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1.dWhichdofdthedfollowingdrequiresdyoudtoddevelopdadplandofdaction,dinitiatedthedplan,dreasse
ssdthedplandasdcaredfordthedpatientdmovesdforward,danddadjustdthedplandasdthedpatient'sdcon
ditiondordcircumstancesdchange?
A.dPrinciplesdofdPHTLS
B.dThedGoldendPeriod
C.dThedXABCDEdassessment
D.dCriticaldthinkingdprocessd-dansQuestiond1:dD
TodhelpdachievedthedPHTLSdgoals,dyoudwilldapplydyourdcriticaldthinkingdskillsdindthedfield.dCri
ticaldthinkingdindmedicinedisdadprocessdindwhichdthedhealthcaredpractitionerdassessesdthedsit
uation,dthedpatient,danddthedresourcesdavailabledanddusesdthedinformationdtoddecidedondand
dprovidedthedbestdcaredfordthedpatient.
1.dYoudanddyourdpartnerdaredrespondingdtodadcalldfordad2-year-
olddpatientdwithdadburndinjurydtodthedhand.dHedhasdadvisibledburndtodthedleftdhand,dendingdatdt
hedleveldabovedthedwrist,dreddcolor,danddwetdindappearance.dWhatdtypedofdburnddodyoudsusp
ectdthedpatientdhasdsustained?
A.dSuperficiald(firstddegree)
B.dPartialdthicknessd(secondddegree)
C.dFulldthicknessd(thirdddegree)
D.dSubdermald(fourthddegree)d-dansQuestiond1:dB
Scalddburnsdaredthedmostdcommondburnsdseendindthedpediatricdpopulationdagesd1dtod5dyear
s.dScaldsdaredpartialdthicknessdburns.dTheddermaldlayerdisddamaged,danddblistersdaredpres
entdordpopped.dItdisdalsodthedmostdpainfuldtypedofdburn.
1.dYoudaredcalleddtodthedscenedofdadpossibledmassdcasualtydmotordvehicledcollisiondondthedh
ighway.dOncedyoudarrivedondscene,dwhatdisdyourdfirstdpriority?
A.dImmediatelydbegindtriagingdpatients.
B.dTreatdthedpatientdwithdthedmostdvisibledblooddloss.
C.dDeterminedthedneeddfordadditionaldresources.
D.dAssessdthedscenedanddensureditdisdsafe.d-dansQuestiond1:dD
Ensuredsafetydfordresponders,dbystanders,danddpatient(s).dThedfirstdconsiderationdwhendap
proachingdanydscenedisdthedsafetydofdalldemergencydresponders.dWhendEMSdpersonneldbe
comedvictims,dtheydnotdonlydcandnodlongerdassistdothers,dbutdalsodadddtodthednumberdofdpati
ents.
1.dYoudaredcalleddtodthedscenedofdandexplosiondanddfiredatdadchemicaldplantdwheredyoudfindd
multipledcasualties.Triagedhasdbegun.dYourdfirstdpatientdisdad40-year-
olddmandwhodwasdneardthedsourcedofdthedexplosion.dHedisdunconsciousdanddhasdextensived
,TNCC TRAUMA NURSING CORE COURSE
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injuries.dYoudnotedgurglingdrespirations.dWhydshoulddyoudusedthedtraumadjawdthrustdmaneu
verdfirstdwhenddealingdwithdadtraumadpatient?
A.dIt'sdandeasydtechniquedthatdalwaysdworksdtodopendthedairway.
B.dItdallowsdyoudtodopendthedairwaydwithdlittledordnodmovementdofdthedheaddanddcervicaldspin
e.
C.dOtherdtechniquesdanddinterventionsddon'tdworkdasdwell.
D.dItdcandrelievedadvarietydofdanatomicdairwaydobstructionsdindpatientsdwhodaredbreathingds
pontaneously.d-dansQuestiond1:dB
Manualdmaneuversdlikedthedtraumadjawdthrustdordchindliftdaredalwaysdthedfirstdairwaydmaneu
verdyoudshoulddmakedwhendtreatingdadtraumadpatient.dIndpatientsdwithdsuspecteddhead,dne
ck,dorfacialdtrauma,dthedcervicaldspinedisdmaintaineddindadneutraldin-
linedposition.Thedtraumadjawdthrustdmaneuverdallowsdyoudtodopendthedairwaydwithdlittledordn
odmovementdofdthedheaddanddcervicaldspine.
1.dYoudaredrespondingdtodadcalldford25-year-
old,dfitdanddhealthydfemaledwhodfelldoffdadmountaindbike.dUpondarrival,dyoudfinddthedpatientdw
alkingdaround.dShedisdalertdbutdcomplainingdofdpaindindherdclavicledanddondherdrightdsidedwh
endshedinhales.dYoudnoticedthatdherdhelmetdisdsplitdindtwo.dWhatdisdthedfirstdthingdyoudneeddt
oddo?
A.dCompletedadreviewdofdthedABCs.
B.dCheckdmotordanddsensorydfunction.
C.dPerformdmanualdin-linedstabilization.
D.dPlacedherdondadbackboard.d-dansQuestiond1:dC
Becausedthere'sdadpossibilitydofdspinaldinjury,dyoudshoulddbringdthedpatient'sdheaddintodadne
utraldin-linedposition.
1.dYoudhavedbeendperformingdongoingdmanagementdondad35-year-
olddfemaledpatientdwhodsustaineddthoracicdtraumadwhendadcardhitdherdasdshedcrosseddthedst
reet.dOriginally,dyourdelectronicdmonitoringddevicesdalldproducedresultsdconsistentdwithdyou
rdpatient'sdclinicaldcondition.dHowever,dendroutedthedtraumadcenter,dthedmonitorsdstartdtoddif
ferdfromdyourdpatient'sdcurrentdclinicaldconditiondeachdtimedyoudreassess.dHowdshoulddyoud
handledthisdsituation?
A.dTreatdthedpatient'sdcondition,dnotdthedmonitordresults.
B.dContinuedtodreassessdthedpatientdanddrecorddthedresultsdfordthedtraumadcenter.
C.dTreatdyourdpatientdbaseddondthedtestdresults.
D.dStopdtestingdanddwaitduntildyoudarrivedatdthedtraumadcenterdfordthemdtodperformdandasses
sment.d-dansQuestiond1:dA
Ifdtheredaredinconsistentddatadfromdelectronicdmonitoringddevices,dreassessdtodbedsuredthed
monitordmatchesdthedpatient'sdcurrentdclinicaldcondition.dHowever,ditdisdmostdimportantdtodtr
eatdthedpatient,dnotdthedmonitor,dsodusedotherdsignsdanddsymptomsdofdpotentialdpatientddete
rioration.
,TNCC TRAUMA NURSING CORE COURSE
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1.dYou'redcalleddoutdtodandassisteddlivingdfacilitydfordad72-year-
olddwomandcomplainingdofdadseveredheadachedanddexperiencingdincreaseddconfusion.dSta
ffdreportsdshedfelldoutdofdherdwheelchairdearlierdindthedweekdbutddidn'tdappeardtodbedhurt;dho
wever,dshe'sdbecomedincreasinglyddisorienteddoverdthedlastddaydordso.dVitaldsignsdshow:dB
Pd110/90;dheartrated118danddirregularlydregular;dventilationdrated20danddslightlydlabored;dS
pO2d93%dondroomdair.dShedisdtakingdwarfarindfordadclottingdissue.dWhichdofdthedfollowingdsh
oulddyoudsuspect?
A.dCerebraldcontusion
B.dEpiduraldhematoma
C.dSubarachnoiddhemorrhage
D.dSubduraldhematomad-dansQuestiond1:dD
Thedpatient'sdage,dusedofdadblooddthinner,danddthedfactdshedfelldrecentlydpointdtodadsubdurald
hematoma.
1.dYourdpartnerdisdcompressingdthedbleedingdsitedofdadmaledpatientdwhodwasdstabbeddmulti
pledtimesdindthedleftdchest.dThedbleedingdseemsdtodbedcontrolled,dyetdthedpatientdbecomesdc
ombative.dHedisdpaledanddisdbreathingdrapidly,dyetdstatesdthatdhed"can'tdbreathe"danddfeelsdt
hatdhedisdaboutdtoddie.dYourdnextdstepdindpatientdmanagementdisdto:
A.dstartdassisteddventilation.
B.dgivedhigh-flowdoxygen.
C.ddecompressdthedleftdchest.
D.dgivedad250-mLdfluiddbolus.d-dansQuestiond1:dC
AfterdXdcomedAdanddB.dYoudcandquicklydauscultatedthedlungsd(pneumothoraxdisdalmostdcert
aindwithdmultipledstabsdindthedchest)dandddecompressdthedchest.dDecompressingdadtensiond
pneumothoraxdisdthedquickestdwaydtodtreatdshock.
1.dYourdpatientdisdexperiencingdseveredpaindafterdsustainingdadfemurdfracturedindadmotorcyc
ledcrash.dYoudhavedad20dminutedtransportdtodthednearestdtraumadcenter.dTheredarednodother
dinjuriesdnoteddondyourdprimarydanddsecondarydassessments.dWhichdofdthedfollowingdmedi
cationsdwoulddbedthedbestdpaindmanagementdchoice?
A.dNSAIDs
B.dAcetaminophen
C.dFentanyl
D.dMorphined-dansQuestiond1:dC
Fentanyldisdoftendadfirst-
linedagentdduedtodspeeddofdonset,dshortddurationdofdaction,danddminimaldeffectdondhemodyn
amics.dFentanyldcandbeadministereddIN,dIM,dIO,dordIV.dThedIVdroutedprovidesdeffectsdinstan
tlydwhereasthedINdanddIMdroutedhavedandonsetdofd<10dminutes.dTheddurationdofdfentanyldisd
shortdatd30dminutesdtodandhour.dThisdwilldprovidedenoughdtimedtodeasedpaindduringdtranspor
tdanddletdthedtraumacenterddecidedpaindmanagementdupondarrival.
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2.dAdtraumadpatientdfromdthedhighwaydincidentdisdholdingdherdrightdarm,danddyoudnotedadsig
nificantdamountdofdblooddsteadilydflowingdfromdadlongdgash.dThisdisdandexampledofdwhatdtyp
edofdhemorrhage?d
A.dCapillarydbleeding
B.dVenousdbleeding
C.dArterialdbleeding
D.dRoaddrashd-dansQuestiond2:dB
Venousdbleedingdtypicallydresultsdindadsteadydflowdofddarkdreddblood.
2.dDuringdprimarydsurvey,dyoudfinddthedfollowing:
.dLOC:dalertdanddoriented;dspeakingdindfulldsentencesd
.dGCS:d15
.dAirway:dgooddairdentrydtodbases
.dBreathing:dbilateral
.dCirculation:dskindwarm,dflushed,ddry
.dPulsedrate:d112dbpm,dstrongdandregular
.dBP:d90/42dmmdHg
.dPain:dPatientdcomplainsdofdseveredpaindatdclavicledsitedanddpaindondinspirationdatdsitedofdp
ossibledfractureddribs.dNodotherdinjuriesddetected.dWhatdisdyourdnextdstep?
A.dApplydadcervicaldcollardanddin-linedimmobilizationddevice.
B.dTreatdfordhypovolemicdshock.
C.dApplydandarmdslingdfordthedclavicledinjury.
D.dAdministerdpaindmedication.d-dansQuestiond2:dA
Althoughdthedpatient'sdGCSdisdnormal,dsheddoesdhavedaddistractingdinjury,danddthedstatedofd
herdhelmetdindicatesdpossibledspinaldcompression/flexion,dsodyoudshoulddimmobilizedthedp
atient.
2.dThedpatientdbecomesdapneic.dYoudsuspectdhedhasdadcervicaldinjury.dWhichdtypedofdairwa
ydshoulddyouduse?
A.dSupraglotticdairway
B.dBlinddnasotrachealdintubation
C.dOropharyngealdairway
D.dSurgicaldairwayd-dansQuestiond2:dA
Thedsupraglotticdairway'sdgreatestdadvantagedisdthatditdcandbedinserteddindependentdofdthed
patient'sdposition,dwhichdmaydbedespeciallydimportantdindtraumadpatientsdwithdhighdsuspicio
ndofdcervicaldinjury.
2.dThedpatient'sdcaredgiverdisdadbabysitterdwhodreportsdthedchilddwasdcrawlingdondthedcount
erdanddplaceddhisdhanddindadpotdofdwaterdthatdwasdboilingdondthedstove.dShedisdapplyingdicedt
odthedburndanddthedchilddisdshivering.dWhatdisdyourdnextdstep?
A.dAdministerdanalgesiadfordpain.
B.dCoverdthedpatientdwithdadblanketdtodstopdthedshivering.