TNCC With Correct Questions & Answers!!

Which of the following mnemonics can help a nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? - ANSWER MARCH You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpitation, fundal height at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cardiotocography. These findings are most consistent with which of the following? - ANSWER Placental abruption Which of the following is NOT considered goal-directed therapy for cardiogenic shock? - ANSWER Pericardiocentesis A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is expected with a musculoskeletal complication associated with this presentation? - ANSWER Elevated creatinine kinase Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER Subdural hematoma What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? - ANSWER Pulse oximetry and capnography Which of the following is a possible complication of positive-pressure ventilation? - ANSWER Worsening pneumothorax Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? - ANSWER Hypotension that worsens with inspiration A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were B/P 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Current vital signs are B/P 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which stage of shock? - ANSWER Compensated Which pulse pressure description is an indication of early hypovolemic shock? - ANSWER Narrowed A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma team's communication? - ANSWER Loop A 36 year old female has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the next appropriate intervention? - ANSWER Apply a splint and elevate the extremity above the level of the heart An intubated trauma patient is being transferred to a tertiary care center. After moving the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is the priority intervention? - ANSWER Check to make sure the ventilator is plugged in Which of the following injuries is LEAST likely to be promptly identified? - ANSWER bowel Which of the following occurs during the third impact of a motor vehicle crash? - ANSWER The aorta is torn at its attachment with the ligamentum arteriosum What finding raises suspicion of a complete spinal cord injury? - ANSWER priapism A 20 year old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question? - ANSWER Straight catheter for a urine sample 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? - ANSWER Elevating the extremity to the level of the heart Which of the following is a late sign of increased intracranial pressure? - ANSWER nausea and vomiting A 56 year old male patient involved in a motor vehicle crash is brought to the emergency department of a rural critical access facility. He complains of neck pain, shortness of breath, and diffuse abdominal pain. His GCS is 15. His vital signs are as follows: BP 98/71, HR 125, RR26, SpO2 94% on high flow oxygen via non-rebreather mask. Which of the following is the priority intervention for this patient? - ANSWER Expedite transfer to the closest trauma center. A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? - ANSWER Bradycardia and absent motor function below the level of injury Which of the following is a component of the trauma triad of death? - ANSWER acidosis EMS brings a patient who fell while riding his bicycle. Using the American College of surgeons screening guidelines, which assessment findings would prompt the nurse to prepare the patient for radiologic spine clearance? - ANSWER Alert with no neurologic deficits EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant damage to the drivers side of the car. The patient is asking to have the cervical collar removed. When is it appropriate to remove the cervical collar? - ANSWER After a physical examination if the patient has no radiologic abnormalities on a CT scan An elderly patient with a history of anticoagulant use presents after a fall at home that day. She denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? - ANSWER subdural hematoma A 49 year old restrained driver involved in a motor vehicle collision presents to the trauma center complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following? - ANSWER serial FAST exams The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patients fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total body surface area burned, how much IV fluid would be administered in the first 8 hours? - ANSWER 2280 mL The trauma nurse knows that placing a bariatric patient is a "ramped position" provides better visualization during the insertion of which device? - ANSWER ET tube A patient has been in the emergency department 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 complaining of leg pain. His wife reported that he 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? - ANSWER fat embolism Which of the following is true about the log roll maneuver? - ANSWER It can worsen cord damage from an unstable spinal injury An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respirations, and dusky skin. The trauma team has administered medications for drug assisted intubation and attempted intubation but was unsuccessful. What is the most appropriate immediate next step? - ANSWER Ventilate with a bag mask device A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention? - ANSWER dressing removal Which of the following considerations is most important when caring for a geriatric trauma patient? - ANSWER medical history Which of the following patients warrants referral to a burn center? - ANSWER A 52 year old diabetic male with a partial thickness burn to the left lower leg You are treating a 27 year old male in respiratory distress who was involved in a house fire. Calculating total body surface area (TBSA) burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation? - ANSWER 500 mL/hour Which of the following is an expected finding in a patient with a tube thoracotomy connected to a chest drainage system? - ANSWER Fluctuation in the water seal chamber The most reassuring finding for a male patient with hip pain after a fall is which of the following? - ANSWER pelvic stability What factor contributes most to the kinetic energy of a body in motion? - ANSWER velocity Patients with a crush injury should be monitored for which of the following conditions? - ANSWER dysrhythmias Caregivers carry a 2 year old into the emergency department who fell out of a second story window. The patient is awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority? - ANSWER Padding the upper back while stabilizing the cervical spine A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures. The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principles? - ANSWER Initiate two large caliber IV lines for LR solution administration Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and is taking steps to minimize the impact of a future disaster. Which phase of the disaster life cycle does this describe? - ANSWER mitigation What is the effect of hypothermia on the oxyhemoglobin dissociati