TNCC 9TH EDITION COMPREHENSIVE QUESTIONS
AND ANSWERS SET A+
✔✔1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ✔✔Auscultate the chest for:
✔✔1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ✔✔Palpate the chest for
✔✔1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ✔✔If breathing is absent..
✔✔trauma its need early supplemental oxygen, start with 15 mL O2 and titrate oxygen
delivery. - ✔✔Oxygen on trauma patients
✔✔Circulation and Control of Hemorrhage
Inspect first for any uncontrolled bleeding
Skin color
palpate for central pulses - carotid and femoral - rate, rhythm, and strength
Skin temp: cool, diaphoretic, or warm and dry - ✔✔C
✔✔apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
, Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
b. infuse warm isotonic fluids
c. consider balanced resuscitation
d. use rapid infusion device - ✔✔C Interventions:
✔✔Disability - Neurologic Status
1. Assess pupils for equality, shape, and reactivity (PERRL)
2. Assess GCS (eye opening, verbal response, and motor response) - ✔✔D
✔✔1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ✔✔D Interventions
✔✔Exposure and Environmental Control
Remove all clothes and assess for any obvious injuries and uncontrolled bleeding -
✔✔E
✔✔IF clothing is needed for evidence preserve in paper bag.
Maintain body temp - cover the pt, turn up heat in room, administer warm fluids - ✔✔E
Interventions:
✔✔Full set of vitals and family presence - ✔✔F
✔✔Get Resuscitation Adjuncts
L - Labs (maybe a lactic acid), a b g 's, blood type
M - monitors
N - naso or oro gastric tubes
O Oxygen and ETC02 monitors
P - pain assessment and management - ✔✔G
✔✔Reevaluation and Consider the need to Transfer - ✔✔Final step in primary survey
✔✔H,I - ✔✔Secondary Survery
✔✔History and Head to toe
AND ANSWERS SET A+
✔✔1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ✔✔Auscultate the chest for:
✔✔1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ✔✔Palpate the chest for
✔✔1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ✔✔If breathing is absent..
✔✔trauma its need early supplemental oxygen, start with 15 mL O2 and titrate oxygen
delivery. - ✔✔Oxygen on trauma patients
✔✔Circulation and Control of Hemorrhage
Inspect first for any uncontrolled bleeding
Skin color
palpate for central pulses - carotid and femoral - rate, rhythm, and strength
Skin temp: cool, diaphoretic, or warm and dry - ✔✔C
✔✔apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
, Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
b. infuse warm isotonic fluids
c. consider balanced resuscitation
d. use rapid infusion device - ✔✔C Interventions:
✔✔Disability - Neurologic Status
1. Assess pupils for equality, shape, and reactivity (PERRL)
2. Assess GCS (eye opening, verbal response, and motor response) - ✔✔D
✔✔1. Get a CT
2. Consider ABG 's if decreased LOC
3. Consider glucose check - ✔✔D Interventions
✔✔Exposure and Environmental Control
Remove all clothes and assess for any obvious injuries and uncontrolled bleeding -
✔✔E
✔✔IF clothing is needed for evidence preserve in paper bag.
Maintain body temp - cover the pt, turn up heat in room, administer warm fluids - ✔✔E
Interventions:
✔✔Full set of vitals and family presence - ✔✔F
✔✔Get Resuscitation Adjuncts
L - Labs (maybe a lactic acid), a b g 's, blood type
M - monitors
N - naso or oro gastric tubes
O Oxygen and ETC02 monitors
P - pain assessment and management - ✔✔G
✔✔Reevaluation and Consider the need to Transfer - ✔✔Final step in primary survey
✔✔H,I - ✔✔Secondary Survery
✔✔History and Head to toe
