TNCC FINAL EXAM TEST OPEN BOOK
WITH COMPLETE SOLUTIONS
You are treating a 27-year old male in respiratory distress who was involved in a house
fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what
rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr - ANSWER-B) 500 mL/hr
A patient has been in the ED 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 c/o
leg pain. His wife reported suddenly becoming anxious and confused. Upon
reassessment, the patient is restless, with respiratory distress and petechiae to his
neck. the patient is exhibiting signs of symptoms commonly associated with which of the
following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion - ANSWER-B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSWER-B) narrowed
Which of the following considerations is most important when caring for a geriatric
trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls - ANSWER-B) medical history
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
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 - ANSWER-c) to gauge end-organ
perfusion and tissue hypoxia
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?
A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath - ANSWER-D) Smell of alcohol on breath
Which of the following occurs during the third impact of a motor vehicle crash?
A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger - ANSWER-C) the aorta is
torn at its attachment with the ligamentum arteriosum
Which of the following assessment findings differentiates a tension pneumothorax from
a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration - ANSWER-D) hypotension that worsens
with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side.
Hypotension due to compression of the heart and great vessels is consistent with
obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is 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 BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL - ANSWER-A) 2280 mL
WITH COMPLETE SOLUTIONS
You are treating a 27-year old male in respiratory distress who was involved in a house
fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what
rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr - ANSWER-B) 500 mL/hr
A patient has been in the ED 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 c/o
leg pain. His wife reported suddenly becoming anxious and confused. Upon
reassessment, the patient is restless, with respiratory distress and petechiae to his
neck. the patient is exhibiting signs of symptoms commonly associated with which of the
following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion - ANSWER-B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSWER-B) narrowed
Which of the following considerations is most important when caring for a geriatric
trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls - ANSWER-B) medical history
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
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 - ANSWER-c) to gauge end-organ
perfusion and tissue hypoxia
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?
A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath - ANSWER-D) Smell of alcohol on breath
Which of the following occurs during the third impact of a motor vehicle crash?
A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger - ANSWER-C) the aorta is
torn at its attachment with the ligamentum arteriosum
Which of the following assessment findings differentiates a tension pneumothorax from
a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration - ANSWER-D) hypotension that worsens
with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side.
Hypotension due to compression of the heart and great vessels is consistent with
obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is 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 BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL - ANSWER-A) 2280 mL
