TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
Which of the following is NOT considered goal-directed therapy of cardiogenic shock?
Answer: C - ANSA) controlled fluid boluses
B) antidysrhythmic administration
C) pericardiocentesis ***
D) cardiac cath
Which of the following is possible complication of positive-pressure ventilation?
Answer: A - ANSA) worsening pneumothorax
B) worsening flail chest
C) reabsorption of pleural air
D) negative intrapleural pressure
Which of the following is true about the log roll maneuver?
Answer: C - ANSA) it causes less spinal motion than the lift and slide manuever
B) it is recommended for patients with unstable pelvic fractures
C) it can worsen cord damage from an unstable spinal injury ***
D) it does not increases the risk of life threatening hemorrhage from unstable injuries
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage?
Answer: B - ANSA) ABC
B) MARCH***
C) AVPU
D) VIPP
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSA) 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 ***
Which of the following patients warrants referral to a burn center?
Answer: C - ANSA) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
C) a 52-year old diabetic male with partial thickness burn to the left lower leg ***
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax.
Which pulse pressure description is an indication of early hypovolemic shock?
Answer: B - ANSA) widened
B) narrowed ***
C) bounding
D) weak
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
,TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
Answer: c - ANSa) 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
You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody
show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are
most consistent with which of the following?
Answer: A - ANSA) placental abruption ***
B) preterm labor
C) uterine rupture
D) fetal demise
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?
Answer: B - ANSA) 1000 mL/hr
B) 500 mL/hr ***
C) 250 mL/hr
D) 125 mL/hr 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?
Answer: A - ANSA) 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 resourse
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycle cross
bars which performing an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and
scrotal ecchymosis. Which of the following orders would the nurse questions?
Answer: C - ANSA) Fast exam
B) CT scan
C) straight cath for urine sample ***
D) ice and elevation of the scrotum
A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-drop
shaped left pupil is noted on exam. What type of injury is suspected?
Answer: B - ANSA) oculomotor nerve palsy
B) globe rupture ***
C) uncal herniation
D) retinal detachment
,TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
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?
Answer: B - ANSA) 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.
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?
Answer: A
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. - ANSA) diagnostic peritoneal lavage ***
B) serial fast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments
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?
Answer: C - ANSA) 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
A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When
significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the
priority interventions?
Answer: A - ANSA) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
A patient arrives with a large open chest wound after being assault ed with a machete, Prehospital
providers placed a nonporous dressing over the chest wound and tapes it on 3 sides. He is now showing
, TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure.
Which of the following is the MOST appropriate interventions?
Answer: C - ANSA) needle decompression
B) tube thoracostomy
C) dressing removal **
D) surgical repair
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?
Answer: B - ANSA) acute lung injury
B) fat embolism ***
C) PTX
D) pulmonary contusion
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values is
expected with a musculoskeletal complication associated with this presentation?
Answer: A - ANSA) elevated creatine kinase ***
B) decreased potassium level
C) decreased WBC
D) elevated GFR
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?
Answer: A - ANSA) initiate two large caliber 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.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs?
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally
relieved by pain medications. Which of the following is the priority nursing intervention?
Answer: C - ANSA) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
Which of the following is NOT considered goal-directed therapy of cardiogenic shock?
Answer: C - ANSA) controlled fluid boluses
B) antidysrhythmic administration
C) pericardiocentesis ***
D) cardiac cath
Which of the following is possible complication of positive-pressure ventilation?
Answer: A - ANSA) worsening pneumothorax
B) worsening flail chest
C) reabsorption of pleural air
D) negative intrapleural pressure
Which of the following is true about the log roll maneuver?
Answer: C - ANSA) it causes less spinal motion than the lift and slide manuever
B) it is recommended for patients with unstable pelvic fractures
C) it can worsen cord damage from an unstable spinal injury ***
D) it does not increases the risk of life threatening hemorrhage from unstable injuries
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage?
Answer: B - ANSA) ABC
B) MARCH***
C) AVPU
D) VIPP
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSA) 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 ***
Which of the following patients warrants referral to a burn center?
Answer: C - ANSA) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
C) a 52-year old diabetic male with partial thickness burn to the left lower leg ***
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax.
Which pulse pressure description is an indication of early hypovolemic shock?
Answer: B - ANSA) widened
B) narrowed ***
C) bounding
D) weak
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
,TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
Answer: c - ANSa) 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
You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody
show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are
most consistent with which of the following?
Answer: A - ANSA) placental abruption ***
B) preterm labor
C) uterine rupture
D) fetal demise
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?
Answer: B - ANSA) 1000 mL/hr
B) 500 mL/hr ***
C) 250 mL/hr
D) 125 mL/hr 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?
Answer: A - ANSA) 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 resourse
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycle cross
bars which performing an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and
scrotal ecchymosis. Which of the following orders would the nurse questions?
Answer: C - ANSA) Fast exam
B) CT scan
C) straight cath for urine sample ***
D) ice and elevation of the scrotum
A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-drop
shaped left pupil is noted on exam. What type of injury is suspected?
Answer: B - ANSA) oculomotor nerve palsy
B) globe rupture ***
C) uncal herniation
D) retinal detachment
,TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
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?
Answer: B - ANSA) 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.
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?
Answer: A
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. - ANSA) diagnostic peritoneal lavage ***
B) serial fast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments
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?
Answer: C - ANSA) 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
A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When
significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the
priority interventions?
Answer: A - ANSA) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
A patient arrives with a large open chest wound after being assault ed with a machete, Prehospital
providers placed a nonporous dressing over the chest wound and tapes it on 3 sides. He is now showing
, TNCC 20TH REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 2500
QUESTIONS AND ANSWERS VERIFIED ANSWER |ALREADY GRADED A|100%
COMPLETE
signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure.
Which of the following is the MOST appropriate interventions?
Answer: C - ANSA) needle decompression
B) tube thoracostomy
C) dressing removal **
D) surgical repair
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?
Answer: B - ANSA) acute lung injury
B) fat embolism ***
C) PTX
D) pulmonary contusion
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab values is
expected with a musculoskeletal complication associated with this presentation?
Answer: A - ANSA) elevated creatine kinase ***
B) decreased potassium level
C) decreased WBC
D) elevated GFR
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?
Answer: A - ANSA) initiate two large caliber 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.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs?
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally
relieved by pain medications. Which of the following is the priority nursing intervention?
Answer: C - ANSA) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
