TNCC Exam 8th edition study Q&A
comprehensive /United States University, San Diego
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve -
{ANSWER}- Hemoglobin does not readily release oxygen for use by the tissues
A shift to the left occurs in an environment of low metabolic demand
(hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
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 it is appropriate to remove the cervical
collar? -{ANSWER}- After a physical examination if the patient has no
radiologic abnormalities on CT A CT is recommended for spinal clearance in an
impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to
the entire surface of both upper extremities and superficial burns to the anterior
chest. Using the modified Lund and Browder chart to calculate the total body
surface area burned, how much IV fluid would be administered in the first 8 hours?
-{ANSWER}- 2280 mL Both upper arms = 8%, both lower arms = 6%, and both
hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to 2280
mL. Superficial burns are not included in the TBSA calculation for fluid
resuscitation.
Which of the following is an expected finding in a patient with a tube
thoracostomy connected to a chest drainage system -{ANSWER}- Fluctuation in
the water seal chamber Fluctuation in the water seal chamber indicates the tube is
placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with
a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? -{ANSWER}- Globe rupture A teardrop-shaped pupil suggests a
globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? -{ANSWER}- Bradycardia and
, absent motor function below the level of injury Patients with a complete spinal
cord injury will have absent motor function below the level of the lesion. They
become hypotensive and bradycardic due to loss of autonomic nervous system
function.
Which of the following patients warrants referral to a burn center? -{ANSWER}-
A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This
patient has a 7% TBSA burn with a preexisting medical history that could
complicate management, prolong recovery, or affect mortality.
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 noted on cardiotocography. These findings are
most consistent with which of the following? -{ANSWER}- Placental abruption
The findings of abdominal pain, elevated fundal height, dark bloody show, and
fetal distress are most consistent with placental abruption.
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? -
{ANSWER}- Straight catheter for urine sample Insertion of a urinary catheter is
contraindicated if urethral transection is suspected. Signs and symptoms of urethral
injury include blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a
high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? -
{ANSWER}- The aorta is torn at its attachment with the ligamentum arteriosum
This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT
which of the following? -{ANSWER}- Defusings A defusing is part of critical
incident stress management but is not considered a critical communication point in
trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma
patient with massive uncontrolled hemorrhage? -{ANSWER}- MARCH The
MARCH mnemonic stands for massive hemorrhage, airway, respiration,
comprehensive /United States University, San Diego
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve -
{ANSWER}- Hemoglobin does not readily release oxygen for use by the tissues
A shift to the left occurs in an environment of low metabolic demand
(hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
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 it is appropriate to remove the cervical
collar? -{ANSWER}- After a physical examination if the patient has no
radiologic abnormalities on CT A CT is recommended for spinal clearance in an
impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to
the entire surface of both upper extremities and superficial burns to the anterior
chest. Using the modified Lund and Browder chart to calculate the total body
surface area burned, how much IV fluid would be administered in the first 8 hours?
-{ANSWER}- 2280 mL Both upper arms = 8%, both lower arms = 6%, and both
hands = 5%, yielding 19 * 2 * 120 = 4560 mL. Half of the total is equal to 2280
mL. Superficial burns are not included in the TBSA calculation for fluid
resuscitation.
Which of the following is an expected finding in a patient with a tube
thoracostomy connected to a chest drainage system -{ANSWER}- Fluctuation in
the water seal chamber Fluctuation in the water seal chamber indicates the tube is
placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with
a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? -{ANSWER}- Globe rupture A teardrop-shaped pupil suggests a
globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? -{ANSWER}- Bradycardia and
, absent motor function below the level of injury Patients with a complete spinal
cord injury will have absent motor function below the level of the lesion. They
become hypotensive and bradycardic due to loss of autonomic nervous system
function.
Which of the following patients warrants referral to a burn center? -{ANSWER}-
A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This
patient has a 7% TBSA burn with a preexisting medical history that could
complicate management, prolong recovery, or affect mortality.
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 noted on cardiotocography. These findings are
most consistent with which of the following? -{ANSWER}- Placental abruption
The findings of abdominal pain, elevated fundal height, dark bloody show, and
fetal distress are most consistent with placental abruption.
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? -
{ANSWER}- Straight catheter for urine sample Insertion of a urinary catheter is
contraindicated if urethral transection is suspected. Signs and symptoms of urethral
injury include blood at the meatus, perineal ecchymosis, scrotal ecchymosis, and a
high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? -
{ANSWER}- The aorta is torn at its attachment with the ligamentum arteriosum
This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT
which of the following? -{ANSWER}- Defusings A defusing is part of critical
incident stress management but is not considered a critical communication point in
trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma
patient with massive uncontrolled hemorrhage? -{ANSWER}- MARCH The
MARCH mnemonic stands for massive hemorrhage, airway, respiration,
