midclavicular line
and at the fifth intercostal space at the anterior axillary line.
9. What are the late signs of breathing compromise? - ANSWER-- Tracheal
deviation
- JVD
10. What are signs of ineffective breathing? - ANSWER-- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and
expiration
- Use of accessory muscles or abdominal muscles or both or
diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask
device, as indicated
- Anticipate definitive airway management to support ventilation.
11. Upon initial assessment, what type of oxygen should be used for
a pt breathing effectively? - ANSWER-A tight-fitting nonrebreather
mask at 12-15 lpm.
12. What intervention should be done if a pt presents with effective
circulation? - ANSWER-- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate
rate
,13. What are signs of ineffective circulation? - ANSWER-- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
14. What are the interventions for Effective/Ineffective Circulation? -
ANSWER-- Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic
crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of
blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
15. How do you assess Mnemonic "D"? - ANSWER-DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
, - Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
16. What are the interventions for Disability? - ANSWER-- If
assessment indicates a decreased LOC, conduct further investigation
during secondary focused assessments
- If pt is not alert or verbal, continue to monitor for any
compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration,
consider hyperventilation.
17. What is assessed and intervened for Expose/Environmental
Controls? - ANSWER-- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous
material
- Keep pt warm
- Keep clothing for evidence
18. What is the first thing assessed under the Secondary
Assessment? - ANSWER-FULL SET VS / FOCUSED ADJUNCTS / FAMILY
PRESENCE
- ABCDE should be completed
- Labs, X-rays, CT, Foley,
- Family Presence
19. What is the second thing assessed under the Secondary
Assessment? - ANSWER-GIVE COMFORT MEASURES
- Talking to pt
- Pharmacologic/Nonpharmacologic pain management
- Observe for physical signs of pain
20. What is assessed under the Mnemonic "H"? - ANSWER-HISTORY /
HEAD-TO-TOE ASSESSMENT
- MIVT
CORRECT ANSWERS
1. What is kinematics? - ANSWER-A branch of mechanics (energy
transfer) that refers to motion and does not consider the concepts of
force and mass of the object or body.
2. What is Newton's First Law? - ANSWER-A body at rest will remain at
rest. A body in motion will remain in motion until acted on by an
outside force.
3. What is the Law of Conservation of Energy? - ANSWER-Energy can
neither be created nor destroyed. It is only changed from one form to
another.
4. What is Newton's Second Law? - ANSWER-Force equals mass multiplied
by acceleration of deceleration.
5. What is kinetic energy (KE)? - ANSWER-KE equals 1/2 the mass (M)
multiplied by the velocity squared.
6. What is the Mnemonic for the Initial Assessment? - ANSWER-A = Airway
with simultaneous cervical spine protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the
patient warm)
7. What is the Mnemonic for the Secondary Assessment? - ANSWER-F =
Full set of VS/Focused adjuncts (includes cardiac monitor, urinary
catheter, and gastric tube)/Family presence
, G = Give comfort measures (verbal reassurance, touch, and
pharmacologic and nonpharmacologic management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
8. Where do you listen to auscultate breath sounds? - ANSWER-Auscultate
the lungs bilaterally at the second intercostal space midclavicular line
and at the fifth intercostal space at the anterior axillary line.
9. What are the late signs of breathing compromise? - ANSWER-- Tracheal
deviation
- JVD
10. What are signs of ineffective breathing? - ANSWER-- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and
expiration
- Use of accessory muscles or abdominal muscles or both or
diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask
device, as indicated
- Anticipate definitive airway management to support ventilation.
11. Upon initial assessment, what type of oxygen should be used for
a pt breathing effectively? - ANSWER-A tight-fitting nonrebreather
mask at 12-15 lpm.
12. What intervention should be done if a pt presents with effective
circulation? - ANSWER-- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate
rate
,13. What are signs of ineffective circulation? - ANSWER-- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
14. What are the interventions for Effective/Ineffective Circulation? -
ANSWER-- Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic
crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of
blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
15. How do you assess Mnemonic "D"? - ANSWER-DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
, - Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
16. What are the interventions for Disability? - ANSWER-- If
assessment indicates a decreased LOC, conduct further investigation
during secondary focused assessments
- If pt is not alert or verbal, continue to monitor for any
compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration,
consider hyperventilation.
17. What is assessed and intervened for Expose/Environmental
Controls? - ANSWER-- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous
material
- Keep pt warm
- Keep clothing for evidence
18. What is the first thing assessed under the Secondary
Assessment? - ANSWER-FULL SET VS / FOCUSED ADJUNCTS / FAMILY
PRESENCE
- ABCDE should be completed
- Labs, X-rays, CT, Foley,
- Family Presence
19. What is the second thing assessed under the Secondary
Assessment? - ANSWER-GIVE COMFORT MEASURES
- Talking to pt
- Pharmacologic/Nonpharmacologic pain management
- Observe for physical signs of pain
20. What is assessed under the Mnemonic "H"? - ANSWER-HISTORY /
HEAD-TO-TOE ASSESSMENT
- MIVT
