TNCC TEST PREPA, TNCC NOTES FOR WRITTEN EXAM
Expedite transfer to the closest trauma center - ANSWER -A 56 y/o M pt
involved in a motor vehicle crash is brought to the ED of a rural critical access
facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15.
His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask.
Which of the following is the priority intervention for this patient?
a pertinent medical hx is crucial - ANSWER -Which of the following
considerations is the most important when caring for a geriatric trauma pt?
Mitigation - ANSWER -Following a review of recent drills and a real disaster
event, a hospital has identified deficiencies and is taking steps to minimize
the impact of a future disaster . Which phase of the disaster life cycle does
this describe?
Multiple requests for water - ANSWER -EMS brings a pt who fell while riding
his bicycle. Using the American College of Surgeobs screening guidelines,
which assessment finding would prompt the RN to prepare the pt for a
radiologic spine clearance?
,hemoglobin does not readily release O2 for use by the tissues - ANSWER -
What is the effect of hypothermia on the oxyhemoglobin dissociation curve?
acidosis - ANSWER -Which of the following is a component of the trauma
triad of death?
Complete - ANSWER -EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12,
temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These
assessment findings are most consistent with which of the following types of
spinal cord injury?
flucuation in the water seal chamber - ANSWER -Which of the following is an
expected finding in a pt with a tube thoracstomy connected to a chest
drainage system?
insert an oropharyngeal airway if there is no gag reflex - ANSWER -During
the primary survey of an unconscious pt with multi-system trauma, the
nurse notes snoring respirations. What priority nursing interventions should
be preformed next?
globe rupture - ANSWER -A 35 y/o M presents with facial trauma after being
struck in the face with a baseball. A teardrop-shaped left pupil is noted on
exam. What type of injury is suspected?
,compensated - ANSWER -A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and
dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx
of which stage of shock?
ventilate with a bag mask device - ANSWER -An unresponsive trauma pt has
an oropharygeal airway in place, shallow and labored respirations, and dusky
skin. The trauma team has administered medications for drug-assisted
intubation and attempted intubation but was unsuccessful. What is the most
appropriate immediate next step?
within 24 hrs of trauma - ANSWER -When is the tertiary survey completed
fora trauma pt?
pressure - ANSWER -An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment syndrome.
What is the most reliable indication of compartment syndrome in a patient
who is unconscious?
worsening pneumothorax - ANSWER -Which of the following is possible
complication of positive-pressure ventilation?
, pelvic stability - ANSWER -the most reassuring finding for a male pt with hip
pain after a fall is which of the following?
narrowed - ANSWER -Which of the following pulse pressures indicate early
hypovolemic shock?
dysrhythmias - ANSWER -Patients with a crush injury should be monitored
for which of the following conditions?
subdural hematoma - ANSWER -Tearing of the bridging veins is most
frequently associated with which brain injury?
straight cath for urine sample - ANSWER -A 20 y/o M presents to the ED
complaining of severe lower abd pain after landing hard on the bicycle cross
bars while preforming an aerial BMX maneuver. Secondary assessment
reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the RN question?
placental abruption - ANSWER -You are caring for a pt who was involved in a
MVC and is 32 weeks pregnant. Findings of your secondary survey include
abd pain on palpation, fundal ht at the costal margin, and some dark bloody
show. Varying accelerations and decelerations are noted on cariocgraphy.
These findings are most consistent with which of the following?
Expedite transfer to the closest trauma center - ANSWER -A 56 y/o M pt
involved in a motor vehicle crash is brought to the ED of a rural critical access
facility. He complains of neck pain, SOB, and diffuse abd pain. His GCS is 15.
His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask.
Which of the following is the priority intervention for this patient?
a pertinent medical hx is crucial - ANSWER -Which of the following
considerations is the most important when caring for a geriatric trauma pt?
Mitigation - ANSWER -Following a review of recent drills and a real disaster
event, a hospital has identified deficiencies and is taking steps to minimize
the impact of a future disaster . Which phase of the disaster life cycle does
this describe?
Multiple requests for water - ANSWER -EMS brings a pt who fell while riding
his bicycle. Using the American College of Surgeobs screening guidelines,
which assessment finding would prompt the RN to prepare the pt for a
radiologic spine clearance?
,hemoglobin does not readily release O2 for use by the tissues - ANSWER -
What is the effect of hypothermia on the oxyhemoglobin dissociation curve?
acidosis - ANSWER -Which of the following is a component of the trauma
triad of death?
Complete - ANSWER -EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12,
temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism. These
assessment findings are most consistent with which of the following types of
spinal cord injury?
flucuation in the water seal chamber - ANSWER -Which of the following is an
expected finding in a pt with a tube thoracstomy connected to a chest
drainage system?
insert an oropharyngeal airway if there is no gag reflex - ANSWER -During
the primary survey of an unconscious pt with multi-system trauma, the
nurse notes snoring respirations. What priority nursing interventions should
be preformed next?
globe rupture - ANSWER -A 35 y/o M presents with facial trauma after being
struck in the face with a baseball. A teardrop-shaped left pupil is noted on
exam. What type of injury is suspected?
,compensated - ANSWER -A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool and
dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx
of which stage of shock?
ventilate with a bag mask device - ANSWER -An unresponsive trauma pt has
an oropharygeal airway in place, shallow and labored respirations, and dusky
skin. The trauma team has administered medications for drug-assisted
intubation and attempted intubation but was unsuccessful. What is the most
appropriate immediate next step?
within 24 hrs of trauma - ANSWER -When is the tertiary survey completed
fora trauma pt?
pressure - ANSWER -An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment syndrome.
What is the most reliable indication of compartment syndrome in a patient
who is unconscious?
worsening pneumothorax - ANSWER -Which of the following is possible
complication of positive-pressure ventilation?
, pelvic stability - ANSWER -the most reassuring finding for a male pt with hip
pain after a fall is which of the following?
narrowed - ANSWER -Which of the following pulse pressures indicate early
hypovolemic shock?
dysrhythmias - ANSWER -Patients with a crush injury should be monitored
for which of the following conditions?
subdural hematoma - ANSWER -Tearing of the bridging veins is most
frequently associated with which brain injury?
straight cath for urine sample - ANSWER -A 20 y/o M presents to the ED
complaining of severe lower abd pain after landing hard on the bicycle cross
bars while preforming an aerial BMX maneuver. Secondary assessment
reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the RN question?
placental abruption - ANSWER -You are caring for a pt who was involved in a
MVC and is 32 weeks pregnant. Findings of your secondary survey include
abd pain on palpation, fundal ht at the costal margin, and some dark bloody
show. Varying accelerations and decelerations are noted on cariocgraphy.
These findings are most consistent with which of the following?
