TRAUMA NURSING PROCESS TNCC 9TH EDITION ELABORATED EXAM WITH ANSWERS

TRAUMA NURSING PROCESS TNCC
9TH EDITION ELABORATED EXAM
WITH ANSWERS


What should you ask yourself after completing all of your interven
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tions and reassessments? - CORRECT ANSWER-
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Does this patient need to be transferred to another hospital, to sur
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gery, or to critical care?
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What happens prior to patient arrival? 1-3 -
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CORRECT ANSWER-1. Activate trauma team
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2. Prepare trauma room
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3. Don PPE
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What happens following patient arrival but before a decision to int
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ubate has been made? 4-8k k k k




may change based on C-ABC - CORRECT ANSWER-
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4. Assess for obvious uncontrolled external hemorrhage or unres
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ponsiveness/apnea and the need to reprioritize to C-ABC k k k k k k k


5**. Assess level of consciousness using AVPU
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6. Open the airway
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7**. Assess the patency and protection of the airway
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8**. Assess breathing effectiveness
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Continue the TNP assuming the patient was intubated. 9-11 -
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CORRECT ANSWER-
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9**. If intubated, assess endotracheal tube placement
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10. If intubated, assess ETT position and securement
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11. If intubated, state the need to begin mechanical ventilation or
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continue assisted ventilation k k




Continue the TNP following assessments of ETT. 12-15
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, **12, 13, and 15 are double-starred - CORRECT ANSWER-
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12**. Assess circulation
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13**. Assess neurologic status using GCS
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14. Assess pupils
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15**. Remove all clothing AND inspect for obvious abnormalities
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or injuries
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Continue the TNP following assessments of circulation, neuro sta
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tus, and removal of clothing to inspect for injury. 16-18 -
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kCORRECT ANSWER-16. Provide warmth k k k


17. Obtain a full set of vital signs and weight in kilograms (if not de
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termined earlier) k


18. Facilitate family presence
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Continue the TNP using the LMNOP mnemonic. 19-23 -
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CORRECT ANSWER-19. L - trauma panel labs
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20. M - monitor (Cardiac, consider EKG)
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21. N - consider need for NG/OG
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22. O - assess O2 and end-tidal capnography
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23**. P - assess pain using appropriate pain scale
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Continue TNP after LMNOP (so after pain has been assessed). 2
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4-26 - CORRECT ANSWER-24. Non-
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pharmacological comfort measures k k k


25. Consider analgesic med order
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26. Obtain pertinent history
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Head-to-Toe 27-43 - CORRECT ANSWER- k k k k


27. Inspect and palpate head for injuries
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28. Inspect and palpate face for injuries
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29. Inspect and palpate neck for injuries
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--
kDemonstrate removal AND reapplication of cervical collar for ass
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essment (if indicated). k k


k30. Inspect and palpate chest for injuries
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31. Auscultate breath sounds
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32. Auscultate heart sounds
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