TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
—What does the J stand for at the end of the secondary
just keep evaluating - vipp
survery?
—What does VIPP stand for? vital signs, injuries/interventions, primary survey, pain
—During the head-to-toe, where would you find
flank
Grey-Turner's sign?
—During the head-to-toe, where would you find Cullen's
umbilicus
sign?
-What is sometimes deferred at the end of the
inspecting posterior
head-to-toe?
-Antibiotics, consults, head CT, imaging, law enforcement,
mandatory reporting, psychosocial support, social ser-
AFTER head-to-toe, BEFORE J (VIPP)
vices, splinting, tetanus, and wound care are all interven-
tions that you do AFTER and before WHAT?
-What three items are obtained during the pertinent his-
Medical records, prehospital report, SAMPLE
tory assessment?
-What are examples of nonpharmacologic measures? Distraction, family presence, padding bony prominences,
(must identify at least one during testing) repositioning, splinting, verbal reassurance
-For whom is capnography highly recommended? all patients
-In step M of "Get Adjuncts", what else might be indicated
EKG
besides cardiac monitor?
-In Step 16 of "Exposure and Environment", you must blankets, room temp increase, warmed fluids, warming
name at least one of these interventions: lights
1. inspect AND palpate skin color, temp, moisture and 2.
-To assess circulation, you must do these two main tasks:
palpate a pulse
-What do you do when alterations are identified in any of
intervene as appropriate and reassess
the steps in the primary survery?
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
1. attach CO2 detector and assess for evidence of exhaled
-What three assessments must be done if the patient is CO2; 2. observe for rise and fall of the chest w/ assisted
intubated? ventilations; 3. auscultate over epigastrium for gurgling
AND lungs for bilateral breath sounds
Breath sounds, depth/pattern/rate, spontaneous breath-
-Four of these must be identified to assess breathing ing, subcutaneous emphysema, increased work of breath-
ettectiveness: ing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
-What can be applied in step 12 of "Circulation and
Control of Hemorrhage" for which credit is given in the cardiac monitor
LMNOP section?
-When should 2 IV sites be established? During "Circulation" assessment
-If the patient is intubated and you've already assessed
assess ETT position by noting the number at teeth/gums
ETT placement, what else needs to be done with the ETT?
AND secure ETT
(step 10)
-What should you verbalize after completing all ETT as-
moving patient from assisted ventilation to mechanical
sessments?
-During which part of the primary survey would you antici-
pate the need for a chest tube, intubation, decompression "Breathing and Ventilation"
of pneumothorax, oxygen, or BVMs?
bony deformity, loose teeth, edema, inhalation injury,
-Four of these must be identified to assess patency and
sounds, tongue obstruction, burns, fluids, foreign objects,
protection of the airway:
vocalization
-During which part of the primary survey would there be Assessing patency and protection of the airway, Step 7 of
anticipation for intubation, insertion of OPA/NPA, removal "Alertness and Airway with Simultaneous Cervical Spinal
of any loose teeth or foreign objects, or suctioning? Stabilization"
If c-spine stabilization is necessary, what need should be the need for a second person to provide manual c-spine
stated? stabilization
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
*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
A.Decrease the rate of manual ventilation.
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?
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 anti-
coagulant therapy. What is most likely the cause of their
post-concussive syndrome
symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Dittuse axonal injury
D.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?
C.Elevating the leg to the level of the heart
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
Bowel sounds heard in the left lower chest
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
A ruptured diaphragm is a potentially life-threatening in-
jury. The patient will most likely have decreased breath
A patient involved in a high-speed rollover is complaining
sounds on the attected side along with pain, which may
of increased diflculty breathing. There is a small penetrat-
radiate to the left shoulder. However, these signs do not
ing wound to the sixth intercostal space in the left lateral
specifically implicate an injury to the diaphragm. Ausculta-
chest. Which finding is most consistent with an injury to
tion of bowel sounds in the chest indicates that abdominal
the diaphragm?
contents have herniated up into the chest through a defect
in the diaphragm.
*A patient has been in the emergency department for
several hours waiting to be admitted. They sustained mul-
tiple 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 B. Fat embolism
most commonly associated with which of the following
conditions?
A. Acute lung injury
B. Fat embolism
C. Pneumothorax
D. Pulmonary contusion
*Three adults present at ditterent times during a one-hour
period with a high fever, fatigue, and headache. All three
C. Immediately initiate isolation precautions
patients have a rash which started on their mouth, face,
and arms with progression to the chest and abdomen. The fact that multiple people with ditterent demographics
They all visited the same grocery store within the last week. are appearing with similar signs and symptoms would
What is the most appropriate intervention from triage for alert the nurse to a possible biological exposure. These
these patients?
—What does the J stand for at the end of the secondary
just keep evaluating - vipp
survery?
—What does VIPP stand for? vital signs, injuries/interventions, primary survey, pain
—During the head-to-toe, where would you find
flank
Grey-Turner's sign?
—During the head-to-toe, where would you find Cullen's
umbilicus
sign?
-What is sometimes deferred at the end of the
inspecting posterior
head-to-toe?
-Antibiotics, consults, head CT, imaging, law enforcement,
mandatory reporting, psychosocial support, social ser-
AFTER head-to-toe, BEFORE J (VIPP)
vices, splinting, tetanus, and wound care are all interven-
tions that you do AFTER and before WHAT?
-What three items are obtained during the pertinent his-
Medical records, prehospital report, SAMPLE
tory assessment?
-What are examples of nonpharmacologic measures? Distraction, family presence, padding bony prominences,
(must identify at least one during testing) repositioning, splinting, verbal reassurance
-For whom is capnography highly recommended? all patients
-In step M of "Get Adjuncts", what else might be indicated
EKG
besides cardiac monitor?
-In Step 16 of "Exposure and Environment", you must blankets, room temp increase, warmed fluids, warming
name at least one of these interventions: lights
1. inspect AND palpate skin color, temp, moisture and 2.
-To assess circulation, you must do these two main tasks:
palpate a pulse
-What do you do when alterations are identified in any of
intervene as appropriate and reassess
the steps in the primary survery?
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
1. attach CO2 detector and assess for evidence of exhaled
-What three assessments must be done if the patient is CO2; 2. observe for rise and fall of the chest w/ assisted
intubated? ventilations; 3. auscultate over epigastrium for gurgling
AND lungs for bilateral breath sounds
Breath sounds, depth/pattern/rate, spontaneous breath-
-Four of these must be identified to assess breathing ing, subcutaneous emphysema, increased work of breath-
ettectiveness: ing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
-What can be applied in step 12 of "Circulation and
Control of Hemorrhage" for which credit is given in the cardiac monitor
LMNOP section?
-When should 2 IV sites be established? During "Circulation" assessment
-If the patient is intubated and you've already assessed
assess ETT position by noting the number at teeth/gums
ETT placement, what else needs to be done with the ETT?
AND secure ETT
(step 10)
-What should you verbalize after completing all ETT as-
moving patient from assisted ventilation to mechanical
sessments?
-During which part of the primary survey would you antici-
pate the need for a chest tube, intubation, decompression "Breathing and Ventilation"
of pneumothorax, oxygen, or BVMs?
bony deformity, loose teeth, edema, inhalation injury,
-Four of these must be identified to assess patency and
sounds, tongue obstruction, burns, fluids, foreign objects,
protection of the airway:
vocalization
-During which part of the primary survey would there be Assessing patency and protection of the airway, Step 7 of
anticipation for intubation, insertion of OPA/NPA, removal "Alertness and Airway with Simultaneous Cervical Spinal
of any loose teeth or foreign objects, or suctioning? Stabilization"
If c-spine stabilization is necessary, what need should be the need for a second person to provide manual c-spine
stated? stabilization
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
*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
A.Decrease the rate of manual ventilation.
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?
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 anti-
coagulant therapy. What is most likely the cause of their
post-concussive syndrome
symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Dittuse axonal injury
D.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?
C.Elevating the leg to the level of the heart
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
Bowel sounds heard in the left lower chest
, TNCC 9th Edition TNP Exam Test Questions and Answers Rated A
A ruptured diaphragm is a potentially life-threatening in-
jury. The patient will most likely have decreased breath
A patient involved in a high-speed rollover is complaining
sounds on the attected side along with pain, which may
of increased diflculty breathing. There is a small penetrat-
radiate to the left shoulder. However, these signs do not
ing wound to the sixth intercostal space in the left lateral
specifically implicate an injury to the diaphragm. Ausculta-
chest. Which finding is most consistent with an injury to
tion of bowel sounds in the chest indicates that abdominal
the diaphragm?
contents have herniated up into the chest through a defect
in the diaphragm.
*A patient has been in the emergency department for
several hours waiting to be admitted. They sustained mul-
tiple 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 B. Fat embolism
most commonly associated with which of the following
conditions?
A. Acute lung injury
B. Fat embolism
C. Pneumothorax
D. Pulmonary contusion
*Three adults present at ditterent times during a one-hour
period with a high fever, fatigue, and headache. All three
C. Immediately initiate isolation precautions
patients have a rash which started on their mouth, face,
and arms with progression to the chest and abdomen. The fact that multiple people with ditterent demographics
They all visited the same grocery store within the last week. are appearing with similar signs and symptoms would
What is the most appropriate intervention from triage for alert the nurse to a possible biological exposure. These
these patients?
