TNCC EVALUATION LATEST EXAM QUESTIONS AND
ANSWERS FIRM A+
✔✔Why is alertness included in the airway assessment? - ✔✔this assessment helps the
RN to evaluate the patient's ability to protect their own airway
✔✔When an intervention is taken during a primary survey, what must the nurse do after
the intervention? - ✔✔once an intervention is established, continue down the list of the
A-E mneumonic to look for other life threatening injuries
✔✔What are the components of secondary survey? - ✔✔History and Head to Toe
Inspecting the Posterior Surface
✔✔What laboratory test are commonly utilized for trauma patients? - ✔✔Type and
Screen
CBC
CMP
Preg
Tox Screen
Lactic acid
Blood gas or ABG
✔✔What should the nurse reevaluate when the patient is in their care? - ✔✔vital signs
any interventions and their effectiveness
primary assessment
pain
✔✔What are the differences between ventilation, diffusion, perfusion? - ✔✔Ventilation:
the active, mechanical movement of air into and out of the lungs
Diffusion: the passive movement of gases from an area of higher concentration to an
area of lower concentration
Perfusion: the movement of blood to and from the lungs as the delivery medium of
oxygen to the entire body
✔✔What are possible causes of airway obstruction and a trauma patient? What
interventions address the causes of airway obstruction - ✔✔Altered LOC
Maxiollofacial trauma
neck or laryngeal trauma
obesity
(provide oxygen, prepare for intubation, Nasopharynx, oraopharynx)
✔✔What is the difference between airway, adjunct, and definite airway? - ✔✔airway:
natural passageway of air into the body
Adjunct: (naso or oropharynx) stenting open the upper airway to enable spontaneous
patient respirations
,Definite: (ETT tube) a tube that has been securely placed in the trachea with the cuff
inflated bewlo the vocal cords in an emergency or trauma situation
✔✔Is there a difficult airway care at your facility? If so, where is it located? - ✔✔in the
intubation box or respiratory
✔✔What is the difference between Normoxia and hyperoxia? - ✔✔normoxia: normal O2
levels in the body,
Hyperoxia: elevated oxygen levels from giving too much O2, can lead to oxygen
poisoning and lung inflamation
✔✔What is the most common type of shock in trauma patients? What are possible
interventions to manage, uncontrolled external hemorrhage? - ✔✔the most common
type of shock is hypovolemic in traumas. Possible interventions are: tourniquets,
damage control resuscitation, fluid resusitation, massive transfusion, calcium chloride
replacement, auto-transfusion, REBOA, damage control surgeries, and tranexamic acid
✔✔What are causes of obstructive shock? - ✔✔-tension penumothorax
-cardiac tamponade
-venous air embolism
✔✔What type of shock may occur following a spinal cord injury in which there is a loss
of sympathetic intervention below the level of injury? - ✔✔neurogenic shock
✔✔What are some possible interventions for cardiogenic shock? - ✔✔- inotropic
support
- antidysrhythmic medications
- correction or treatment of underlying causes
✔✔What is damage control resuscitation? - ✔✔rapid restoration of homeostasis through
the control of hemorrhage, administration of blood, and other interventions directed
toward the prevention of the trauma triad of death
✔✔What type of rapid fluid infuser is used at your facility? Where is the equipment
located? - ✔✔-Level 1 H-1200 in the trauma rooms
✔✔Why is it critical to rapidly recognize an intervene during compensatory stage of
shock? - ✔✔by intervening early, you are able to maintain a blood pressure and tissue
perfusion. more perfusion=more live tissues
✔✔What two physiological abnormalities should be avoided to prevent secondary brain
injury in a patient with a traumatic brain injury? - ✔✔hypoxia and hypotension
, ✔✔What are early indications for increasing intracranial pressure? - ✔✔severe
headache, nausea, vomiting, blurred vision, change in mental status
✔✔What are the three signs of Cushing's triad and why is it ominous when these three
signs are present? - ✔✔-widening pulse pressure
-reflex bradycardia
irregular, decreased respiratory effort
✔✔What focal brain injury is typically caused by arterial bleeding versus Venus
bleeding? - ✔✔arterial: epidural hematoma
venous: subdural hematoma
✔✔What mechanism of injury is associated with major injuries to the thorax? - ✔✔blunt
traumas such as MVCs, fall from heights, sports related injuries
✔✔What injuries are associated with fractures the thorax? What is significance of a flail
chest and what interventions should be anticipated? - ✔✔typically pneumothorax,
pulmonary contusion, lacerated organs, and/or flail chest. Flail chest is significant
because is causes parodoxical chest movement, leading to severe respiratory
compromise. Interventions include supplemental O2, prep for intubation, possible
surgery
✔✔What are the three signs of Beck's triad? What are the limitations when assessing
these sign signs when a patient is hypovolemic? - ✔✔Beck's triad includes:
hypotension, distended neck veins, muffled heart sounds. Hypovolemia may prevent
distention of neck veins and the often loud trauma bay may disallow identifying muffled
heart sounds
✔✔What is the most important intervention for a patient in acute respiratory distress
with tachycardia, hypotension, jugular vein, distention, and unilateral absent breath
sounds? - ✔✔needle decompression of a tension pneumothorax
✔✔What are the differences between a simple (closed) pneumothorax and a complex
or communicating open pneumothorax? What causes progression to a tension
pneumothorax? - ✔✔A simple (closed) pneumothorax occurs when air leaks from the
lung into the pleural space without a chest wall injury, while a complex or
communicating open pneumothorax happens when a wound in the chest wall allows air
from the outside to directly enter the pleural space, creating a communication between
the outside atmosphere and the chest cavity. Tension pneumo is caused by the air
entering the pleural space but cannot escape on expiration
✔✔What interventions should the nurse anticipate for a patient with a massive
hemothorax? - ✔✔-prep for a chest tube
- 2 large bore IVs
ANSWERS FIRM A+
✔✔Why is alertness included in the airway assessment? - ✔✔this assessment helps the
RN to evaluate the patient's ability to protect their own airway
✔✔When an intervention is taken during a primary survey, what must the nurse do after
the intervention? - ✔✔once an intervention is established, continue down the list of the
A-E mneumonic to look for other life threatening injuries
✔✔What are the components of secondary survey? - ✔✔History and Head to Toe
Inspecting the Posterior Surface
✔✔What laboratory test are commonly utilized for trauma patients? - ✔✔Type and
Screen
CBC
CMP
Preg
Tox Screen
Lactic acid
Blood gas or ABG
✔✔What should the nurse reevaluate when the patient is in their care? - ✔✔vital signs
any interventions and their effectiveness
primary assessment
pain
✔✔What are the differences between ventilation, diffusion, perfusion? - ✔✔Ventilation:
the active, mechanical movement of air into and out of the lungs
Diffusion: the passive movement of gases from an area of higher concentration to an
area of lower concentration
Perfusion: the movement of blood to and from the lungs as the delivery medium of
oxygen to the entire body
✔✔What are possible causes of airway obstruction and a trauma patient? What
interventions address the causes of airway obstruction - ✔✔Altered LOC
Maxiollofacial trauma
neck or laryngeal trauma
obesity
(provide oxygen, prepare for intubation, Nasopharynx, oraopharynx)
✔✔What is the difference between airway, adjunct, and definite airway? - ✔✔airway:
natural passageway of air into the body
Adjunct: (naso or oropharynx) stenting open the upper airway to enable spontaneous
patient respirations
,Definite: (ETT tube) a tube that has been securely placed in the trachea with the cuff
inflated bewlo the vocal cords in an emergency or trauma situation
✔✔Is there a difficult airway care at your facility? If so, where is it located? - ✔✔in the
intubation box or respiratory
✔✔What is the difference between Normoxia and hyperoxia? - ✔✔normoxia: normal O2
levels in the body,
Hyperoxia: elevated oxygen levels from giving too much O2, can lead to oxygen
poisoning and lung inflamation
✔✔What is the most common type of shock in trauma patients? What are possible
interventions to manage, uncontrolled external hemorrhage? - ✔✔the most common
type of shock is hypovolemic in traumas. Possible interventions are: tourniquets,
damage control resuscitation, fluid resusitation, massive transfusion, calcium chloride
replacement, auto-transfusion, REBOA, damage control surgeries, and tranexamic acid
✔✔What are causes of obstructive shock? - ✔✔-tension penumothorax
-cardiac tamponade
-venous air embolism
✔✔What type of shock may occur following a spinal cord injury in which there is a loss
of sympathetic intervention below the level of injury? - ✔✔neurogenic shock
✔✔What are some possible interventions for cardiogenic shock? - ✔✔- inotropic
support
- antidysrhythmic medications
- correction or treatment of underlying causes
✔✔What is damage control resuscitation? - ✔✔rapid restoration of homeostasis through
the control of hemorrhage, administration of blood, and other interventions directed
toward the prevention of the trauma triad of death
✔✔What type of rapid fluid infuser is used at your facility? Where is the equipment
located? - ✔✔-Level 1 H-1200 in the trauma rooms
✔✔Why is it critical to rapidly recognize an intervene during compensatory stage of
shock? - ✔✔by intervening early, you are able to maintain a blood pressure and tissue
perfusion. more perfusion=more live tissues
✔✔What two physiological abnormalities should be avoided to prevent secondary brain
injury in a patient with a traumatic brain injury? - ✔✔hypoxia and hypotension
, ✔✔What are early indications for increasing intracranial pressure? - ✔✔severe
headache, nausea, vomiting, blurred vision, change in mental status
✔✔What are the three signs of Cushing's triad and why is it ominous when these three
signs are present? - ✔✔-widening pulse pressure
-reflex bradycardia
irregular, decreased respiratory effort
✔✔What focal brain injury is typically caused by arterial bleeding versus Venus
bleeding? - ✔✔arterial: epidural hematoma
venous: subdural hematoma
✔✔What mechanism of injury is associated with major injuries to the thorax? - ✔✔blunt
traumas such as MVCs, fall from heights, sports related injuries
✔✔What injuries are associated with fractures the thorax? What is significance of a flail
chest and what interventions should be anticipated? - ✔✔typically pneumothorax,
pulmonary contusion, lacerated organs, and/or flail chest. Flail chest is significant
because is causes parodoxical chest movement, leading to severe respiratory
compromise. Interventions include supplemental O2, prep for intubation, possible
surgery
✔✔What are the three signs of Beck's triad? What are the limitations when assessing
these sign signs when a patient is hypovolemic? - ✔✔Beck's triad includes:
hypotension, distended neck veins, muffled heart sounds. Hypovolemia may prevent
distention of neck veins and the often loud trauma bay may disallow identifying muffled
heart sounds
✔✔What is the most important intervention for a patient in acute respiratory distress
with tachycardia, hypotension, jugular vein, distention, and unilateral absent breath
sounds? - ✔✔needle decompression of a tension pneumothorax
✔✔What are the differences between a simple (closed) pneumothorax and a complex
or communicating open pneumothorax? What causes progression to a tension
pneumothorax? - ✔✔A simple (closed) pneumothorax occurs when air leaks from the
lung into the pleural space without a chest wall injury, while a complex or
communicating open pneumothorax happens when a wound in the chest wall allows air
from the outside to directly enter the pleural space, creating a communication between
the outside atmosphere and the chest cavity. Tension pneumo is caused by the air
entering the pleural space but cannot escape on expiration
✔✔What interventions should the nurse anticipate for a patient with a massive
hemothorax? - ✔✔-prep for a chest tube
- 2 large bore IVs
