TNS REVIEW EXAM QUESTIONS WITH
VERIFIED SOLUTIONS
,What are the 4 maneuvers of performing a physical exam? - ANSWERInspect.
Auscultate.
Palpate.
Percuss.
What are the 5 priorities of the primary survey? - ANSWERA - Airway
access/maintenance and c-spine control.
B - Breathing and ventilatory status: assess/support.
C - Circulation and hemorrhage control.
D - Disability/neurological status.
E - Expose.
At what point in the primary survey are life-saving interventions performed? -
ANSWERprimary survey as soon as life-threats are identified.
During which phase of assessments are vital signs counted/measured for the first time?
- ANSWERSecondary Survey.
At what point in the assessment should TNS assume and take precautions to prevent
further c-spine injury? - ANSWERmulti-system trauma
appropriate MOI
altered LOC
injury above clavicles from blunt trauma
List the expected outcomes of airway resuscitation/mgmt in the trauma pt. -
ANSWERVentilations are quiet w/o stridor or retractions.
Pt speaks or makes appropriate sounds.
Chest rises and falls easily w/ spontaneous/assisted ventilations.
Foreign material not visible in upper airway.
List at least 4 things a TNS should inspect for when exposing the chest during the
primary survey. - ANSWER- Appearance of chest: contour and integrity of chest wall
- Symmmetry of expansion and adequacy of excursion
- contusions, abrasions, lacerations, and penetrating wounds
- Use of assessory muscles, nasal flaring, tracheal tugging or retractions.
What is the difference between central and peripheral cyanosis? - ANSWERCentral:
lips, mucous membranes, conjunctiva; late signs of hypoxia.
Peripheral: nailbeds; Occurs when tissues extract more oxygen from blood than normal.
How many grams of desaturated Hgb are necessary to produce cyanosis in the tissues?
- ANSWER5 g/dL of Hgb.
,Is cyanosis an early or late sign of hypoxia? - ANSWERCentral cyanosis is a late sign.
What 2 immediate life threats should be suspected if a pt with a chest trauma presents
with jugular vein distention? - ANSWERTension pneumonthorax.
Pericardial tamponade.
What info. can be determined by palpating the chest during the primary survey? -
ANSWER- Pain, point tenderness
- deformity, chest wall expansion
- rib mobility, instability, abnormal movements
- crepitus: bony vs. subcutaneous
- skin temperature/moisture
- subcutaneous emphysema
- tactile fremitus - vibration of chest wall.
List 3 sounds that should be detected w/o a stethoscope during the primary survey that
suggest a partial airway obstruction. - ANSWERSnoring.
Gurgling.
Stridor.
What is the most ominous sound when auscultating the chest wall of a trauma pt in
severe ventilatory distress? - ANSWERSilence.
Under what circumstances may a pt have a pulse oximetry reading of over 95% in the
presence of severe hypoxia? - ANSWER- anemia
- abnormal forms of Hgb are present.
- Carboxyhemoglobin.
What 3 immediate life-threats that must be found during the breathing/oxygenation
phase of the primary survey? - ANSWERTension pneumothorax.
Open pneumothorax.
Flail chest.
If a pt has a radial pulse, the minimum Systolic BP is :
If a pt has a carotid pulse, the minimum Systolic BP is:
If a pt has a femoral pulse, the minimum Systolic BP is: - ANSWER80 - 90 mmHg.
60 mmHg.
70 mmHg.
Under what circumstances may the usual tachycardic response to volume lass be
absent? - ANSWERelderly
beta or calcium blockers.
, neurogenic shock.
If the pt has a irregular pulse, a TNS should immediately apply a ___________? -
ANSWERCardiac monitor.
What 3 factors should be assessed to determine perfusion adequacy during the primary
survey? - ANSWERPulses.
Skin signs.
Mental status.
What should be assessed relative to the nature of uncontrolled external bleeding? -
ANSWERType of bleeding.
Amount of blood loss.
Rate of blood loss.
List 2 immediate life-threatening conditions that must be found during the cardiac
portions of the primary survey? - ANSWERCardiac tamponade.
Shock.
What are the progressive steps of external hemorrhage control of a mangled extremity?
- ANSWERDirect pressure.
Pressure points.
Tourniquets.
What is the most sensitive indicator of cerebral perfusion and brain function? -
ANSWERLOC.
A pt with head trauma repeats his name over and over again but does not answer
questions. What score should be given to this verbal response? -
ANSWERInappropriate words.
A pt does not obey commands, but moves his arm towards a pain stimulus and
attempts to grab at it or push it away with purposeful movement. What GCS score
should be given to this motor response? - ANSWERLocalize pain (protective response).
Where on an apparently unconscious pt's body should a TNS first apply a pain stimulus
to determine initial LOC? - ANSWERThrough a cranial nerve - orbital rim or ear lobe.
When should a TNS first assess the back? Primary or secondary survey? -
ANSWERprimary survey during E - Exposure portion.
Under what circumstances should an orogastric as opposed to a nasogastric tube be
inserted? - ANSWERAny trauma to the nose
cocaine abuser, septal defect
suspected basilar skull fx.
VERIFIED SOLUTIONS
,What are the 4 maneuvers of performing a physical exam? - ANSWERInspect.
Auscultate.
Palpate.
Percuss.
What are the 5 priorities of the primary survey? - ANSWERA - Airway
access/maintenance and c-spine control.
B - Breathing and ventilatory status: assess/support.
C - Circulation and hemorrhage control.
D - Disability/neurological status.
E - Expose.
At what point in the primary survey are life-saving interventions performed? -
ANSWERprimary survey as soon as life-threats are identified.
During which phase of assessments are vital signs counted/measured for the first time?
- ANSWERSecondary Survey.
At what point in the assessment should TNS assume and take precautions to prevent
further c-spine injury? - ANSWERmulti-system trauma
appropriate MOI
altered LOC
injury above clavicles from blunt trauma
List the expected outcomes of airway resuscitation/mgmt in the trauma pt. -
ANSWERVentilations are quiet w/o stridor or retractions.
Pt speaks or makes appropriate sounds.
Chest rises and falls easily w/ spontaneous/assisted ventilations.
Foreign material not visible in upper airway.
List at least 4 things a TNS should inspect for when exposing the chest during the
primary survey. - ANSWER- Appearance of chest: contour and integrity of chest wall
- Symmmetry of expansion and adequacy of excursion
- contusions, abrasions, lacerations, and penetrating wounds
- Use of assessory muscles, nasal flaring, tracheal tugging or retractions.
What is the difference between central and peripheral cyanosis? - ANSWERCentral:
lips, mucous membranes, conjunctiva; late signs of hypoxia.
Peripheral: nailbeds; Occurs when tissues extract more oxygen from blood than normal.
How many grams of desaturated Hgb are necessary to produce cyanosis in the tissues?
- ANSWER5 g/dL of Hgb.
,Is cyanosis an early or late sign of hypoxia? - ANSWERCentral cyanosis is a late sign.
What 2 immediate life threats should be suspected if a pt with a chest trauma presents
with jugular vein distention? - ANSWERTension pneumonthorax.
Pericardial tamponade.
What info. can be determined by palpating the chest during the primary survey? -
ANSWER- Pain, point tenderness
- deformity, chest wall expansion
- rib mobility, instability, abnormal movements
- crepitus: bony vs. subcutaneous
- skin temperature/moisture
- subcutaneous emphysema
- tactile fremitus - vibration of chest wall.
List 3 sounds that should be detected w/o a stethoscope during the primary survey that
suggest a partial airway obstruction. - ANSWERSnoring.
Gurgling.
Stridor.
What is the most ominous sound when auscultating the chest wall of a trauma pt in
severe ventilatory distress? - ANSWERSilence.
Under what circumstances may a pt have a pulse oximetry reading of over 95% in the
presence of severe hypoxia? - ANSWER- anemia
- abnormal forms of Hgb are present.
- Carboxyhemoglobin.
What 3 immediate life-threats that must be found during the breathing/oxygenation
phase of the primary survey? - ANSWERTension pneumothorax.
Open pneumothorax.
Flail chest.
If a pt has a radial pulse, the minimum Systolic BP is :
If a pt has a carotid pulse, the minimum Systolic BP is:
If a pt has a femoral pulse, the minimum Systolic BP is: - ANSWER80 - 90 mmHg.
60 mmHg.
70 mmHg.
Under what circumstances may the usual tachycardic response to volume lass be
absent? - ANSWERelderly
beta or calcium blockers.
, neurogenic shock.
If the pt has a irregular pulse, a TNS should immediately apply a ___________? -
ANSWERCardiac monitor.
What 3 factors should be assessed to determine perfusion adequacy during the primary
survey? - ANSWERPulses.
Skin signs.
Mental status.
What should be assessed relative to the nature of uncontrolled external bleeding? -
ANSWERType of bleeding.
Amount of blood loss.
Rate of blood loss.
List 2 immediate life-threatening conditions that must be found during the cardiac
portions of the primary survey? - ANSWERCardiac tamponade.
Shock.
What are the progressive steps of external hemorrhage control of a mangled extremity?
- ANSWERDirect pressure.
Pressure points.
Tourniquets.
What is the most sensitive indicator of cerebral perfusion and brain function? -
ANSWERLOC.
A pt with head trauma repeats his name over and over again but does not answer
questions. What score should be given to this verbal response? -
ANSWERInappropriate words.
A pt does not obey commands, but moves his arm towards a pain stimulus and
attempts to grab at it or push it away with purposeful movement. What GCS score
should be given to this motor response? - ANSWERLocalize pain (protective response).
Where on an apparently unconscious pt's body should a TNS first apply a pain stimulus
to determine initial LOC? - ANSWERThrough a cranial nerve - orbital rim or ear lobe.
When should a TNS first assess the back? Primary or secondary survey? -
ANSWERprimary survey during E - Exposure portion.
Under what circumstances should an orogastric as opposed to a nasogastric tube be
inserted? - ANSWERAny trauma to the nose
cocaine abuser, septal defect
suspected basilar skull fx.
