TNCC Notes for Written Exam
What is kinematics? - ✔✔A branch of mechanics (energy transfer) that refers to motion and does not
consider the concepts of force and mass of the object or body.
What is Newton's First Law? - ✔✔A body at rest will remain at rest. A body in motion will remain in
motion until acted on by an outside force.
What is the Law of Conservation of Energy? - ✔✔Energy can neither be created nor destroyed. It is
only changed from one form to another.
What is Newton's Second Law? - ✔✔Force equals mass multiplied by acceleration of deceleration.
What is kinetic energy (KE)? - ✔✔KE equals 1/2 the mass (M) multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? - ✔✔A = Airway with simultaneous cervical spine
protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient warm)
What is the Mnemonic for the Secondary Assessment? - ✔✔F = Full set of VS/Focused adjuncts
(includes cardiac monitor, urinary catheter, and gastric tube)/Family presence
G = Give comfort measures (verbal reassurance, touch, and pharmacologic and nonpharmacologic
management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds? - ✔✔Auscultate the lungs bilaterally at the second
intercostal space midclavicular line and at the fifth intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - ✔✔- Tracheal deviation
,- JVD
What are signs of ineffective breathing? - ✔✔- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing effectively? - ✔✔A
tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? - ✔✔- Insert 2 large
caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - ✔✔- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - ✔✔- Control any uncontrolled
external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
, - Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? - ✔✔DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
What are the interventions for Disability? - ✔✔- If assessment indicates a decreased LOC, conduct
further investigation during secondary focused assessments
- If pt is not alert or verbal, continue to monitor for any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration, consider hyperventilation.
What is assessed and intervened for Expose/Environmental Controls? - ✔✔- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
What is kinematics? - ✔✔A branch of mechanics (energy transfer) that refers to motion and does not
consider the concepts of force and mass of the object or body.
What is Newton's First Law? - ✔✔A body at rest will remain at rest. A body in motion will remain in
motion until acted on by an outside force.
What is the Law of Conservation of Energy? - ✔✔Energy can neither be created nor destroyed. It is
only changed from one form to another.
What is Newton's Second Law? - ✔✔Force equals mass multiplied by acceleration of deceleration.
What is kinetic energy (KE)? - ✔✔KE equals 1/2 the mass (M) multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? - ✔✔A = Airway with simultaneous cervical spine
protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient warm)
What is the Mnemonic for the Secondary Assessment? - ✔✔F = Full set of VS/Focused adjuncts
(includes cardiac monitor, urinary catheter, and gastric tube)/Family presence
G = Give comfort measures (verbal reassurance, touch, and pharmacologic and nonpharmacologic
management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds? - ✔✔Auscultate the lungs bilaterally at the second
intercostal space midclavicular line and at the fifth intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - ✔✔- Tracheal deviation
,- JVD
What are signs of ineffective breathing? - ✔✔- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing effectively? - ✔✔A
tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? - ✔✔- Insert 2 large
caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - ✔✔- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - ✔✔- Control any uncontrolled
external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
, - Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? - ✔✔DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
What are the interventions for Disability? - ✔✔- If assessment indicates a decreased LOC, conduct
further investigation during secondary focused assessments
- If pt is not alert or verbal, continue to monitor for any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration, consider hyperventilation.
What is assessed and intervened for Expose/Environmental Controls? - ✔✔- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
