TNCC 9TH EDITION 100 COMPREHENSIVE
TEST PAPER QUESTIONS AND SOLUTIONS
GRADED A+
◉ During which part of the primary survey would there be
anticipation for intubation, insertion of OPA/NPA, removal of any
loose teeth or foreign objects, or suctioning?
Answer: Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal
Stabilization"
◉ If c-spine stabilization is necessary, what need should be stated?
Answer: the need for a second person to provide manual c-spine
stabilization
◉ An adult patient 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 patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry
is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
,C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
Answer: A.Decrease the rate of manual ventilation.
◉ An older adult presents to the emergency department with
complaints of dizziness, headache, and nausea. The patient 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
patient is currently on anticoagulant therapy. What is most likely the
cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome
Answer: post-concussive syndrome
◉ A patient with a 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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
, D.Preparing the patient for ultrasound of the leg
Answer: C.Elevating the leg to the level of the heart
◉ A patient involved in a high-speed rollover is complaining of
increased difficulty breathing. There is a small penetrating wound to
the sixth intercostal space in the left lateral chest. Which finding is
most consistent with an injury to the diaphragm?
A.Severe left-sided abdominal pain
B.Bowel sounds heard in the left lower chest
C.Pain radiating to the left shoulder.
D.Decreased breath sounds on the left side
Answer: Bowel sounds heard in the left lower chest
◉ A patient 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 patient has been awake, alert, and
complaining of leg pain. Their spouse reported that the patient
suddenly became anxious and confused. Upon reassessment, the
patient is restless, with respiratory distress and petechiae to his
neck. The patient is exhibiting signs and symptoms most commonly
associated with which of the following conditions?
A.Acute lung injury
TEST PAPER QUESTIONS AND SOLUTIONS
GRADED A+
◉ During which part of the primary survey would there be
anticipation for intubation, insertion of OPA/NPA, removal of any
loose teeth or foreign objects, or suctioning?
Answer: Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal
Stabilization"
◉ If c-spine stabilization is necessary, what need should be stated?
Answer: the need for a second person to provide manual c-spine
stabilization
◉ An adult patient 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 patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry
is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
,C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
Answer: A.Decrease the rate of manual ventilation.
◉ An older adult presents to the emergency department with
complaints of dizziness, headache, and nausea. The patient 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
patient is currently on anticoagulant therapy. What is most likely the
cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome
Answer: post-concussive syndrome
◉ A patient with a 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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
, D.Preparing the patient for ultrasound of the leg
Answer: C.Elevating the leg to the level of the heart
◉ A patient involved in a high-speed rollover is complaining of
increased difficulty breathing. There is a small penetrating wound to
the sixth intercostal space in the left lateral chest. Which finding is
most consistent with an injury to the diaphragm?
A.Severe left-sided abdominal pain
B.Bowel sounds heard in the left lower chest
C.Pain radiating to the left shoulder.
D.Decreased breath sounds on the left side
Answer: Bowel sounds heard in the left lower chest
◉ A patient 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 patient has been awake, alert, and
complaining of leg pain. Their spouse reported that the patient
suddenly became anxious and confused. Upon reassessment, the
patient is restless, with respiratory distress and petechiae to his
neck. The patient is exhibiting signs and symptoms most commonly
associated with which of the following conditions?
A.Acute lung injury
