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TNCC Which of the following mnemonics can help a nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? - MARCH You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain on palpitation, fundal height at the costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on cardiotocography. These findings are most consistent with which of the following? - Placental abruption Which of the following is NOT considered goal-directed therapy for cardiogenic shock? - Pericardiocentesis A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is expected with a musculoskeletal complication associated with this presentation? - Elevated creatinine kinase Tearing of the bridging veins is most frequently associated with which brain injury? - Subdural hematoma What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? - Pulse oximetry and capnography Which of the following is a possible complication of positive-pressure ventilation? - Worsening pneumothorax Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? - Hypotension that worsens with inspiration A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were B/P 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Current vital signs are B/P 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which stage of shock? - Compensated Which pulse pressure description is an indication of early hypovolemic shock? - Narrowed A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma team's communication? - Loop A 36 year old female has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the next appropriate intervention? - Apply a splint and elevate the extremity above the level of the heart An intubated trauma patient is being transferred to a tertiary care center. After moving the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is the priority intervention? - Check to make sure the ventilator is plugged in Which of the following injuries is LEAST likely to be promptly identified? - bowel Which of the following occurs during the third impact of a motor vehicle crash? - The aorta is torn at its attachment with the ligamentum arteriosum What finding raises suspicion of a complete spinal cord injury? - priapism A 20 year old male presents to the ED complaining of severe lower abdominal pain after landing hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question? - Straight catheter for a urine sample A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? - Elevating the extremity to the level of the heart Which of the following is a late sign of increased intracranial pressure? - nausea and vomiting A 56 year old male patient involved in a motor vehicle crash is brought to the emergency department of a rural critical access facility. He complains of neck pain, shortness of breath, and diffuse abdominal pain. His GCS is 15. His vital signs are as follows: BP 98/71, HR 125, RR26, 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. A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? - Bradycardia and absent motor function below the level of injury Which of the following is a component of the trauma triad of death? - acidosis EMS brings a patient who fell while riding his bicycle. Using the American College of surgeons screening guidelines, which assessment findings would prompt the nurse to prepare the patient for radiologic spine clearance? - Alert with no neurologic deficits EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant damage to the drivers side of the car. The patient is asking to have the cervical collar removed. When is it appropriate to remove the cervical collar? - After a physical examination if the patient has no radiologic abnormalities on a CT scan An elderly patient with a history of anticoagulant use presents after a fall at home that d