TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
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A patient with a spinal cord injury at C5 is being cared for in the emergency department
A adult patient with a knife injury to the neck has an intact airway and is while awaiting transport to a trauma center. Which of the following represents the
hemodynamically stable. They complain of difficulty swallowing and speaking. In the highest priority for ongoing assessment and management for this patient? a. maintain
primary survey, further assessment is indicated next for which of the following adequate respiratory status.
conditions? b. administer balanced resuscitation fluid
a. Damage to the cervical spine
b. An expanding pneumothorax c. perform serial assessments of neurologic function
c. Laceration of the carotid artery d. maintain core temperature - ansa. maintain adequate respiratory status
d. Injury to the thyroid gland - ansa. Damage to the cervical spine
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
A patient arrives at the emergency department by private vehicle after sustaining an called in sick for a couple of days and is now back working on the team. Which of the
injury to the right lower extremity while using a saw. There is a large gaping wound following behaviors would indicate this nurse is coping well?
to the right thigh area with significant bleeding. What is the priority intervention? a. a. They are talking about taking the emergency nursing certification examination.
Elevate the extremity to the level of the heart b. They keep requesting to be assigned to the walk-in/ambulatory area
b. Initiate direct pressure c. They are impatient and snap at their coworkers.
c. Apply a tourniquet d. They are thinking about transferring out of the emergency department. - ansa. They
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure are talking about taking the emergency nursing certification examination.
A patient fell two weeks ago, striking their head. Today, the patient presented with a Following a bomb explosion, fragmentation injuries from the bomb or objects in the
persistent headache and nausea and was diagnosed with a small subdural hematoma. environment are examples of which phase of injury? a. primary
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift b. secondary
nurse reports the patient has been anxious, restless, shaky, and vomited twice during c. tertiary
the night. The patient states they couldn't sleep because a young child kept coming into d. quaternary - ansb. secondary
the room. What is the most likely cause for these signs and symptoms? a. increase
intracranial pressure In a patient with severe traumatic brain injury, hypocapnia causes which condition?
b. alcohol withdrawal a. Respiratory acidosis
c. rhabdomyolysis b. Metabolic acidosis
d. pulmonary embolus - ansb. alcohol withdrawal c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction
A patient involved in a MVC has sustained a fracture to the second rib of the anterior left
chest. Which concurrent injury is most commonly associated with this fracture? The general impression step in the initial assessment provides the opportunity to do
a. Blunt cardiac injury which of the following?
b. Brachial plexus injury a. Assess for uncontrolled internal hemorrhage
c. Pneumothorax b. Accurately triage the patient
d. Hemothorax - ansb. Brachial plexus injury c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.
,TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
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The nurse is obtaining a history for a patient who presents following sexual assault. This What is the best measure of the adequacy of cellular perfusion and can help to predict
history is completed using which of the following techniques? a. Bring the family in to the outcome of resuscitation?
the interview room. a. End-tidal carbon dioxide
b. Use direct quotes to record information. b. Hematocrit level
c. Obtain information specific only to the assault. c. Base deficit
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record d. Oxygen saturation - ansc. Base deficit
information.
What is the best position for maintaining an open airway in the obese patient? a.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of Prone
94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 b. Supine
beats/minute. The emergency nurse interprets the patient's hemodynamic findings
as an indication of which of the following? a. Decompensated shock
c. Reverse Trendelenburg
b. Normal vital signs in pregnancy
d. Right lateral recumbent - ansc. Reverse Trendelenburg
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy
What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
Treatment for frostbite can include which of the following interventions?
a. Airway compromise
a. warm the affected part over 30-60 minutes b. Ineffective ventilation
b. use gentle friction to improve circulation c. Secondary head injury
c. administer tissue plasminogen activator d. Uncontrolled external hemorrhage - ansd. Uncontrolled external hemorrhage
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator
Which of the following accurately describes ventilation principles associated with use of
Understanding the kinematic concepts associated with the mechanism of injury and a bag-mask device for an adult?
energy transfer can initially assist the trauma care provider in which of the following? a. a. Compress the bag-mask device at a rate of one breath every 6 seconds.
Anticipating the types of injuries that may be present b. Delivers 100% oxygen.
b. Deciding whether law enforcement should be notified c. Squeeze the bag-mask device completely for each breath.
c. Determining needed laboratory tests d. Maintain the oxygen saturation levels between 92% and 94%. - ansa. Compress the
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries bag-mask device at a rate of one breath every 6 seconds.
that may be present
Which of the following is considered a cornerstone of a high-performance trauma team?
What is the appropriate technique for palpating the pelvis for stability? a. a. Individual goals
Apply gentle pressure over the iliac crests, downward and laterally.
b. Use of TeamSTEPPS
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Identification of a single decision maker
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Effective communication - ansd. Effective communication
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply
gentle pressure over the iliac crests, downward and medially.
,TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
TEST BANK VERIFIED TEST BANK VERIFIED
While performing an assessment on a 13-month-old involved in a motor vehicle contusions/abrasions/deformities (signs of underlying injury), open pneumothoraces
collision, the nurse identifies which of the following findings from the patient as a sign of (sucking chest wound), JVD, tracheal position, signs of inhalation injury
possible altered mental status? a. Sunken fontanel
b. Crying, but consolable Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
c. Spontaneous movement of arms and legs midclavicular line and bases at the fifth intercostal space anterior axillary line
d. Cooperation with the assessment - ansd. Cooperation with the assessment
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
A (AVPU) - ansAlert. Will be able to maintain airway once clear.
pulsations at suprasternal notch or supraclavicular area
A (Primary Survey) - ansAirway and alertness with simultaneous cervical spinal
Life-threatening pulmonary injuries requiring immediate intervention: open
stabilization.
pneumothorax, tension pneumothorax, flail chest, hemothorax.
Airway Assessment - ansInspect: tongue obstruction, loose/missing teeth, foreign
Breathing and Ventilation Intervention - ansBreathing absent: jaw-thrust maneuver, oral
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury
airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or
higher. If ineffective: assist with bag-mask and determine need for definitive airway
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
C (Primary Survey) - ansCirculation and Control of Hemorrhage
Airway Interventions: - ansSuction
Remove foreign body if noted
Cardiogenic Shock - ansResults from pump failure in the presence of adequate
Jaw thrust maneuver (maintain cspine)
intravascular volume. There is a lack of cardiac output and end-organ perfusion
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway secondary to a decrease in myocardial contractility and/or valvular insufficiency.
Alertness Assessment - ansA-Alert Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart
V-Verbal failure is a chronic cause.
P-Painful
Blunt cardiac injury may present similar to MI.
U-Unresponsive
B (Primary Survey) - ansBreathing and Ventilation Excess of volume administration or increased after load can result in pulmonary edema
and increased myocardial ischemia.
Breathing and Ventilation Assessment - ansInspect: spontaneous breathing,
symmetrical rise and fall, depth/pattern/rate of respirations, accessory muscle use, Inotropic support to improve contractility.
diaphragmatic breathing, skin color (normal, pale, flushed, cyanotic),
Circulation and Control of Hemorrhage Assessment - ansInspect: Uncontrolled external
, TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
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bleeding, skin color Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain,
ophthalmic NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
Auscultate: Muffled heart sounds - may indicate pericardial tamponade (Do NOT patch - increases infection)
Palpate: carotid and/or femoral pulses for rate, rhythm, strength Corneal Foreign Body - ansRoutinely metal, plastic or wood.
Circulation and Control of Hemorrhage Interventions - ansControl and treat external Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
bleeding: apply direct pressure, elevate bleeding extremity, apply pressure over arterial
sites, consider use of a tourniquet. Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics,
oral analgesia
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
Corneal Laceration - ansInvolves one or more layers of the cornea. Visualized with a slit
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L. lamp.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis Findings: similar to abrasion, pain out of proportion to findings, decreased vision
and may cause hypothermia. Component therapy, including administering RBC, plasma
and platelets is a balanced approach so that O2 delivery is optimized, acidosis Treatment: treat small lacerations similar to an abrasion, larger lacerations need
corrected and coagulopathy prevented. ophthalmology referral and possible surgery
Classifications of Shock - ansHypovolemic - decrease in the amount of circulating blood Cycloplegic agent - ansCycloplegia is paralysis of the ciliary muscle of the eye, resulting
volume in a loss of accommodation. Because of the paralysis of the ciliary muscle, the
curvature of the lens can no longer be adjusted to focus on nearby objects.
Obstructive - obstruction in either the vasculature or heart
D (Primary Survey) - ansDisability (Neurologic Status)
Cardiogenic - pump failure in the presence of adequate intravascular volume
Disability Assessment - ansAssess GCS on arrival and repeat per policy.
Distributive - maldistribution of an adequate circulating blood volume (septic,
anaphylactic, neurogenic) Assess pupils for equality, shape and reactivity (PERRL)
Corneal Abrasion - ansDamage to the corneal epithelium. Easy to evaluate with Disability interventions - ansEvaluate for need for CT. Assume AMS to be the result of
fluorescein. CNS injury until proven otherwise.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling, Consider ABGs - AMS may be indicator of decreased cerebral perfusion,
irritation hypoventilation or acid-base imbalance.
Consider bedside glucose.
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
TEST BANK VERIFIED TEST BANK VERIFIED
A patient with a spinal cord injury at C5 is being cared for in the emergency department
A adult patient with a knife injury to the neck has an intact airway and is while awaiting transport to a trauma center. Which of the following represents the
hemodynamically stable. They complain of difficulty swallowing and speaking. In the highest priority for ongoing assessment and management for this patient? a. maintain
primary survey, further assessment is indicated next for which of the following adequate respiratory status.
conditions? b. administer balanced resuscitation fluid
a. Damage to the cervical spine
b. An expanding pneumothorax c. perform serial assessments of neurologic function
c. Laceration of the carotid artery d. maintain core temperature - ansa. maintain adequate respiratory status
d. Injury to the thyroid gland - ansa. Damage to the cervical spine
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
A patient arrives at the emergency department by private vehicle after sustaining an called in sick for a couple of days and is now back working on the team. Which of the
injury to the right lower extremity while using a saw. There is a large gaping wound following behaviors would indicate this nurse is coping well?
to the right thigh area with significant bleeding. What is the priority intervention? a. a. They are talking about taking the emergency nursing certification examination.
Elevate the extremity to the level of the heart b. They keep requesting to be assigned to the walk-in/ambulatory area
b. Initiate direct pressure c. They are impatient and snap at their coworkers.
c. Apply a tourniquet d. They are thinking about transferring out of the emergency department. - ansa. They
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure are talking about taking the emergency nursing certification examination.
A patient fell two weeks ago, striking their head. Today, the patient presented with a Following a bomb explosion, fragmentation injuries from the bomb or objects in the
persistent headache and nausea and was diagnosed with a small subdural hematoma. environment are examples of which phase of injury? a. primary
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift b. secondary
nurse reports the patient has been anxious, restless, shaky, and vomited twice during c. tertiary
the night. The patient states they couldn't sleep because a young child kept coming into d. quaternary - ansb. secondary
the room. What is the most likely cause for these signs and symptoms? a. increase
intracranial pressure In a patient with severe traumatic brain injury, hypocapnia causes which condition?
b. alcohol withdrawal a. Respiratory acidosis
c. rhabdomyolysis b. Metabolic acidosis
d. pulmonary embolus - ansb. alcohol withdrawal c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction
A patient involved in a MVC has sustained a fracture to the second rib of the anterior left
chest. Which concurrent injury is most commonly associated with this fracture? The general impression step in the initial assessment provides the opportunity to do
a. Blunt cardiac injury which of the following?
b. Brachial plexus injury a. Assess for uncontrolled internal hemorrhage
c. Pneumothorax b. Accurately triage the patient
d. Hemothorax - ansb. Brachial plexus injury c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.
,TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
TEST BANK VERIFIED TEST BANK VERIFIED
The nurse is obtaining a history for a patient who presents following sexual assault. This What is the best measure of the adequacy of cellular perfusion and can help to predict
history is completed using which of the following techniques? a. Bring the family in to the outcome of resuscitation?
the interview room. a. End-tidal carbon dioxide
b. Use direct quotes to record information. b. Hematocrit level
c. Obtain information specific only to the assault. c. Base deficit
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record d. Oxygen saturation - ansc. Base deficit
information.
What is the best position for maintaining an open airway in the obese patient? a.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of Prone
94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 b. Supine
beats/minute. The emergency nurse interprets the patient's hemodynamic findings
as an indication of which of the following? a. Decompensated shock
c. Reverse Trendelenburg
b. Normal vital signs in pregnancy
d. Right lateral recumbent - ansc. Reverse Trendelenburg
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy
What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
Treatment for frostbite can include which of the following interventions?
a. Airway compromise
a. warm the affected part over 30-60 minutes b. Ineffective ventilation
b. use gentle friction to improve circulation c. Secondary head injury
c. administer tissue plasminogen activator d. Uncontrolled external hemorrhage - ansd. Uncontrolled external hemorrhage
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator
Which of the following accurately describes ventilation principles associated with use of
Understanding the kinematic concepts associated with the mechanism of injury and a bag-mask device for an adult?
energy transfer can initially assist the trauma care provider in which of the following? a. a. Compress the bag-mask device at a rate of one breath every 6 seconds.
Anticipating the types of injuries that may be present b. Delivers 100% oxygen.
b. Deciding whether law enforcement should be notified c. Squeeze the bag-mask device completely for each breath.
c. Determining needed laboratory tests d. Maintain the oxygen saturation levels between 92% and 94%. - ansa. Compress the
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries bag-mask device at a rate of one breath every 6 seconds.
that may be present
Which of the following is considered a cornerstone of a high-performance trauma team?
What is the appropriate technique for palpating the pelvis for stability? a. a. Individual goals
Apply gentle pressure over the iliac crests, downward and laterally.
b. Use of TeamSTEPPS
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Identification of a single decision maker
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Effective communication - ansd. Effective communication
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply
gentle pressure over the iliac crests, downward and medially.
,TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
TEST BANK VERIFIED TEST BANK VERIFIED
While performing an assessment on a 13-month-old involved in a motor vehicle contusions/abrasions/deformities (signs of underlying injury), open pneumothoraces
collision, the nurse identifies which of the following findings from the patient as a sign of (sucking chest wound), JVD, tracheal position, signs of inhalation injury
possible altered mental status? a. Sunken fontanel
b. Crying, but consolable Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
c. Spontaneous movement of arms and legs midclavicular line and bases at the fifth intercostal space anterior axillary line
d. Cooperation with the assessment - ansd. Cooperation with the assessment
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
A (AVPU) - ansAlert. Will be able to maintain airway once clear.
pulsations at suprasternal notch or supraclavicular area
A (Primary Survey) - ansAirway and alertness with simultaneous cervical spinal
Life-threatening pulmonary injuries requiring immediate intervention: open
stabilization.
pneumothorax, tension pneumothorax, flail chest, hemothorax.
Airway Assessment - ansInspect: tongue obstruction, loose/missing teeth, foreign
Breathing and Ventilation Intervention - ansBreathing absent: jaw-thrust maneuver, oral
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury
airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or
higher. If ineffective: assist with bag-mask and determine need for definitive airway
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
C (Primary Survey) - ansCirculation and Control of Hemorrhage
Airway Interventions: - ansSuction
Remove foreign body if noted
Cardiogenic Shock - ansResults from pump failure in the presence of adequate
Jaw thrust maneuver (maintain cspine)
intravascular volume. There is a lack of cardiac output and end-organ perfusion
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway secondary to a decrease in myocardial contractility and/or valvular insufficiency.
Alertness Assessment - ansA-Alert Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart
V-Verbal failure is a chronic cause.
P-Painful
Blunt cardiac injury may present similar to MI.
U-Unresponsive
B (Primary Survey) - ansBreathing and Ventilation Excess of volume administration or increased after load can result in pulmonary edema
and increased myocardial ischemia.
Breathing and Ventilation Assessment - ansInspect: spontaneous breathing,
symmetrical rise and fall, depth/pattern/rate of respirations, accessory muscle use, Inotropic support to improve contractility.
diaphragmatic breathing, skin color (normal, pale, flushed, cyanotic),
Circulation and Control of Hemorrhage Assessment - ansInspect: Uncontrolled external
, TNCC 10TH EDITION – QUESTIONS AND ANSWERS TNCC 10TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE SOLVED 2026 GRADED A+ 100% COMPLETE SOLVED 2026
TEST BANK VERIFIED TEST BANK VERIFIED
bleeding, skin color Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain,
ophthalmic NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
Auscultate: Muffled heart sounds - may indicate pericardial tamponade (Do NOT patch - increases infection)
Palpate: carotid and/or femoral pulses for rate, rhythm, strength Corneal Foreign Body - ansRoutinely metal, plastic or wood.
Circulation and Control of Hemorrhage Interventions - ansControl and treat external Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
bleeding: apply direct pressure, elevate bleeding extremity, apply pressure over arterial
sites, consider use of a tourniquet. Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics,
oral analgesia
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
Corneal Laceration - ansInvolves one or more layers of the cornea. Visualized with a slit
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L. lamp.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis Findings: similar to abrasion, pain out of proportion to findings, decreased vision
and may cause hypothermia. Component therapy, including administering RBC, plasma
and platelets is a balanced approach so that O2 delivery is optimized, acidosis Treatment: treat small lacerations similar to an abrasion, larger lacerations need
corrected and coagulopathy prevented. ophthalmology referral and possible surgery
Classifications of Shock - ansHypovolemic - decrease in the amount of circulating blood Cycloplegic agent - ansCycloplegia is paralysis of the ciliary muscle of the eye, resulting
volume in a loss of accommodation. Because of the paralysis of the ciliary muscle, the
curvature of the lens can no longer be adjusted to focus on nearby objects.
Obstructive - obstruction in either the vasculature or heart
D (Primary Survey) - ansDisability (Neurologic Status)
Cardiogenic - pump failure in the presence of adequate intravascular volume
Disability Assessment - ansAssess GCS on arrival and repeat per policy.
Distributive - maldistribution of an adequate circulating blood volume (septic,
anaphylactic, neurogenic) Assess pupils for equality, shape and reactivity (PERRL)
Corneal Abrasion - ansDamage to the corneal epithelium. Easy to evaluate with Disability interventions - ansEvaluate for need for CT. Assume AMS to be the result of
fluorescein. CNS injury until proven otherwise.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling, Consider ABGs - AMS may be indicator of decreased cerebral perfusion,
irritation hypoventilation or acid-base imbalance.
Consider bedside glucose.
