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TNCC FINAL EXAM TEST OPEN BOOK
QUESTIONS WITH DETAILED VERIFIED
ANSWERS
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 Ans: B) 500 mL/hr
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?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion Ans: B) fat embolism
Which pulse pressure description is an indication of early hypovolemic
shock?
A) widened
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B) narrowed
C) bounding
D) weak Ans: B) narrowed
Which of the following considerations is most important when caring for a
geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls Ans: B) medical history
Which of the following assessment findings differentiates a tension
pneumothorax from a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration Ans: D) hypotension that
worsens with inspiration.
Assessment findings associated with tension pneumothorax include
anxiety, severe restlessness, severe respiratory distress, and absent
breath sounds on the injured side. Hypotension due to compression of
the heart and great vessels is consistent with obstructive shock.
Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and
cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire
and is calculating the patient's fluid resuscitation needs. He has painful
red blistering to the entire surface of both upper extremities and
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superficial burns to the anterior chest. Using the modified Lund and
Browder chart to calculate the total BSA burned, how much IV fluids
would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL Ans: A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis Ans: A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
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
TNCC FINAL EXAM TEST OPEN BOOK
QUESTIONS WITH DETAILED VERIFIED
ANSWERS
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 Ans: B) 500 mL/hr
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?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion Ans: B) fat embolism
Which pulse pressure description is an indication of early hypovolemic
shock?
A) widened
, Page | 2
B) narrowed
C) bounding
D) weak Ans: B) narrowed
Which of the following considerations is most important when caring for a
geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls Ans: B) medical history
Which of the following assessment findings differentiates a tension
pneumothorax from a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration Ans: D) hypotension that
worsens with inspiration.
Assessment findings associated with tension pneumothorax include
anxiety, severe restlessness, severe respiratory distress, and absent
breath sounds on the injured side. Hypotension due to compression of
the heart and great vessels is consistent with obstructive shock.
Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and
cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire
and is calculating the patient's fluid resuscitation needs. He has painful
red blistering to the entire surface of both upper extremities and
, Page | 3
superficial burns to the anterior chest. Using the modified Lund and
Browder chart to calculate the total BSA burned, how much IV fluids
would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL Ans: A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis Ans: A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
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
