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TNCC Notes For Written Exam
What Is Kinematics? -
✅ A Branch Of Mechanics (Energy Transfer) That Refers To Motion And Does Not
Consider The Concepts Of Force And Mass Of The Object Or Body.
What Is Newton's First Law? -
✅ A Body At Rest Will Remain At Rest. A Body In Motion Will Remain In Motion
Until Acted On By An Outside Force.
What Is The Law Of Conservation Of Energy? -
✅ Energy Can Neither Be Created Nor Destroyed. It Is Only Changed From One
Form To Another.
What Is Newton's Second Law? -
✅ Force Equals Mass Multiplied By Acceleration Of Deceleration.
What Is Kinetic Energy (KE)? -
✅ KE Equals 1/2 The Mass (M) Multiplied By The Velocity Squared.
What Is The Mnemonic For The Initial Assessment? -
✅ A = Airway With Simultaneous Cervical Spine Protection
B = Breathing
C = Circulation
D = Disability (Neurologic Status)
E = Expose/Environmental Controls (Remove Clothing And Keep The Patient Warm)
What Is The Mnemonic For The Secondary Assessment? -
✅ F = Full Set Of VS/Focused Adjuncts (Includes Cardiac Monitor, Urinary
Catheter, And Gastric Tube)/Family Presence
G = Give Comfort Measures (Verbal Reassurance, Touch, And Pharmacologic And
Nonpharmacologic Management Of Pain).
H = Hx And Head-To-Toe Assessment
I = Inspect Posterior Surfaces
Where Do You Listen To Auscultate Breath Sounds? -
✅ Auscultate The Lungs Bilaterally At The Second Intercostal Space Midclavicular
Line And At The Fifth Intercostal Space At The Anterior Axillary Line.
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What Are The Late Signs Of Breathing Compromise? -
✅ - Tracheal Deviation
- JVD
What Are Signs Of Ineffective Breathing? -
✅ - AMS
- Cyanosis, Especially Around The Mouth
- Asymmetric Expansion Of Chest Wall
- Paradoxical Movement Of The Chest Wall During Inspiration And Expiration
- Use Of Accessory Muscles Or Abdominal Muscles Or Both Or Diaphragmatic
Breathing
- Sucking Chest Wounds
- Absent Or Diminished Breath Sounds
- Administer O2 Via NRB Or Assist Ventilations With A Bag-Mask Device, As
Indicated
- Anticipate Definitive Airway Management To Support Ventilation.
Upon Initial Assessment, What Type Of Oxygen Should Be Used For A Pt Breathing
Effectively? -
✅ A Tight-Fitting Nonrebreather Mask At 12-15 Lpm.
What Intervention Should Be Done If A Pt Presents With Effective Circulation? -
✅ - Insert 2 Large Caliber IV's
- Administer Warmed Isotonic Crystalloid Solution At An Appropriate Rate
What Are Signs Of Ineffective Circulation? -
✅ - Tachycardia
- AMS
- Uncontrolled External Bleeding
- Pale, Cool, Moist Skin
- Distended Or Abnormally Flattened External Jugular Veins
- Distant Heart Sounds
What Are The Interventions For Effective/Ineffective Circulation? -
✅ - Control Any Uncontrolled External Bleeding By:
- Applying Direct Pressure Over Bleeding Site
- Elevating Bleeding Extremity
- Applying Pressure Over Arterial Pressure Points
- Using Tourniquet (Last Resort).
- Cannulate 2 Large-Caliber IV's And Initiate Infusions Of An Isotonic Crystalloid
Solution
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- Use Warmed Solution
- Use Pressure Bags To Increase Speed Of IVF Infusion
- Use Blood Administration Tubing For Possible Administration Of Blood
- Use Rapid Infusion Device Based On Protocol
- Use NS 0.9% In Same Tubing As Blood Product
- IV = Surgical Cut-Down, Central Line, Or Both.
- Blood Sample To Determine ABO And Rh Group
- IO In Sternum, Legs, Arms Or Pelvis
- Administer Blood Products
- PASG (Without Interfering With Fluid Resuscitation)
How Do You Assess Mnemonic "D"? -
✅ DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine Presence Of Lateralizing Signs Including:
- Unilateral Deterioration In Motor Movements Or Unequal Pupils
- Symptoms That Help To Locate Area Of Injury In Brain
What Are The Interventions For Disability? -
✅ - If Assessment Indicates A Decreased LOC, Conduct Further Investigation
During Secondary Focused Assessments
- If Pt Is Not Alert Or Verbal, Continue To Monitor For Any Compromise To ABC's
- If Pt Demonstrates Signs Of Herniation Or Neurologic Deterioration, Consider
Hyperventilation.
What Is Assessed And Intervened For Expose/Environmental Controls? -
✅ - Remove Clothing
- Ensure Appropriate Decontamination If Exposed To Hazardous Material
- Keep Pt Warm
- Keep Clothing For Evidence
What Is The First Thing Assessed Under The Secondary Assessment? -
✅ FULL SET VS / FOCUSED ADJUNCTS / FAMILY PRESENCE
- ABCDE Should Be Completed
- Labs, X-Rays, CT, Foley,
- Family Presence