TNCC Final Exam with Revised Test Q & A 2024 You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr C) 250 mL/hr
D) 125 mL/hr - answer B) 500 mL/hr
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with
which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion - answer B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed C) bounding
D) weak - answer B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls - answer B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration - answer D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total BSA burned, how much IV fluids would be administered in the first 8 hours?
A) 2280 mL B) 3840 mL
C) 4560 mL
D) 7680 mL - answer A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL (half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis - answer A) Acidosis hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient? A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - answer C) expedite transfer to the closest trauma center
An elderly patient with a history of anticoagulant use presents after a fall at home that day. she denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma - answer D) subdural hematoma
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock? A) compensated B) Progressive
C) irreversible
D) decompensated - answer A) compensated
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a) to measure oxygenation and ventilation
A) 1000 mL/hr
B) 500 mL/hr C) 250 mL/hr
D) 125 mL/hr - answer B) 500 mL/hr
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with
which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion - answer B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed C) bounding
D) weak - answer B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls - answer B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax?
A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration - answer D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the total BSA burned, how much IV fluids would be administered in the first 8 hours?
A) 2280 mL B) 3840 mL
C) 4560 mL
D) 7680 mL - answer A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL (half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis - answer A) Acidosis hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient? A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - answer C) expedite transfer to the closest trauma center
An elderly patient with a history of anticoagulant use presents after a fall at home that day. she denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma - answer D) subdural hematoma
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock? A) compensated B) Progressive
C) irreversible
D) decompensated - answer A) compensated
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a) to measure oxygenation and ventilation
