TNCC FINAL EXAM TEST 2024

TNCC FINAL EXAM TEST 2024/2025
OPEN QUESTIONS AND ANSWERS


You are treating a 27-
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year old male in respiratory distress who was involved in a house
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fire. Calculating TBSA burned is deferred d/t the need for emerge
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nt intubation. At what rate should you begin fluid resuscitation?
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A) 1000 mL/hr
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B) 500 mL/hr
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C) 250 mL/hr
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D) 125 mL/hr - CORRECT ANSWER-B) 500 mL/hr
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A patient has been in the ED for several hours waiting to be admitt
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ed. He sustained multiple rib fractures and a femur fracture after a
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kfall. He has been awake, alert, and c/o leg pain. His wife reported
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suddenly becoming anxious and confused. Upon reassessment,
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the patient is restless, with respiratory distress and petechiae to h
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is neck. the patient is exhibiting signs of symptoms commonly ass
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ociated with which of the following conditions?
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A) acute lung injury
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B) fat embolism
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C) PTX k


D) pulmonary contusion - CORRECT ANSWER-B) fat embolism
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Which pulse pressure description is an indication of early hypovol
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emic shock? k




A) widened
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B) narrowed
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C) bounding
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D) weak - CORRECT ANSWER-B) narrowed
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,Which of the following considerations is most important when cari
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ng for a geriatric trauma patient?
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A) head to to exam
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B) medical history
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C) incontinence
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D) falls - CORRECT ANSWER-B) medical history
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Which of the following assessment findings differentiates a tensio
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n pneumothorax from a simple pneumothorax?
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A) increased work of breathing
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B) unilaterally diminished breath sounds
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C) pleuritic chest pain
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D) hypotension that worsens with inspiration -
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CORRECT ANSWER-
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D) hypotension that worsens with inspiration.
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Assessment findings associated with tension pneumothorax incl
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ude anxiety, severe restlessness, severe respiratory distress, an
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d absent breath sounds on the injured side. Hypotension due to c
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ompression of the heart and great vessels is consistent with obstr
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uctive shock. Hypotension worsens with inspiration due to increa
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sed intrathoracic pressure. Late signs include distended neck vei
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ns, tracheal deviation, and cyanosis.
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The nurse is caring for a 120 kg male is brought in after a warehou
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se fire and is calculating the patient's fluid resuscitation needs. H
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e has painful red blistering to the entire surface of both upper extr
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emities and superficial burns to the anterior chest. Using the modi
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fied Lund and Browder chart to calculate the total BSA burned, ho
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w much IV fluids would be administered in the first 8 hours?
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A) 2280 mL
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B) 3840 mL
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C) 4560 mL
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D) 7680 mL - CORRECT ANSWER-A) 2280 mL
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(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
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, 120 kg x (2 mL) x (19% TBSA) = 4560 mL
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(half of fluids given in first 8 hours) = 2280 mL
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Which of the following is a component of the trauma triad of death
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?

A) Acidosis k


B) hyperthermia
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C) hemorrhage
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D) sepsis - CORRECT ANSWER-A) Acidosis
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k hypothermia, metabolic acidosis, coagulopathy k k k




A 56-year-
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kmale patient involved in a MVC is brought to the ED of a rural criti
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cal access facility. He c/o neck pain, SOB, and diffuse abd pain. H
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is GCS is 15. His vitals are as follows:
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BP 98/71 k


HR 125 beats/min k k


RR 26 breaths/min k k


SpO2 94% on high flow O2 via NRB mask
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which of the following is the priority intervention for this patient?
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A) Expedite transport to the CT scanner
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B) prepare the patient for spinal radiographs
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C) expedite transfer to the closest trauma center
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D) notify the patients family - CORRECT ANSWER-
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C) expedite transfer to the closest trauma center
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An elderly patient with a history of anticoagulant use presents aft
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er a fall at home that day. she denies any loss of consciousness.
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She has a hematoma to her forehead and complains of headache
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, dizziness, and nausea. Which is a most likely cause of her symp
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toms?