TNCC 9th Edition(questions and answers)2023/2024 updated exam

TNCC 9th Edition(questions and answers)2023 The trauma nurse knows that placing a bariatric patient in a "ramped position" provides better visualization during the insertion of which device? - CORRECT ANSWERendotracheal tube Tearing of the bridging veins is most frequently associated with which brain injury? - CORRECT ANSWER-subdural hematoma A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is expected with a musculoskeletal complication associated with this presentation? - CORRECT ANSWER-Elevated creatine kinase A patient is brought to the emergency department of a rural hospital following a highspeed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority intervention? - CORRECT ANSWER-Initiate transfer to a trauma center Which of the following injuries is LEAST likely to be promptly identified? - CORRECT ANSWER-bowel Which of the following patients warrants referral to a burn center? - CORRECT ANSWER-A 52-year-old diabetic male with a partial-thickness burn to the left lower leg A patient has been in the emergency department for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and symptoms most commonly associated with which of the follow conditions? - CORRECT ANSWER-fat embolism A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? - CORRECT ANSWER-Apply a splint and elevate the extremity ABOVE the level of the heart A 56-year-old male patient involved in a motor vehicle crash is brought to the emergency department of a rural critical assess facility. He complaints of neck pain, shortness of breath, and diffuse abdominal pain. His Glasgow Coma Score is 15. His vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the follow is the priority intervention for this patient? - CORRECT ANSWER-Expedite transfer to the closest trauma center Which of the following values indicates the need for alcohol withdrawal interventions? - CORRECT ANSWER-CIWA-Ar of 36 A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma team's communication? - CORRECT ANSWER-huddle A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? - CORRECT ANSWER-Bradycardia and absent motor function below the level of injury Which of the following is true about the log-roll maneuver? - CORRECT ANSWER-It can worsen cord damage from a unstable spinal injury What factor contributes most to the kinetic energy of a body in motion? - CORRECT ANSWER-velocity A 5-year-old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? - CORRECT ANSWERReport your suspicion of maltreatment in accordance with local regulations A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question? - CORRECT ANSWERStraight catheter for urine sample You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal margin, and some dark bloody show. Varying accelerations and decelerations are note don cardiotocography. These findings are most consistent with which of the following? - CORRECT ANSWER-placental abruption Which of the following occurs during the third impact of a motor vehicle crash? - CORRECT ANSWER-The aorta is torn at its attachment with the ligmentum arteriosum Which pulse pressure description is an indication of early hypovolemic shock? - CORRECT ANSWER-narrowed An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? - CORRECT ANSWER-Ventilate with a bagmask device Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? - CORRECT ANSWER-Hypotension that worsens with inspiration 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? - CORRECT ANSWER-Elevating the extremity TO the level of the heart A 49-year-old restrained driver involved in a motor vehicle collision present to the trauma center complaining of abdominal, pelvis, and bilateral lower extremity pain. Vital signs are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? - CORRECT ANSWER-diagnostic peritoneal lavage What finding raises suspicion of a complete spinal cord injury? - CORRECT ANSWERpriapism EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When is it appropriate to remove the cervical collar? - CORRECT ANSWER-After a physical examination if the patient has no radiologic abnormalities on a computed tomography scan During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which priority nursing intervention should be performed next? - CORRECT ANSWER-Insert an oropharyngeal airway if there is no gag reflex Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? - CORRECT ANSWER-To gauge end-organ perfusion and tissue hypoxia A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Currently vital signs are BP 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which stage of shock? - CORRECT ANSWER-compensated Which of the following is a possible complication of positive-pressure ventilation? - CORRECT ANSWER-Worsening pneumothorax