Mental Health Nursing (NURSING 212) TNCC Final Exam Test 2023 Answered

TNCC Final Exam Test 2023 Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? Answer: c . A) to measure oxygenation and ventilation B) to quantify the base deficit for the adequacy of cellular perfusion C) *to gauge end-organ perfusion and tissue hypoxia ** D) to determine the underlying cause of shock A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock? Answer: A . A) compensated ** B) Progressive C) irreversible D) decompensated An elderly patient with a history of anticoagulant use presents after a fall at home that day. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms? Answer: D . A) epidural hematoma B) diffuse axonal injury C) post-concussive syndrome D) subdural hematoma *** EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? Answer: D . A) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath *** Which of the following occurs during the third impact of a motor vehicle crash? Answer: C . A) The driver of the vehicle collides with the steering wheel