TNCC Initial Written Assessment Questions and Answers 2024 What are the guidelines for field triage of injured patients? - answer Transport patients with the greatest degree of injury to highest level of care.
Examples of physiologic derangements. - answer GCS <13
SBP <90
RR <10 or >29
Need for ventilatory support
Examples of anatomical injuries. - answer Open or decompressed skull
Penetrating injuries to head, neck, torso, extremities proximal elbow or knee
Flail chest
Crushed, mangled, pulseless extremity
Amputation proximal wrist/ankle
Long-bone fx
Pelvic fx
Paralysis
Examples of mechanism of injury (MOI) and high-energy impact. - answer Falls >20 ft for adults
Falls >10 ft for children
MVC (roof intrusion, body ejection, passenger death)
Auto vs. ped
Motorcycle crash >20 mph Which special population group should be triaged to trauma center? - answer Age >55 with SBP <110 (might represent shock)
Elderly with ground level falls
Pediatrics
Anticoagulants & bleeding disorders
Burns
Pregnancy >20 weeks
Steps in the Trauma Nursing Process (TNP) - answer Mnemonic that helps trauma nurse assess and intervene life-threatening injuries: A-J
A Across the room assessment for uncontrolled hemorrhage
B Breathing and ventilation
C Circulation and control of hemorrhage
D Disability (neuro status)
E Exposure and environmental control
F Full set of VS; Family presence
G Get devises and Give comfort via LMNOP
H Hx and Head-to-toe assessment
I Inspect posterior surfaces
J Just keep reevaluating A-I
List resuscitation monitoring devices and support. - answer L Labs
M monitor EKG
N NGT or OGT decompression O Oxygen (SaO2) vs ventilation (ETCO2)
P Pain assessment & management
Difference between primary and secondary survey - answer Primary: A-E
Secondary: H-J
When is the appropriate time to perform secondary survey? - answer After initiating resuscitative efforts (A-E), when vital functions have stabilized, and after additional monitoring have been considered (F-G).
What are important aspects of patient history? - answer S Symptoms of illness or injury
A Allergies
M Medication used, including anticoag
P PMH, including hospitalizations and surgeries
L Last oral intake/menstruation
E Events and environmental factors related to injury
What comorbid conditions or special considerations increase the patient's risk for complications? - answer Age <55 or pediatrics
Burns
Pregnancy
Disabilities (physical, mental, emotional)
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - answer Base deficit used in conjunction with serum lactate
Examples of physiologic derangements. - answer GCS <13
SBP <90
RR <10 or >29
Need for ventilatory support
Examples of anatomical injuries. - answer Open or decompressed skull
Penetrating injuries to head, neck, torso, extremities proximal elbow or knee
Flail chest
Crushed, mangled, pulseless extremity
Amputation proximal wrist/ankle
Long-bone fx
Pelvic fx
Paralysis
Examples of mechanism of injury (MOI) and high-energy impact. - answer Falls >20 ft for adults
Falls >10 ft for children
MVC (roof intrusion, body ejection, passenger death)
Auto vs. ped
Motorcycle crash >20 mph Which special population group should be triaged to trauma center? - answer Age >55 with SBP <110 (might represent shock)
Elderly with ground level falls
Pediatrics
Anticoagulants & bleeding disorders
Burns
Pregnancy >20 weeks
Steps in the Trauma Nursing Process (TNP) - answer Mnemonic that helps trauma nurse assess and intervene life-threatening injuries: A-J
A Across the room assessment for uncontrolled hemorrhage
B Breathing and ventilation
C Circulation and control of hemorrhage
D Disability (neuro status)
E Exposure and environmental control
F Full set of VS; Family presence
G Get devises and Give comfort via LMNOP
H Hx and Head-to-toe assessment
I Inspect posterior surfaces
J Just keep reevaluating A-I
List resuscitation monitoring devices and support. - answer L Labs
M monitor EKG
N NGT or OGT decompression O Oxygen (SaO2) vs ventilation (ETCO2)
P Pain assessment & management
Difference between primary and secondary survey - answer Primary: A-E
Secondary: H-J
When is the appropriate time to perform secondary survey? - answer After initiating resuscitative efforts (A-E), when vital functions have stabilized, and after additional monitoring have been considered (F-G).
What are important aspects of patient history? - answer S Symptoms of illness or injury
A Allergies
M Medication used, including anticoag
P PMH, including hospitalizations and surgeries
L Last oral intake/menstruation
E Events and environmental factors related to injury
What comorbid conditions or special considerations increase the patient's risk for complications? - answer Age <55 or pediatrics
Burns
Pregnancy
Disabilities (physical, mental, emotional)
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - answer Base deficit used in conjunction with serum lactate
