TNCC 8TH QUESTIONS WITH ANSWERS

TNCC 8TH QUESTIONS WITH ANSWERS The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patients 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? 2280 mL 3840 mL A fluid total of 3840 mL is not correct because only partial or full thickness burn areas are used in calculating TBSA. The anterior chest shows evidence of superficial burns. - ANSWER- 2280 mL - -3840 mL A fluid total of 3840 mL is not correct because only partial or full thickness burn areas are used in calculating TBSA. The anterior chest shows evidence of superficial burns. 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? Placental abruption - ANSWER- Placental abruption Patients with a crush injury should be monitored for which of the following conditions? Dysrhythmias Hyperkalemia and other electrolyte abnormalities can lead to lifethreatening dysrhythmias. - ANSWER- Dysrhythmias Hyperkalemia and other electrolyte abnormalities can lead to life-threatening dysrhythmias. A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center complaining of abdominal, pelvic, 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? Diagnostic peritoneal lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable patients or if FAST and CT are not available. - ANSWER- Diagnostic peritoneal lavage is indicated for hemodynamically unstable patients or if FAST and CT are not available. 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? Initiate transfer to a trauma center - ANSWER- Initiate transfer to a trauma center What finding raises suspicion of a complete spinal cord injury? Priapism - ANSWER- Priapism Which of the following is a component of the trauma triad of death? Acidosis - ANSWER- Acidosis Tearing of the bridging veins is most frequently associated with which brain injury? Subdural hematoma - ANSWER- Subdural hematoma During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. What priority nursing intervention should be performed next? Open the airway with the head-tilt, chin lift maneuver xx The unconscious patient with multi-system trauma should be suspected of having a cervical spine injury. The jawthrust procedure is recommended to open the airway. Insert an oropharyngeal airway if there is no gag reflex - ANSWER- Insert an oropharyngeal airway if there is no gag reflex A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention? If signs and symptoms of tension pneumothorax develop after the application of the dressing, remove the dressing and reevaluate the patient. Needle decompression might be necessary if the patient does not improve after removal of the dressing. Dressing removal - ANSWER- Dressing removal You are treating a 27-year-old male in respiratory distress who was involved in a house fire. Calculating total body surface area (TBSA) burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation? 1 500 mL/hour - ANSWER- 500 mL/hour What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? Pulse oximetry and capnography - ANSWER- Pulse oximetry and capnography EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant damage to the drivers side of the car. The patient is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar? After a physical examination if the patient has no radiologic abnormalities on CT - ANSWER- After a physical examination if the patient has no radiologic abnormalities on CT Which of the following injuries is LEAST likely to be promptly identified? Bowel - ANSWER- Bowel 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? Elevated creatinine phosphokinase - ANSWER- Elevated creatinine phosphokinase Caregivers carry in a 2-year-old into the emergency