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TNCC Study Guide Resource | Practice-Ready Answer Guide An adult pt who sustained a severe head trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. the PaCO2 is 30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most important intervention to manage the cerebral blood flow? - answer - Decrease the rate of manual ventilation An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The pt was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the forehead. The pt is currently on anticoagulant therapy. What is most likely the cause of their symptoms? - answer - post-concussive syndrome A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medication. Which of the following is the priority nursing intervention? - answer - Elevating the leg to the LEVEL of the heart (compression/crush- level of the heart) (regular fracture- above the heart) A pt involved in a high-speed rollover is complaining of increased difficulty breathing. There is a small penetrating wound to the 6th intercostal space in the left lateral chest. Which finding is most consistent with an injury to the diaphragm? - answer - Bowel sounds heard in the lower left chest A pt has been in the emergency department for several hours waiting to be admitted. They sustained multiple rib fractures and a femur fracture after a fall. The pt has been awake, alert, and complaining of leg pain. Their spouse reported that the pt suddenly became anxious and confused. Upon reassessment, the pt is restless, with respiratory distress and petechiae to his neck. The pt is exhibiting signs and symptoms most commonly associated with which of the following conditions? - answer - Fat embolism 3 adult pts present at different times during a 1-hour period with a high fever, fatigue, and headache. All 3 pts have a rash which started on their mouth, face, and arms with progression to the chest and abdomen. They all visited the same grocery store within the last week. What is the most appropriate intervention from triage for these pts? - answer - Immediately initiate contact precautions A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. Witai type of injury is suspecied? - answer - Globe rupture A trauma patient who is 30 - weeks pregnant arrives at the emergency department following a motor vehicle collision Which normal physiologic change should be considered when assessing ventilatory status ? - answer - Increased oxygen consumption A patient who sustained severe injuries was brought to the emergency department following a high - speed motor vehicle collision . Interventions for hypovolemic shock have been initiated . What component of the trauma triad of death is most likely to have begun at the time of injury ? - answer - Coagulopathy An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural critical access facility . They complain of neck pain , shortness of breath , and diffuse abdominal pain . The Glasgow Coma Score is 15. Vital signs are : BP 98/71 mm Hg , HR 125 beats / minute , RR 26 breaths / minute , and SpO2 94 % on high - flow oxygen via non - rebreather mask . Which of the following is the priority intervention for this patient ? - answer - Expedite transfer to the closest trauma center A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness burns to both upper extremities and chest with a total body surface area burned of 27 % . How much intravenous fluid should be administered in the first 8 hours ? - answer - 3240 mL A trauma patien