TNCC 9th EDITION FINAL TEST WITH 100% ACCURATE ANSWERS AND RATIONALE

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 - Correct Answer-C. Elevating the leg to the level of the heart Rationale: Musculoskeletal and WoundsMusculoskeletal This patient is exhibiting signs of possible compartment syndrome which is a dangerous complication of fractured extremities. The pain is often out of proportion to the injury and might not respond to pain medications. Elevate the limb to the level of the heart to decrease dependent edema but not above the heart, which can cause increased venous congestion and pressure within the compartment. 8. A teenaged patient presents to the emergency department with left arm pain after a ground level fall. The patient identifies as transgender and shares they are homeless. The ED staff are concerned the patient is experiencing human trafficking. What is most consistent with human trafficking? A. The individual appears well nourished. B. Those who are being trafficked rarely seek medical care. C. It is infrequently associated with substance abuse. D. Those experiencing human trafficking rarely self-disclose. - Correct Answer-D. Those experiencing human trafficking rarely self-disclose. 9. An intubated trauma patient has just been transported back from CT scan. Upon arrival to their room in the emergency department, resistance is noted with bag-mask ventilations and auscultation reveals unequal breath sounds. What is the most appropriate initial intervention for this patient? A. Place the patient back on the ventilator. B. Extubated the patient. C. Reposition the endotracheal tube. D. Suction the endotracheal tube. - Correct Answer-C. Reposition the endotracheal tube. 10. Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? A. Increased work of breathing B. Unilaterally diminished breath sounds C. Tachycardia D. Hypotension - Correct Answer-D. Hypotension 11. A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what is the priority intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - Correct Answer-A. Initiate transfer to a trauma center 12. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority intervention? A. Initiate two intravenous access sites B. Place the patient on supplemental oxygen C. Apply direct pressure to the wound D. Use a tourniquet to control the bleeding - Correct Answer-C. Apply direct pressure to the wound 13. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib fractures on the right side, a small pneumothorax on the right, and a Grade III liver injury. The patient was intubated and placed on a ventilator with PEEP. Chest tube was deferred at this time. Upon reassessment, which finding is most concerning? A. Severely diminished breath sounds on the right B. Guarding in the right upper quadrant C. Ecchymosis in the right upper quadrant D. Crepitus to the right chest - Correct Answer-A. Severely diminished breath sounds on the right 14. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an indication of the body's response to these findings? A. Increased respiratory effort B. Widening pulse pressure C. Reflex tachycardia D. Reflex hypotension - Correct Answer-B. Widening pulse pressure Rationale: Head and Torso TraumaHead Trauma This patient has a CPP (MAP − ICP) of less than 60 mm Hg (8 kPa) which is associated with poor outcomes. When the CPP falls below normal levels, the central nervous system initiates the Cushing response in an attempt to increase mean arterial pressure and improve CPP. Cushing response assessment findings include widening pulse pressure, reflex bradycardia, and irregular, decreased respiratory effort. A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right lower chest and complaints of shortness of breath. What is the priority intervention? A. Surgical intervention B. Chest tube insertion C. Needle decompression D. Airway and ventilation support - Correct Answer-D. Airway and ventilation support 18. A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these findings? A. Rhabdomyolysis B. Fat embolism C. Disseminated intravascular coagulopathy D. Multiple organ dysfunctions syndrome - Correct Answer-C. Disseminated intravascular coagulopathy 16. 1. 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 - Correct Answer-D. Post-concussive syndrome Rationale: Special PopulationsOlder Adult Post-concussive syndrome can occur days to weeks after injury or trauma. The other three conditions present as a more rapid decline, especially in patients who are on anticoagulants. 1. Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is concerned about injury to which organ? A. Transverse colon B. Pancreas C. Liver D. Spleen - Correct Answer-C. Liver Rationale: Head and Torso TraumaAbdominal and Pelvic Trauma Liver injuries are associated with right, lower rib fractures. They also can present with tenderness, guarding, or rigidity in the right upper quadrant, along with ecchymosis of the right upper quadrant or around the umbilicus, known as Cullen's sign