TNCC 9th Edition Test Exam Questions And Answers Verified 100% Correct

TNCC 9th Edition Test Exam Questions And Answers Verified 100% Correct Describe the measurement of an NPA - ANSWER Measure from the tip of the patient's nose to the tip of the patients earlobe. Measurement of an OPA - ANSWER Place the proximal end or flange of the airway adjunct at the corner of the mouth to the tip of the mandibular angle. True or false: NPAs and OPAs are definitive airways. - ANSWER False. When placing one of these? One should consider the potential need for a definitive airway. Name the three ways to confirm ETT placement - ANSWER Placement of a CO2 monitoring device, Assessing for equal chest rise and fall, and listening at the epigastrium and four lung fields for equal breath sounds. When capnography measurement reads greater than 45MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSWER Increasing the ventilation rate. Doing so would allow the patient to blow off retained CO2. When capnography measurement reads less than 35MMHG, the nurse should consider increasing or decreasing the ventilation rate? - ANSWER Decreasing the ventilation rate. By doing so, the nurse allows the patient to retain CO2. What are the three stages of shock - ANSWER Compensated, decompensated or progressive, and irreversible. What are the signs of compensated shock? - ANSWER Anxiety, confusion, restlessness, increased respiratory rate, narrowing pulse pressure were diastolic increases yet systolic remains unchanged, tachycardia with bounding pulses, and decreased urinary output What are the signs and symptoms of decompensated shock? - ANSWER Decreased level of consciousness, hypertension, narrow pulse pressure, tachycardia with weak pulses, tachypnea, skin that is cool clammy and cyanotic, base access outside the normal range, and serum lactate levels greater than two to 4MMOL/L. What are the signs and symptoms of irreversible shock? - ANSWER Obtunded stuporous or comatose state, marked hypertension and heart failure, bradycardia with possible dysrhythmias, decreased and shallow respiratory rate, pale cool and clammy skin, kidney liver and other organ failure, severe acidosis, elevated lactic acid levels, worsening base access on ABGs, coagulopathies with petechiae purpura or bleeding. What are the four types of shock? - ANSWER Hypovolemic, Cardiogenic, Obstructive, & Distributive What is the trauma triad of death? - ANSWER hypothermia, acidosis, coagulopathy Describe the characteristics of obstructive shock - ANSWER Obstructive shock is it mechanical problem that results from hypoperfusion of the tissue due to an obstruction in either the vasculature or the heart resulting in decreased cardiac output. Some causes include a tension pneumothorax, cardiac tamponade, or venous air embolism on the right side of the heart during systole in the pulmonary artery.Signs include anxiety, muffled heart sounds, JVD, hypertension, chest pain, difficulty breathing, or pulses paradoxes. Describe the characteristics of cardiogenic shock - ANSWER Cardiogenic shock results from pump failure in the presence of adequate intravascular volume. Lack of cardiac output and an organ perfusion occurs secondary to a decrease in myocardial contractility and or valvular insufficiency. This can happen with blunt cardiac trauma or an MI. Symptoms can include low blood pressure increase heart rate and respiratory rate chest pain shortness of breath dysrhythmias increase troponin and pale cool moist skin Describe the characteristics of distributive shock. - ANSWER Distributive shock occurs as a result of Mel distribution of an adequate circulating blood volume with the loss of vascular tone or increased permeability. This can occur with spinal cord injuries, sepsis, or anaphylaxis. Symptoms include low blood pressure heart rate respiratory rate preload and afterload, spinal tenderness, difficulty breathing, warm pink and dry skin with a cool core temperature. Describe the characteristics of hypovolemic shock - ANSWER Hypovolemia is caused by a decrease in the amount of circulating volume usually caused by massive bleeding, but also can be from vomiting and diarrhea. Characteristics include low blood pressure and preload, increase heart rate respiratory rate and afterload, with contractility unchanged. Signs include obvious bleeding, weak peripheral pulses, pale cool and moist skin, distended abdomen, pelvic fracture, or bruise swollen and deformed extremities especially long bones. What is the recommended fluid bolus for a trauma? - ANSWER 500 ML's of warmed isotonic crystalloid. Ongoing fluid boluses of 500 ML's should be given judiciously with constant reassessments after administration. What is the minimum permissive hypertension and a trauma patient? - ANSWER A systolic of greater than or equal to 90 MMHG What is Cullen's sign and its significance? - ANSWER Cullens sign is periumbilical bruising and is indicative of intraperitoneal bleeding Define Cushing's triad - ANSWER Bradycardia, progressive hypertension (widening pulse pressure), and decreased respiratory effort What are the early signs of increased Intracranial pressure - ANSWER headache, vomiting, behavioral changes that begin with restlessness and may progress to confusion, drowsiness, or impaired judgment