TNCC Final Exam Final Exam Open
Book (COMPLETE SOLUTIONS AT
HAND)
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - ANSWER-A)
initiate two large bore intravenous lines for Ringers lactate solution administration
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 36-year old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and elevate above the level of the heart
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart. - ANSWER-B) apply
a splint and ELEVATE ABOVE THE LEVEL OF THE HEART
During the primary survey of an unconscious patient with multi-system trauma, the
nurse notes snoring respirations. Which priority nursing interventions should be
performed next?
A) open the airway with the head-tilt/chin lift maneuver
B) auscultate bilateral breath sounds to assess ventilatory status
C) assist respirations using a BVM
D) insert an oropharyngeal airway if there is no gag reflex - ANSWER-D) insert an
oropharyngeal airway if there is no gag reflex
, A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all
of these negative fast exam except which of the following?
A. Diagnostic peritoneal lavage
B. Serial FAST exams
C. Abdominal and pelvic CT scans
D. Serial abdominal assessments - ANSWER-A) diagnostic peritoneal lavage
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma.
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in
various stages of healing and multiple small, clean, round burns to the back. There are
no abnormalities found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
A) report your suspicion of the maltreatment in accordance with local regulations
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention recourses - ANSWER-A) report your
suspicion of the maltreatment in accordance with local regulations
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - ANSWER-C) expedite transfer to the closest trauma
center
Book (COMPLETE SOLUTIONS AT
HAND)
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - ANSWER-A)
initiate two large bore intravenous lines for Ringers lactate solution administration
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 36-year old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and elevate above the level of the heart
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart. - ANSWER-B) apply
a splint and ELEVATE ABOVE THE LEVEL OF THE HEART
During the primary survey of an unconscious patient with multi-system trauma, the
nurse notes snoring respirations. Which priority nursing interventions should be
performed next?
A) open the airway with the head-tilt/chin lift maneuver
B) auscultate bilateral breath sounds to assess ventilatory status
C) assist respirations using a BVM
D) insert an oropharyngeal airway if there is no gag reflex - ANSWER-D) insert an
oropharyngeal airway if there is no gag reflex
, A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all
of these negative fast exam except which of the following?
A. Diagnostic peritoneal lavage
B. Serial FAST exams
C. Abdominal and pelvic CT scans
D. Serial abdominal assessments - ANSWER-A) diagnostic peritoneal lavage
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma.
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in
various stages of healing and multiple small, clean, round burns to the back. There are
no abnormalities found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
A) report your suspicion of the maltreatment in accordance with local regulations
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention recourses - ANSWER-A) report your
suspicion of the maltreatment in accordance with local regulations
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - ANSWER-C) expedite transfer to the closest trauma
center
