TNCC 12th Edition Questions and Answers(2022 edition).pdf

2024 TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exa
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-cANSPrehospitalcshockcindexcpg.c85

..cactivation ...... arecfoundcinctheccarotidcsinuscandcalongcthecaorticcarch,carecsensitivectocthecdegreecof
stretchcincthecarterialcwall.cWhencthecreceptorscsensecacdecreasecincstretch,ctheycstimulatecthecsympathetic
cnervouscsystem ctocreleasecEpi,cnorepi,ccausingcstimulationcofccardiaccactivitycandcconstrictioncofcbloodcves

sels,cwhichccausescacrisecincheartcratecandcdiastoliccbloodcpressurec-cANSBaroreceptors:

1. A-cairwaycandcAlertnesscwithcsimultaneousccervicalcspinalcstabilization
2. B-cbreathingcandcVentilation
3. circulationcandccontrolcofchemorrhage
4. Dc-cdisabilityc(neurologiccstatus)
5. Fc-cfullcsetcofcvitalscandcFamilycpresence
6. Gc-cGetcresuscitationcadjuncts
cL-cLabcresultsc(arterialcgases,cbloodctypecandccrossmatch)

cM-cmonitorcforccontinuousccardiaccrhythm candcratecassessment

cN-cnasocorcorogastricctubecconsideration

cO-coxygenationcandcventilationcanalysis:cPulsecoxygemetrycandcend-

tidalccaroncdioxidec(ETC02)cmonitoringcandccapnopgraphy
cH-cHistorycandcheadctoctoecassessment

cI-cInspectcposteriorcsurfacesc-cANSABCDEFGHI



1. Apnea
2. GCSc8corcless
3. Maxillarycfractures
4. Evidencecofcinhalationcinjuryc(facialcburns)
5. Laryngealcorctrachealcinjurycorcneckchematoma
6. Highcriskcofcaspirationcandcpatientscinabilityctocprotectcthecairway
7. Compromisedcorcineffectivecventilationc-cANSFollowingcconditionscmightcrequirecacdefinitivecairway

1. bonycfracturescandcpossiblecribcfractures,cwhichcmaycimpactcventilation
2. palpatecforccrepitus
3. subcutaneouscemphysemacwhichcmaycbecacsigncforcacpneumothorax
4. softctissuecinjuryc-cANSPalpatecthecchestcfor

1. Checkcthecpresencecofcadequatecrisecandcfallcofcthecchestcwithcassistedcventilation
2. Absencecofcgurglingconcauscultationcovercthecepigastrium
3. Bilateralcbreathcsoundscpresentconcauscultation
4. Presencecofccarboncdioxidec(CO2)cverifiedcbycacCO2cdevicecorcmonitorc-
cANSIfcthecptchascacdefinitivecairwaycincwhatcshouldc youcdo?



1. Dyspnea
2. Tachycardia
3. Decreasedcorcabsentcbreathcsoundsconcthecinjuredcside
4. CPc-cANSSimplecPneumocassessment:

1. equalcbreathcsoundscbilaterallycatcthecsecondcintercostalcspacecmidclavicularclinecandcthecbasescforcfifthci
ntercostalcspacecatcthecaxillaryclinec-cANSAuscultatecthecchestcfor:

1. GetcacCT
2. ConsidercABGc'scifcdecreasedcLOC
3. Considercglucoseccheckc-cANSDcInterventions

1. Hypotension

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2. JVD
3. Muffledcheartcsoundsc-cANSBeckscTriad:

1. opencthecairway,cusecjawcthrust
2. insertcancoralcairway
3. assistcventilationscwithcacbagcmask
4. preparecforcdefinitivecairwayc-cANSIfcbreathingciscabsent..

1. painc-challmarkcsign,cearlycsign
2. pressurec-cearlycsign
3. pallor,cpules,cparesthesia,cparalysisc-clatecsignc-cANSSixcP'scofccompartmentcsyndrome:

1. Preparation
2. Preoxygenation
3. Pretreatment
4. ParalysiscandcInduction
5. Protectingcandcpositioningc-cv
6. Placementcofcproofc-csecurecthectube
7. Postcintubationc-csecurecETTcTube,cgetcX-raycforcplacementc-cANSStepscofcRapidcSequencecIntubation

1. PreparationcandcTriage
2. PrimarycSurveryc(ABCDE)cwithcresuscitationcadjunctsc(F,G)
3. Reevaluationc(considerationcofctransfer)
4. SecondarycSurveyc(HI)cwithcreevaluationcadjuncts
5. Reevaluationcandcpostcresuscitationccare
6. Definitiveccarecofctransferctocancappropriatectraumacnursec-cANSInitialcAssessment

1. Suctioncthecairway
2,cUseccarectocavoidcstimulatingcthecgagcreflex
3.cIfcthecairwayciscobstructedcbycbloodcorcvomituscsecretions,cusecacrigidcsuctioncdevice
Ifcforeigncbodyciscnoted,cremovecitccarefullycwithcforcepscorcanothercappropriatecmethodc-
cANSIfcAirwayciscnotcpatent



1. Thectonguecobstructingcthecairway
2. loosecorcmissingcteeth
3. foreigncobjects
4. blood,cvomit,corcsecretions'
5. edema
6. burnscorcevidencecofcinhalationcinjury

Auscultiatecorclistencfor:
1. Obstructivecairwaycsoundscsuchcascsnoringcorcgurgling
2. Possiblecocclusivecmaxillofacialcbonycdeformity
3. Subcutaneouscemphysemac-cANSInspectcthecmouthcfor:

50ctoc150c-cANSMAPcRange

500cmL/hrc-
cANSYoucarectreatingcac27cy/ocMcincrespiratorycdistress cwhocwascinvolvedcincachousecfire.cCalculatingcTBSA

cburnedciscdeferredcduectocthecneedcforcemergentcintubation.cAtcwhatcratecshouldcyoucbegincfluidcresuscitatio

n?

Ac14cgaugecneedlecthatciscinsertedcintocthec2ndcintercostalcspacecincthecmidclavicularclineconcthecaffectedcsi
decovercthectopcofcthecribctocavoidcneuromuscularcbundlecthatcrunscundercthecrib.

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Preparecforcchestctubecplacement.c-cANSTensioncpneumocintervention

ac52cy/ocdiabeticcmalecwithcacpartialcthicknesscburnctocthecleftclowerclegc-
cANSWhichcofcthecfollowingcpatientscwarrantscreferralctocacburnccenter?



Acbreathceveryc5ctoc6cseconds:c10-12cventilationscpercminutec-cANSBagcmaskcventilation

acpertinentcmedicalchxcisccrucialc-
cANSWhichcofcthecfollowingcconsiderationsciscthecmostcimportantcwhenccaringcforcacgeriatricctraumacpt?



Accordingctocnewtonsclawcwhichcofcthesectwocforceciscgreater:csizecorcforce?c-
cANSNeither.cForceachcforcecthereciscancequalcandcoppositecreaction.



acidosisc-cANSWhichcofcthecfollowingciscaccomponentcofcthectraumactriadcofcdeath?

activation:cconsistcofccarotidcandcaorticcbodies ....... detectcchangescincbloodcoxygencandcCo2candcpH.cWhen
Co2crisescorcoxygenclevelcofcpHcfallscthesecreceptorscarecactivatedcandcinformationciscrelayedctocthecCNScan
dctheccardiorespiratoryccenterscincthecmedullac,cwhichcincreasescrespiratorycragecandcdepthcandcBPc-
cANSChemoreceptors:



advancedcagec-
cANSWhichcofcthecfollowingciscmostclikelyctoccontributectocinadequatecoxygenationcandcventilation?



aftercacphysicalcexaminationcifcthecptchascnocradiologiccabnormalitiesconcCTc-
cANSEMScarrivescwithcthecintoxicatedcdrivercofcaccarcinvolvedcincacMVC.cEMScreportscsignificantcdamag

ectocthecdriverscsidecofctheccar.cThecptciscaskingctochavectheccervicalccollarcremoved.cWhencitciscappropria
tectocremovectheccervicalccollar?

Airccannotcescapecintrapleuralcspace..ccancbeginctoccompresscheart.cptcwillchavecsevercrespcdistress,chypote
nsion,cJVD.c-cANSTensioncpneumo

anycdeformities?cbleeding?ccontusions,clacs?cskinctemp??cplacecsplintsconcdeformities,cpulsesc-
cANSHeadctoctoecassessment:cExtremities



anyclacs?cdeformities?cbloodcatcthecurtheralcmeatus

palpatecpelviscwithchighcpressurecoverctheciliaccwingscdownwardcandcmediallyc-
cANSHeadctoctoecassessment:cpelviscandcperineum



AorticcDissectionc-cANSUnequalcextremitycpulsecstrengthcpossibilitycof..

applycdirectcpressurectocbleeding

elevatecextremity

applycpressurecovercarterialcsites

Considercacpelviccbindercforcpelviccfractures

considercactourniquet

cannulatectwocveinscwithclargeccalibercIVc-cifcunablectocgaincassesscconsidercIO

, 2024 TNCC test prepa, TNCC Notes for Written Exam, TNCC Notes for Written Exa
c c c c c c c c c c c c c c

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ca.cobtainclabs,ctypecandccross
cb.cinfusecwarmcisotoniccfluids
cc.cconsidercbalancedcresuscitation

cd.cusecrapidcinfusioncdevicec-cANSCcInterventions:



applycsplintcandcelevatecabovectheclevelcofcthecheartc-
cANSac37cy/ocFchascacdeformitycofcthecLcwristcaftercacfall.cSheciscreluctantctocmovecherchandcduectocpain.cWhi

chcofcthecfollowingciscthecmostcappropriatecintervention?

askcptctocpenchiscorchercmouthc-
cANSWhilecassessingcairwaycthecpatientciscalertcandcrespondsctocverbalcstimulicyoucshould..



bardycardiacandcabsentcmotorcfunctioncbelowctheclevelcofcinjuryc-
cANSAcptcwithcaccompletecspinalccordcinjurycincneurogeniccshock cwillcdemonstratechypotensioncandcwhichco

thercclinicalcsigns?

Beforecthecarrivalcofcthecptc-cANSWhencshouldcPPEcbecplaced:

Biomechanicsc-cANSIscthecgeneralcstudycofcforcescandctheirceffects.

bowelc-cANSWhichcofcthecfollowingcinjuriesciscLEASTclikelyctocbecpromptlycidentified?

brachialcpulsec-cANSUndercagecofc1cwherecdocyoucfindcacpulse

Breathing:cTocassesscbreathingcexposecthecchest:
1. Inspectcfor
ca.cspontaneouscbreathing

cb.csymmetricalcrisecandcfall

cc.cdepth,cpattern,candcratecofcrespiration

cd.csignscofcdifficultycbreathingcsuchcascaccessorycmusclecuse

ce.cskinccolorc(normal,cpale,cflushed,ccyanotic)

cf.ccontusions,cabrasions,cdeformitiesc(flailcchest)

cg.copencpneumothoracesc(suckingcchestcwounds)

ch.cJVD

ci.csignscofcinhalationcinjuryc(singedcnasalchairs,ccarbonaceouscsputum)c-cANSB



calciumc-
cANSifcacptchascreceivedcmultiplectransfusionscofcbankedcbloodcpreservedcwithccitrate,cwhichcelectrolyteciscmostcl

ikelyctocdropcandcrequirecsupplementation?

cancbeccausedcbycbluntctrauma.caircescapescfromcinjuredclungctocpleuralcspacecandcnegativecintrapleuralcpressur
ecisclostccausingcpartialcorccollapsedclungc-cANSSimplecPneumothorax

cancresultcfromcpenetratingcwoundcthroughcchestcwallccausingcairctocbectrappedcinctocthecintrapleuralcplace.cMigh
tchearc"sucking"

Tx:cnonporouscdressingctapesconc3csided,cthencChestctubecandcwouldcclosurecsurgicalcrepair.c-
cANSOpencPneumo:



Capnographycmonitorscnumericcvalue,cascwellcasccontinuouscwaveform,cindicatingcreal-
timecmeasurementcandctrendingcoverctime.c-cANSQuantitative:

Causedcbycbloodcincthecintrapleuralcspace/cMaycalsococcurcfromclacctoclivecorcspleenccombinedcwithcinjuryct
octhecdiaphragm.