TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Ag5-
yeargoldgchildgpresentsgtogthegEDgwithgbruisesgtogtheguppergarmsgandgbuttocksgingvariou
sgstagesgofghealinggandgmultiplegsmall,gclean,groundgburnsgtogthegback.gTheregaregnogab
normalitiesgfoundgbasedgongthegpediatricgassessmentgtrianglegorgprimarygsurvey.gWhich
gofgthegfollowinggisgthegprioritygnursinggintervention?
Answer:gAg-
gANSA)greportgyourgsuspiciongofgthegmaltreatmentgingaccordancegwithglocalgregulationsg*
**
applygicegtogthegbruisesgandgconsultgwoundgcare
engagegingtherapeuticgcommunicationgtogdeterminegthegMOI
providegthegfamilygwithginjurygpreventiongresourse
Ag20-
yeargoldgmalegpresentsgtogthegEDgc/ogsevereglowergabdgpaingafterglandingghardgongthegb
icyclegcrossgbarsgwhichgperforminggangaerialgBMXgmaneuver.gSecondarygassessmentgr
evealsglowergabdgtendernessgandgscrotalgecchymosis.gWhichgofgthegfollowinggordersgwo
uldgthegnursegquestions?
Answer:gCg-gANSA)gFastgexam
CTgscan
straightgcathgforgurinegsampleg***
icegandgelevationgofgthegscrotum
Ag35-
yeargoldgmalegpresentsgwithgfacialgtraumagaftergbringgstruckginthegfacegwithgagbaseball.g
agtear-dropgshapedgleftgpupilgisgnotedgongexam.gWhatgtypegofginjurygisgsuspected?
Answer:gBg-gANSA)goculomotorgnervegpalsy
globegruptureg***
uncalgherniation
retinalgdetachment
Ag36-
yeargoldgfemaleghasgagdeformitygofgthegleftgwristgaftergagfall.gShegisgreluctantgtogmovegh
erghandgduegtogpain.gWhichgofgthegfollowinggisgthegmostgappropriategintervention?
Answer:gBg-gANSA)gapplygagslinggandgelevategthegextremitygtogtheglevelgofgthegheart.
applygagsplintgandgELEVATEgABOVEgTHEgLEVELgOFgTHEgHEARTg***
Applygagslinggandgelevategthegextremitygabovegtheglevelgofgthegheart
applygagsplintgandgelevategthegextremitygtogtheglevelgofgthegheart.
Ag49-
yeargoldgrestrainedgdriverginvolvedgingagMVCgpresentsgtogthegtraumagcentergc/ogabd,gpel
vic,gandgbilglowergextremitygpaingVitalsgsignsgaregstable.gThegnursegcanganticipategallg of
gthesegnegativegfastgexamgexceptgwhichgofgthegfollowing?
,TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Answer:gA
ThegFASTgexamgisgdonegatgthegbedsidegtogidentifygpathologicalgfluidgingthegabdominalga
ndgpelvicgcavities.gFASTgexamsgreducegthegusegofgmoreginvasivegdiagnosticgperitonealgl
avagegandgcangbegrepeatedgifgclinicalgchangesgorghemodynamicgchangesgoccur.gAgneg
ativegFASTgstudygdoesgnotgrulegoutginjurygandgmaygwarrantgagfollow-
upgcomputedgtomographygscan.gSerialgFASTgexamsgcangidentifygincreasinggabdominalgf
luidgcollectionsgfromghemorrhage.gDiagnosticgperitonealglavage/diagnosticgperitonealgas
pirationgisgperformedgbygthegsurgicalgteamgtograpidlygidentifygthegpresencegofghemorrha
gegingpatientsgwhogareghemodynamicallygunstablegaftergtrauma.g-
gANSA)gdiagnosticgperitonealglavageg***
serialgfastgexams
abdominalgandgpelvicgCTgscans
serialgabdominalgassessments
Ag56-year-
gmalegpatientginvolvedgingagMVCgisgbroughtgtogthegEDgofgagruralgcriticalgaccessgfacility.gH
egc/ogneckgpain,gSOB,gandgdiffusegabdgpain.gHisgGCSgisg15.gHisgvitalsgaregasgfollows:
BPg98/71
HRg125gbeats/min
RRg26gbreaths/min
SpO2g94%gonghighgflowgO2gviagNRBgmask
whichgofgthegfollowinggisgthegpriorityginterventiongforgthisgpatient?
Answer:gCg-gANSA)gExpeditegtransportgtogthegCTgscanner
preparegthegpatientgforgspinalgradiographs
expeditegtransfergtogthegclosestgtraumagcenterg***
notifygthegpatientsgfamily
Agpassengergisgbroughtgtogthegemergencygdepartmentgofgagruralghospitalgfollowingg
aghigh-
speedgMVC.gWhengsignificantgabdominalgandgpelvicginjuriesgaregnotedgingthegprim
arygsurvey,gwhichgofgthegfollowinggisgthegpriorityginterventions?
Answer:gAg-gANSA)ginitiategtransfergtogagtraumagcenterg**
providegreportgtogthegoperatinggroomgnurse
Obtainedgimaginggstudies
Placegaggastricgtube
Agpatientgarrivesgwithgaglargegopengchestgwoundgaftergbeinggassaultgedgwithgagmachete,g
Prehospitalgprovidersgplacedgagnonporousgdressinggovergthegchestgwoundgandgtapesgit
,TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
ong3gsides.gHegisgnowgshowinggsignsgofganxiety,grestlessness,gseveregrespiratorygdistr
ess,gcyanosis,gandgdecreasinggbloodgpressure.gWhichgofgthegfollowinggisgthegMOSTgap
propriateginterventions?
Answer:gCg-gANSA)gneedlegdecompression
tubegthoracostomy
dressinggremovalg**
surgicalgrepair
AgpatientghasgbeengingthegEDgforgseveralghoursgwaitinggtogbegadmitted.gHegsustainedgm
ultiplegribgfracturesgandgagfemurgfracturegaftergagfall.gHeghasgbeengawake,galert,gandgc/og
leggpain.gHisgwifegreportedgsuddenlygbecomingganxiousgandgconfused.gUpongreassess
ment,gthegpatientgisgrestless,gwithgrespiratorygdistressgandgpetechiaegtoghisgneck.gthegpa
tientgisgexhibitinggsignsgofgsymptomsgcommonlygassociatedgwithgwhichgofgthegfollowinggc
onditions?
Answer:gBg-gANSA)gacuteglungginjury
fatgembolismg***
PTX
pulmonarygcontusion
Agpatientgisgfoundglyinggongthegfloorgaftergfallingg13ghoursgago.gWhichgofgthegfollowinggla
bgvaluesgisgexpectedgwithgagmusculoskeletalgcomplicationgassociatedgwithgthisgpresenta
tion?
Answer:gAg-gANSA)gelevatedgcreatinegkinaseg***
decreasedgpotassiumglevel
decreasedgWBC
elevatedgGFR
Agpatientgisgthrowngagainstgagcargduringgagtornadogandgpresentsgwithgobviousgbilateralgfe
moralgfractures.gThegpatientgisgpale,galert,gdisoriented,gandghasgdelayedgcapgrefill.
Whichgofgthegfollowingginterventionsgwouldgbegmostgappropriategforgthisgpatientgbasedgo
ngthegdisastergtriagegprinciple?
Answer:gAg-
gANSA)ginitiategtwoglargegcalibergintravenousglinesgforgRingersglactategsolutiongadminist
rationg***
AdministergDilaudidgforgpaingcontrolgandgprovidegcomfortgcare
Placegthegpatientgingangobservationgareagforgcaregwithingthegnextgfewghours
Contactgthegcommandgcentergforgthegpersonnelgtognotifygnextgofgkin.
Agpatientgwithgagcompletegspinalgcordginjurygingneurogenicgshockgwillgdemonstrateghypot
ensiongandgwhichgothergclinicalgsigns?
, TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Answer:gDg-gANSA)gBradycardiagandgipsilateralgabsencesgofgmotorgfunction
Tachycardiagandgrespiratorygdepression
Tachycardiagandgabsentgmotorgfunctiongbelowgtheglevelgofginjury
Bradycardiagandgabsentgmotorgfunctiongbelowgtheglevelgofgtheginjuryg***
Agpatientgwithglowergextremitygfracturegcomplainsgofgseveregpaingandgtightnessginghisgcal
f,gminimallygrelievedgbygpaingmedications.gWhichgofgthegfollowinggisgthegprioritygnursinggi
ntervention?
Answer:gCg-gANSA)gelevatinggthegextremitygabovegtheglevelgofgthegheart
repositioninggandgapplygice
Elevatinggthegextremitygtogtheglevelgofgthegheartg***
Preparinggthegpatientgforgultrasound
AgtraumagpatientgisgengroutegtogagruralgED.gRadiologygnotifiesgthegchargegnursegthatgtheg
CTgscannergwillgbegoutgofgservicegforgseveralgofghours.gThegteamggathersgtogplangaccord
ingly.gWhichgofgthegfollowinggtermsgbestgdescribesgthisgtraumagteamsgcommunication?
Answer:gDg-gANSA)gBrief
loop
debrief
huddleg***
Agtraumagpatientgisgrestlessgandgrepeatedlygaskingg"wheregamgI?"gvitalgsignsgupongarriv
algweregBPg100/60gmmgHg,gHRg96gbeats/min,gandgRRg24gbreaths/min.gHergskingisgcoolg
andgdry.gCurrentgvitalgsignsgaregBPg104/84mmgHg,gHRg108,gRRg28gbreaths/min.gThegp
atientgisgdemonstratinggsignsgandgsymptomsgofgwhichgstagegofgshock?
Answer:gAg-gANSA)gcompensatedg**
Progressive
irreversible
decompensated
Angelderlygpatientgwithgaghistorygofganticoagulantgusegpresentsgaftergagfallgatghomegthatg
day.gshegdeniesganyglossgofgconsciousness.gSheghasgaghematomagtoghergforeheadgandg
complainsgofgheadache,gdizziness,gandgnausea.gWhichgisgagmostglikelygcausegofghergsy
mptoms?
Answer:gDg-gANSA)gepiduralghematoma
diffusegaxonalginjury
post-concussivegsyndrome
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Ag5-
yeargoldgchildgpresentsgtogthegEDgwithgbruisesgtogtheguppergarmsgandgbuttocksgingvariou
sgstagesgofghealinggandgmultiplegsmall,gclean,groundgburnsgtogthegback.gTheregaregnogab
normalitiesgfoundgbasedgongthegpediatricgassessmentgtrianglegorgprimarygsurvey.gWhich
gofgthegfollowinggisgthegprioritygnursinggintervention?
Answer:gAg-
gANSA)greportgyourgsuspiciongofgthegmaltreatmentgingaccordancegwithglocalgregulationsg*
**
applygicegtogthegbruisesgandgconsultgwoundgcare
engagegingtherapeuticgcommunicationgtogdeterminegthegMOI
providegthegfamilygwithginjurygpreventiongresourse
Ag20-
yeargoldgmalegpresentsgtogthegEDgc/ogsevereglowergabdgpaingafterglandingghardgongthegb
icyclegcrossgbarsgwhichgperforminggangaerialgBMXgmaneuver.gSecondarygassessmentgr
evealsglowergabdgtendernessgandgscrotalgecchymosis.gWhichgofgthegfollowinggordersgwo
uldgthegnursegquestions?
Answer:gCg-gANSA)gFastgexam
CTgscan
straightgcathgforgurinegsampleg***
icegandgelevationgofgthegscrotum
Ag35-
yeargoldgmalegpresentsgwithgfacialgtraumagaftergbringgstruckginthegfacegwithgagbaseball.g
agtear-dropgshapedgleftgpupilgisgnotedgongexam.gWhatgtypegofginjurygisgsuspected?
Answer:gBg-gANSA)goculomotorgnervegpalsy
globegruptureg***
uncalgherniation
retinalgdetachment
Ag36-
yeargoldgfemaleghasgagdeformitygofgthegleftgwristgaftergagfall.gShegisgreluctantgtogmovegh
erghandgduegtogpain.gWhichgofgthegfollowinggisgthegmostgappropriategintervention?
Answer:gBg-gANSA)gapplygagslinggandgelevategthegextremitygtogtheglevelgofgthegheart.
applygagsplintgandgELEVATEgABOVEgTHEgLEVELgOFgTHEgHEARTg***
Applygagslinggandgelevategthegextremitygabovegtheglevelgofgthegheart
applygagsplintgandgelevategthegextremitygtogtheglevelgofgthegheart.
Ag49-
yeargoldgrestrainedgdriverginvolvedgingagMVCgpresentsgtogthegtraumagcentergc/ogabd,gpel
vic,gandgbilglowergextremitygpaingVitalsgsignsgaregstable.gThegnursegcanganticipategallg of
gthesegnegativegfastgexamgexceptgwhichgofgthegfollowing?
,TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Answer:gA
ThegFASTgexamgisgdonegatgthegbedsidegtogidentifygpathologicalgfluidgingthegabdominalga
ndgpelvicgcavities.gFASTgexamsgreducegthegusegofgmoreginvasivegdiagnosticgperitonealgl
avagegandgcangbegrepeatedgifgclinicalgchangesgorghemodynamicgchangesgoccur.gAgneg
ativegFASTgstudygdoesgnotgrulegoutginjurygandgmaygwarrantgagfollow-
upgcomputedgtomographygscan.gSerialgFASTgexamsgcangidentifygincreasinggabdominalgf
luidgcollectionsgfromghemorrhage.gDiagnosticgperitonealglavage/diagnosticgperitonealgas
pirationgisgperformedgbygthegsurgicalgteamgtograpidlygidentifygthegpresencegofghemorrha
gegingpatientsgwhogareghemodynamicallygunstablegaftergtrauma.g-
gANSA)gdiagnosticgperitonealglavageg***
serialgfastgexams
abdominalgandgpelvicgCTgscans
serialgabdominalgassessments
Ag56-year-
gmalegpatientginvolvedgingagMVCgisgbroughtgtogthegEDgofgagruralgcriticalgaccessgfacility.gH
egc/ogneckgpain,gSOB,gandgdiffusegabdgpain.gHisgGCSgisg15.gHisgvitalsgaregasgfollows:
BPg98/71
HRg125gbeats/min
RRg26gbreaths/min
SpO2g94%gonghighgflowgO2gviagNRBgmask
whichgofgthegfollowinggisgthegpriorityginterventiongforgthisgpatient?
Answer:gCg-gANSA)gExpeditegtransportgtogthegCTgscanner
preparegthegpatientgforgspinalgradiographs
expeditegtransfergtogthegclosestgtraumagcenterg***
notifygthegpatientsgfamily
Agpassengergisgbroughtgtogthegemergencygdepartmentgofgagruralghospitalgfollowingg
aghigh-
speedgMVC.gWhengsignificantgabdominalgandgpelvicginjuriesgaregnotedgingthegprim
arygsurvey,gwhichgofgthegfollowinggisgthegpriorityginterventions?
Answer:gAg-gANSA)ginitiategtransfergtogagtraumagcenterg**
providegreportgtogthegoperatinggroomgnurse
Obtainedgimaginggstudies
Placegaggastricgtube
Agpatientgarrivesgwithgaglargegopengchestgwoundgaftergbeinggassaultgedgwithgagmachete,g
Prehospitalgprovidersgplacedgagnonporousgdressinggovergthegchestgwoundgandgtapesgit
,TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
ong3gsides.gHegisgnowgshowinggsignsgofganxiety,grestlessness,gseveregrespiratorygdistr
ess,gcyanosis,gandgdecreasinggbloodgpressure.gWhichgofgthegfollowinggisgthegMOSTgap
propriateginterventions?
Answer:gCg-gANSA)gneedlegdecompression
tubegthoracostomy
dressinggremovalg**
surgicalgrepair
AgpatientghasgbeengingthegEDgforgseveralghoursgwaitinggtogbegadmitted.gHegsustainedgm
ultiplegribgfracturesgandgagfemurgfracturegaftergagfall.gHeghasgbeengawake,galert,gandgc/og
leggpain.gHisgwifegreportedgsuddenlygbecomingganxiousgandgconfused.gUpongreassess
ment,gthegpatientgisgrestless,gwithgrespiratorygdistressgandgpetechiaegtoghisgneck.gthegpa
tientgisgexhibitinggsignsgofgsymptomsgcommonlygassociatedgwithgwhichgofgthegfollowinggc
onditions?
Answer:gBg-gANSA)gacuteglungginjury
fatgembolismg***
PTX
pulmonarygcontusion
Agpatientgisgfoundglyinggongthegfloorgaftergfallingg13ghoursgago.gWhichgofgthegfollowinggla
bgvaluesgisgexpectedgwithgagmusculoskeletalgcomplicationgassociatedgwithgthisgpresenta
tion?
Answer:gAg-gANSA)gelevatedgcreatinegkinaseg***
decreasedgpotassiumglevel
decreasedgWBC
elevatedgGFR
Agpatientgisgthrowngagainstgagcargduringgagtornadogandgpresentsgwithgobviousgbilateralgfe
moralgfractures.gThegpatientgisgpale,galert,gdisoriented,gandghasgdelayedgcapgrefill.
Whichgofgthegfollowingginterventionsgwouldgbegmostgappropriategforgthisgpatientgbasedgo
ngthegdisastergtriagegprinciple?
Answer:gAg-
gANSA)ginitiategtwoglargegcalibergintravenousglinesgforgRingersglactategsolutiongadminist
rationg***
AdministergDilaudidgforgpaingcontrolgandgprovidegcomfortgcare
Placegthegpatientgingangobservationgareagforgcaregwithingthegnextgfewghours
Contactgthegcommandgcentergforgthegpersonnelgtognotifygnextgofgkin.
Agpatientgwithgagcompletegspinalgcordginjurygingneurogenicgshockgwillgdemonstrateghypot
ensiongandgwhichgothergclinicalgsigns?
, TNCCg9THgREALgEXAMgACTUALgVERIFIEDgEXAMgTESTgBANKg250gQUESTION
SgANDgANSWERSgVERIFIEDgANSWERg|ALREADYgGRADEDgA|100%gCOMPLETE
Answer:gDg-gANSA)gBradycardiagandgipsilateralgabsencesgofgmotorgfunction
Tachycardiagandgrespiratorygdepression
Tachycardiagandgabsentgmotorgfunctiongbelowgtheglevelgofginjury
Bradycardiagandgabsentgmotorgfunctiongbelowgtheglevelgofgtheginjuryg***
Agpatientgwithglowergextremitygfracturegcomplainsgofgseveregpaingandgtightnessginghisgcal
f,gminimallygrelievedgbygpaingmedications.gWhichgofgthegfollowinggisgthegprioritygnursinggi
ntervention?
Answer:gCg-gANSA)gelevatinggthegextremitygabovegtheglevelgofgthegheart
repositioninggandgapplygice
Elevatinggthegextremitygtogtheglevelgofgthegheartg***
Preparinggthegpatientgforgultrasound
AgtraumagpatientgisgengroutegtogagruralgED.gRadiologygnotifiesgthegchargegnursegthatgtheg
CTgscannergwillgbegoutgofgservicegforgseveralgofghours.gThegteamggathersgtogplangaccord
ingly.gWhichgofgthegfollowinggtermsgbestgdescribesgthisgtraumagteamsgcommunication?
Answer:gDg-gANSA)gBrief
loop
debrief
huddleg***
Agtraumagpatientgisgrestlessgandgrepeatedlygaskingg"wheregamgI?"gvitalgsignsgupongarriv
algweregBPg100/60gmmgHg,gHRg96gbeats/min,gandgRRg24gbreaths/min.gHergskingisgcoolg
andgdry.gCurrentgvitalgsignsgaregBPg104/84mmgHg,gHRg108,gRRg28gbreaths/min.gThegp
atientgisgdemonstratinggsignsgandgsymptomsgofgwhichgstagegofgshock?
Answer:gAg-gANSA)gcompensatedg**
Progressive
irreversible
decompensated
Angelderlygpatientgwithgaghistorygofganticoagulantgusegpresentsgaftergagfallgatghomegthatg
day.gshegdeniesganyglossgofgconsciousness.gSheghasgaghematomagtoghergforeheadgandg
complainsgofgheadache,gdizziness,gandgnausea.gWhichgisgagmostglikelygcausegofghergsy
mptoms?
Answer:gDg-gANSA)gepiduralghematoma
diffusegaxonalginjury
post-concussivegsyndrome
