TNCC FINAL EXAM TEST 2024/2025
OPEN QUESTIONS AND ANSWERS
You are treating a 27-
k k k k
year old male in respiratory distress who was involved in a house
k k k k k k k k k k k k
fire. Calculating TBSA burned is deferred d/t the need for emerge
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nt intubation. At what rate should you begin fluid resuscitation?
k k k k k k k k k
A) 1000 mL/hr
k k
B) 500 mL/hr
k k k
C) 250 mL/hr
k k
D) 125 mL/hr - CORRECT ANSWER-B) 500 mL/hr
k k k k k k k
A patient has been in the ED for several hours waiting to be admitt
k k k k k k k k k k k k k
ed. He sustained multiple rib fractures and a femur fracture after a
k k k k k k k k k k k
kfall. He has been awake, alert, and c/o leg pain. His wife reported
k k k k k k k k k k k k k
suddenly becoming anxious and confused. Upon reassessment,
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the patient is restless, with respiratory distress and petechiae to h
k k k k k k k k k k
is neck. the patient is exhibiting signs of symptoms commonly ass
k k k k k k k k k k
ociated with which of the following conditions?
k k k k k k
A) acute lung injury
k k k
B) fat embolism
k k
C) PTX k
D) pulmonary contusion - CORRECT ANSWER-B) fat embolism
k k k k k k k
Which pulse pressure description is an indication of early hypovol
k k k k k k k k k
emic shock? k
A) widened
k
B) narrowed
k k
C) bounding
k
D) weak - CORRECT ANSWER-B) narrowed
k k k k k
,Which of the following considerations is most important when cari
k k k k k k k k k
ng for a geriatric trauma patient?
k k k k k
A) head to to exam
k k k k
B) medical history
k k
C) incontinence
k
D) falls - CORRECT ANSWER-B) medical history
k k k k k k
Which of the following assessment findings differentiates a tensio
k k k k k k k k
n pneumothorax from a simple pneumothorax?
k k k k k
A) increased work of breathing
k k k k
B) unilaterally diminished breath sounds
k k k k
C) pleuritic chest pain
k k k
D) hypotension that worsens with inspiration -
k k k k k k
CORRECT ANSWER-
k k
D) hypotension that worsens with inspiration.
k k k k k
Assessment findings associated with tension pneumothorax incl
k k k k k k
ude anxiety, severe restlessness, severe respiratory distress, an
k k k k k k k
d absent breath sounds on the injured side. Hypotension due to c
k k k k k k k k k k k
ompression of the heart and great vessels is consistent with obstr
k k k k k k k k k k
uctive shock. Hypotension worsens with inspiration due to increa
k k k k k k k k
sed intrathoracic pressure. Late signs include distended neck vei
k k k k k k k k
ns, tracheal deviation, and cyanosis.
k k k k
The nurse is caring for a 120 kg male is brought in after a warehou
k k k k k k k k k k k k k k
se fire and is calculating the patient's fluid resuscitation needs. H
k k k k k k k k k k
e has painful red blistering to the entire surface of both upper extr
k k k k k k k k k k k k
emities and superficial burns to the anterior chest. Using the modi
k k k k k k k k k k
fied Lund and Browder chart to calculate the total BSA burned, ho
k k k k k k k k k k k
w much IV fluids would be administered in the first 8 hours?
k k k k k k k k k k k
A) 2280 mL
k k k
B) 3840 mL
k k
C) 4560 mL
k k
D) 7680 mL - CORRECT ANSWER-A) 2280 mL
k k k k k k k
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
k k k k k k k k k k k k
, 120 kg x (2 mL) x (19% TBSA) = 4560 mL
k k k k k k k k k k
(half of fluids given in first 8 hours) = 2280 mL
k k k k k k k k k k k k k
Which of the following is a component of the trauma triad of death
k k k k k k k k k k k k
?
A) Acidosis k
B) hyperthermia
k
C) hemorrhage
k
D) sepsis - CORRECT ANSWER-A) Acidosis
k k k k k
k hypothermia, metabolic acidosis, coagulopathy k k k
A 56-year-
k
kmale patient involved in a MVC is brought to the ED of a rural criti
k k k k k k k k k k k k k k
cal access facility. He c/o neck pain, SOB, and diffuse abd pain. H
k k k k k k k k k k k k
is GCS is 15. His vitals are as follows:
k k k k k k k k
BP 98/71 k
HR 125 beats/min k k
RR 26 breaths/min k k
SpO2 94% on high flow O2 via NRB mask
k k k k k k k k
which of the following is the priority intervention for this patient?
k k k k k k k k k k
A) Expedite transport to the CT scanner
k k k k k k
B) prepare the patient for spinal radiographs
k k k k k k
C) expedite transfer to the closest trauma center
k k k k k k k
D) notify the patients family - CORRECT ANSWER-
k k k k k k k
C) expedite transfer to the closest trauma center
k k k k k k k
An elderly patient with a history of anticoagulant use presents aft
k k k k k k k k k k
er a fall at home that day. she denies any loss of consciousness.
k k k k k k k k k k k k k
She has a hematoma to her forehead and complains of headache
k k k k k k k k k k
, dizziness, and nausea. Which is a most likely cause of her symp
k k k k k k k k k k k k
toms?
OPEN QUESTIONS AND ANSWERS
You are treating a 27-
k k k k
year old male in respiratory distress who was involved in a house
k k k k k k k k k k k k
fire. Calculating TBSA burned is deferred d/t the need for emerge
k k k k k k k k k k
nt intubation. At what rate should you begin fluid resuscitation?
k k k k k k k k k
A) 1000 mL/hr
k k
B) 500 mL/hr
k k k
C) 250 mL/hr
k k
D) 125 mL/hr - CORRECT ANSWER-B) 500 mL/hr
k k k k k k k
A patient has been in the ED for several hours waiting to be admitt
k k k k k k k k k k k k k
ed. He sustained multiple rib fractures and a femur fracture after a
k k k k k k k k k k k
kfall. He has been awake, alert, and c/o leg pain. His wife reported
k k k k k k k k k k k k k
suddenly becoming anxious and confused. Upon reassessment,
k k k k k k k
the patient is restless, with respiratory distress and petechiae to h
k k k k k k k k k k
is neck. the patient is exhibiting signs of symptoms commonly ass
k k k k k k k k k k
ociated with which of the following conditions?
k k k k k k
A) acute lung injury
k k k
B) fat embolism
k k
C) PTX k
D) pulmonary contusion - CORRECT ANSWER-B) fat embolism
k k k k k k k
Which pulse pressure description is an indication of early hypovol
k k k k k k k k k
emic shock? k
A) widened
k
B) narrowed
k k
C) bounding
k
D) weak - CORRECT ANSWER-B) narrowed
k k k k k
,Which of the following considerations is most important when cari
k k k k k k k k k
ng for a geriatric trauma patient?
k k k k k
A) head to to exam
k k k k
B) medical history
k k
C) incontinence
k
D) falls - CORRECT ANSWER-B) medical history
k k k k k k
Which of the following assessment findings differentiates a tensio
k k k k k k k k
n pneumothorax from a simple pneumothorax?
k k k k k
A) increased work of breathing
k k k k
B) unilaterally diminished breath sounds
k k k k
C) pleuritic chest pain
k k k
D) hypotension that worsens with inspiration -
k k k k k k
CORRECT ANSWER-
k k
D) hypotension that worsens with inspiration.
k k k k k
Assessment findings associated with tension pneumothorax incl
k k k k k k
ude anxiety, severe restlessness, severe respiratory distress, an
k k k k k k k
d absent breath sounds on the injured side. Hypotension due to c
k k k k k k k k k k k
ompression of the heart and great vessels is consistent with obstr
k k k k k k k k k k
uctive shock. Hypotension worsens with inspiration due to increa
k k k k k k k k
sed intrathoracic pressure. Late signs include distended neck vei
k k k k k k k k
ns, tracheal deviation, and cyanosis.
k k k k
The nurse is caring for a 120 kg male is brought in after a warehou
k k k k k k k k k k k k k k
se fire and is calculating the patient's fluid resuscitation needs. H
k k k k k k k k k k
e has painful red blistering to the entire surface of both upper extr
k k k k k k k k k k k k
emities and superficial burns to the anterior chest. Using the modi
k k k k k k k k k k
fied Lund and Browder chart to calculate the total BSA burned, ho
k k k k k k k k k k k
w much IV fluids would be administered in the first 8 hours?
k k k k k k k k k k k
A) 2280 mL
k k k
B) 3840 mL
k k
C) 4560 mL
k k
D) 7680 mL - CORRECT ANSWER-A) 2280 mL
k k k k k k k
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
k k k k k k k k k k k k
, 120 kg x (2 mL) x (19% TBSA) = 4560 mL
k k k k k k k k k k
(half of fluids given in first 8 hours) = 2280 mL
k k k k k k k k k k k k k
Which of the following is a component of the trauma triad of death
k k k k k k k k k k k k
?
A) Acidosis k
B) hyperthermia
k
C) hemorrhage
k
D) sepsis - CORRECT ANSWER-A) Acidosis
k k k k k
k hypothermia, metabolic acidosis, coagulopathy k k k
A 56-year-
k
kmale patient involved in a MVC is brought to the ED of a rural criti
k k k k k k k k k k k k k k
cal access facility. He c/o neck pain, SOB, and diffuse abd pain. H
k k k k k k k k k k k k
is GCS is 15. His vitals are as follows:
k k k k k k k k
BP 98/71 k
HR 125 beats/min k k
RR 26 breaths/min k k
SpO2 94% on high flow O2 via NRB mask
k k k k k k k k
which of the following is the priority intervention for this patient?
k k k k k k k k k k
A) Expedite transport to the CT scanner
k k k k k k
B) prepare the patient for spinal radiographs
k k k k k k
C) expedite transfer to the closest trauma center
k k k k k k k
D) notify the patients family - CORRECT ANSWER-
k k k k k k k
C) expedite transfer to the closest trauma center
k k k k k k k
An elderly patient with a history of anticoagulant use presents aft
k k k k k k k k k k
er a fall at home that day. she denies any loss of consciousness.
k k k k k k k k k k k k k
She has a hematoma to her forehead and complains of headache
k k k k k k k k k k
, dizziness, and nausea. Which is a most likely cause of her symp
k k k k k k k k k k k k
toms?
