TNCC Written Exam
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of
resuscitation? - (correct Answer) - Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - (correct
Answer) - Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - (correct Answer) - Metabolic acidosis
What type of shock results in generalized vasodilation? - (correct Answer) - Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - (correct Answer) -
Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? - (correct Answer) -
Compartment Syndrome
What is a high risk of frostbite? - (correct Answer) - Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along with
rewarming? - (correct Answer) - Tissue plasminogen activator or non steroidal anti-inflammatory
medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - (correct Answer) - Peripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient? - (correct Answer) -
Reverse Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or
penetrating injuries? - (correct Answer) - Secondary Phase
What phase of a blast results from any explosion-related illness or injury including hyperglycemia,
hypertension, angina, asthma, COPD, or sepsis? - (correct Answer) - Quaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or
any hard object? - (correct Answer) - Tertiary Phase
What phase of a blast results from impact of the over and under pressurization wave with body surfaces.
Injuries include blast lung, tympanic membrane rupture, abdominal hemorrhage, globe rupture, and
mild traumatic brain injury? - (correct Answer) - Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or malaise,
and elevated creatinine kinase levels? - (correct Answer) - Rhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea,
adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - (correct
Answer) - Pulmonary Embolus
, Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of
consciousness? - (correct Answer) - Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure,
abnormal motor posturing, bradycardia, and decreased respiratory effort? - (correct Answer) - Late signs
of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery? - (correct Answer) -
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. -
(correct Answer) - Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. - (correct Answer) -
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - (correct Answer) - MAP - ICP
What is the range for CO2 to maximize perfusion? - (correct Answer) - 35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - (correct Answer) -
Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - (correct Answer) - Constriction d/t low CO2
Pupils with pressure on cranial nerve - (correct Answer) - Fixed and dilated
Pupils with opiates vs stimulants - (correct Answer) - small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - (correct Answer) - large
Sluggish reaction of pupils is an early sign of what? - (correct Answer) - Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - (correct Answer) - Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - (correct Answer) - <15
Goal value for Cerebral Perfusion Pressure (CPP) - (correct Answer) - >60
Le Fort Fracture - (correct Answer) - Fracture of the maxilla
What decrease ICP by decreasing cellular edema? - (correct Answer) - Osmotic diuretics (such as 3%
saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - (correct Answer) - Cardiac
Tamponade;
1. Hypotension
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of
resuscitation? - (correct Answer) - Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - (correct
Answer) - Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - (correct Answer) - Metabolic acidosis
What type of shock results in generalized vasodilation? - (correct Answer) - Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - (correct Answer) -
Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? - (correct Answer) -
Compartment Syndrome
What is a high risk of frostbite? - (correct Answer) - Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along with
rewarming? - (correct Answer) - Tissue plasminogen activator or non steroidal anti-inflammatory
medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - (correct Answer) - Peripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient? - (correct Answer) -
Reverse Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or
penetrating injuries? - (correct Answer) - Secondary Phase
What phase of a blast results from any explosion-related illness or injury including hyperglycemia,
hypertension, angina, asthma, COPD, or sepsis? - (correct Answer) - Quaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or
any hard object? - (correct Answer) - Tertiary Phase
What phase of a blast results from impact of the over and under pressurization wave with body surfaces.
Injuries include blast lung, tympanic membrane rupture, abdominal hemorrhage, globe rupture, and
mild traumatic brain injury? - (correct Answer) - Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or malaise,
and elevated creatinine kinase levels? - (correct Answer) - Rhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough, orthopnea,
adventitious lung sounds, decreased lung sounds, jugular vein distention, or hypotension? - (correct
Answer) - Pulmonary Embolus
, Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level of
consciousness? - (correct Answer) - Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure,
abnormal motor posturing, bradycardia, and decreased respiratory effort? - (correct Answer) - Late signs
of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery? - (correct Answer) -
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. -
(correct Answer) - Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. - (correct Answer) -
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - (correct Answer) - MAP - ICP
What is the range for CO2 to maximize perfusion? - (correct Answer) - 35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - (correct Answer) -
Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - (correct Answer) - Constriction d/t low CO2
Pupils with pressure on cranial nerve - (correct Answer) - Fixed and dilated
Pupils with opiates vs stimulants - (correct Answer) - small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - (correct Answer) - large
Sluggish reaction of pupils is an early sign of what? - (correct Answer) - Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - (correct Answer) - Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - (correct Answer) - <15
Goal value for Cerebral Perfusion Pressure (CPP) - (correct Answer) - >60
Le Fort Fracture - (correct Answer) - Fracture of the maxilla
What decrease ICP by decreasing cellular edema? - (correct Answer) - Osmotic diuretics (such as 3%
saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - (correct Answer) - Cardiac
Tamponade;
1. Hypotension
