Page 1 of 47
TNCC 9th Edition FIINAL Exam 300 TEST
Questions and Verified Solutions Latest
Update This Year
A pt with a lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medication. Which of the following is the priority nursing
intervention?
Elevating the leg to the LEVEL of the heart
(compression/crush- level of the heart)
(regular fracture- above the heart)
A pt involved in a high-speed rollover is complaining of increased difficulty breathing. There is
a small penetrating wound to the 6th intercostal space in the left lateral chest. Which finding
is most consistent with an injury to the diaphragm?
Bowel sounds heard in the lower left chest
A pt has been in the emergency department for several hours waiting to be admitted. They
sustained multiple rib fractures and a femur fracture after a fall. The pt has been awake,
alert, and complaining of leg pain. Their spouse reported that the pt suddenly became
anxious and confused. Upon reassessment, the pt is restless, with respiratory distress and
1
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petechiae to his neck. The pt is exhibiting signs and symptoms most commonly associated
with which of the following conditions?
Fat embolism
3 adult pts present at different times during a 1-hour period with a high fever, fatigue, and
headache. All 3 pts have a rash which started on their mouth, face, and arms with
progression to the chest and abdomen. They all visited the same grocery store within the last
week. What is the most appropriate intervention from triage for these pts?
Immediately initiate contact precautions
An adult pt who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. the PaCO2 is
30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most
important intervention to manage the cerebral blood flow?
Decrease the rate of manual ventilation
An older adult presents to the emergency department with complaints of dizziness,
headache, and nausea. The pt 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 pt is currently on
anticoagulant therapy. What is most likely the cause of their symptoms?
post-concussive syndrome
2
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A 35-year-old male presents with facial trauma after being struck in the face with a baseball.
A teardrop-shaped left pupil is noted on exam.
Witai type of injury is suspecied?
Globe rupture
A trauma patient who is 30 - weeks pregnant arrives at the emergency department following
a motor vehicle collision Which normal physiologic change should be considered when
assessing ventilatory status ?
Increased oxygen consumption
A patient who sustained severe injuries was brought to the emergency department following
a high - speed motor vehicle collision . Interventions for hypovolemic shock have been
initiated . What component of the trauma triad of death is most likely to have begun at the
time of injury ?
Coagulopathy
An adult patient involved in a motor vehicle collision is brought to the emergency
department of a rural critical access facility . They complain of neck pain , shortness of breath
, and diffuse abdominal pain . The Glasgow Coma Score is 15. Vital signs are : BP 98/71 mm
Hg , HR 125 beats / minute , RR 26 breaths / minute , and SpO2 94 % on high - flow oxygen via
non - rebreather mask . Which of the following is the priority intervention for this patient ?
Expedite transfer to the closest trauma center
3
, Page 4 of 47
A patient who weighs 120 kg is brought to the emergency department after sustaining partial
thickness burns to both upper extremities and chest with a total body surface area burned of
27 % . How much intravenous fluid should be administered in the first 8 hours ?
3240 mL
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 ?
Disseminated intravascular coagulopathy
A patient is brought to the emergency department following a snowmobile crash with
prolonged exposure time prior to transport . The patient is confused . Vital signs are BP 96/54
mm Hg , HR 114 beats / minute , RR 24 breaths / minute , T 34.60C ( 94.20F ) and an SpO2 of
90 % on oxygen at 15L per non - rebreather mask . Other findings include ETCO2 24 , scrum
lactate of 6 mmol / L , and a pH of 6.8 . Based on these findings what is the most appropriate
intervention
Initiate warming measures
Which of the following is a late sign of increased intracranial pressure ?
Decreased respiratory effort
Based on fall mechanism , which patient warrants prehospital transfer to a trauma center ?
4
TNCC 9th Edition FIINAL Exam 300 TEST
Questions and Verified Solutions Latest
Update This Year
A pt with a lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medication. Which of the following is the priority nursing
intervention?
Elevating the leg to the LEVEL of the heart
(compression/crush- level of the heart)
(regular fracture- above the heart)
A pt involved in a high-speed rollover is complaining of increased difficulty breathing. There is
a small penetrating wound to the 6th intercostal space in the left lateral chest. Which finding
is most consistent with an injury to the diaphragm?
Bowel sounds heard in the lower left chest
A pt has been in the emergency department for several hours waiting to be admitted. They
sustained multiple rib fractures and a femur fracture after a fall. The pt has been awake,
alert, and complaining of leg pain. Their spouse reported that the pt suddenly became
anxious and confused. Upon reassessment, the pt is restless, with respiratory distress and
1
, Page 2 of 47
petechiae to his neck. The pt is exhibiting signs and symptoms most commonly associated
with which of the following conditions?
Fat embolism
3 adult pts present at different times during a 1-hour period with a high fever, fatigue, and
headache. All 3 pts have a rash which started on their mouth, face, and arms with
progression to the chest and abdomen. They all visited the same grocery store within the last
week. What is the most appropriate intervention from triage for these pts?
Immediately initiate contact precautions
An adult pt who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. the PaCO2 is
30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most
important intervention to manage the cerebral blood flow?
Decrease the rate of manual ventilation
An older adult presents to the emergency department with complaints of dizziness,
headache, and nausea. The pt 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 pt is currently on
anticoagulant therapy. What is most likely the cause of their symptoms?
post-concussive syndrome
2
, Page 3 of 47
A 35-year-old male presents with facial trauma after being struck in the face with a baseball.
A teardrop-shaped left pupil is noted on exam.
Witai type of injury is suspecied?
Globe rupture
A trauma patient who is 30 - weeks pregnant arrives at the emergency department following
a motor vehicle collision Which normal physiologic change should be considered when
assessing ventilatory status ?
Increased oxygen consumption
A patient who sustained severe injuries was brought to the emergency department following
a high - speed motor vehicle collision . Interventions for hypovolemic shock have been
initiated . What component of the trauma triad of death is most likely to have begun at the
time of injury ?
Coagulopathy
An adult patient involved in a motor vehicle collision is brought to the emergency
department of a rural critical access facility . They complain of neck pain , shortness of breath
, and diffuse abdominal pain . The Glasgow Coma Score is 15. Vital signs are : BP 98/71 mm
Hg , HR 125 beats / minute , RR 26 breaths / minute , and SpO2 94 % on high - flow oxygen via
non - rebreather mask . Which of the following is the priority intervention for this patient ?
Expedite transfer to the closest trauma center
3
, Page 4 of 47
A patient who weighs 120 kg is brought to the emergency department after sustaining partial
thickness burns to both upper extremities and chest with a total body surface area burned of
27 % . How much intravenous fluid should be administered in the first 8 hours ?
3240 mL
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 ?
Disseminated intravascular coagulopathy
A patient is brought to the emergency department following a snowmobile crash with
prolonged exposure time prior to transport . The patient is confused . Vital signs are BP 96/54
mm Hg , HR 114 beats / minute , RR 24 breaths / minute , T 34.60C ( 94.20F ) and an SpO2 of
90 % on oxygen at 15L per non - rebreather mask . Other findings include ETCO2 24 , scrum
lactate of 6 mmol / L , and a pH of 6.8 . Based on these findings what is the most appropriate
intervention
Initiate warming measures
Which of the following is a late sign of increased intracranial pressure ?
Decreased respiratory effort
Based on fall mechanism , which patient warrants prehospital transfer to a trauma center ?
4
