TNCC 9TH EDITION FINAL EXAM ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 100% A+ SCORE

TNCC 9TH EDITION FINAL EXAM ACTUAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES 100% A+ SCORE An adult pt who sustained a severe head trauma has been intubated and is being manually ventilated via bag-mask device at a rate of 18 bpm. The pt has received one IV fluid bolus of 500 mL of warm isotonic crystalloid solution. The PaCO2 is 30 mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is the most important intervention to manage the cerebral blood flow? a) decrease the rate of manual ventilation b) initiate another fluid bolus c) recheck endotracheal tube placement d) increase the amount of oxygen delivered - ANSWER-a) decrease the rate of manual ventilation CO2 is the primary regulator of blood flow to the brain. Aggro manual ventilation results in decreased PaCO2 levels, which results in vasoconstriction, which then leads to decreased ICP and inadequate delivery of O2 and glucose to the brain. Bagging should be at a rate of one breath every 6 or 10 seconds A patient with a chest tube transported to the ICU and fluctuation is noted in the water seal chamber during inspiration and expiration. What is the best action for the nurse to take? a) clamp the chest tube b) return to the ED c) assist with ventilation via bag-mask device d) continue to ICU - ANSWER-d) continue to ICU fluctuation of the water seal chamber during insp and expr is a normal finding Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? a) stabilizing the cervical spine b) applying a nonrebreather mask c) establishing IV access d) preparing for drug-assisted intubation - ANSWER-a) stabilizing the cervical spine A retained driver involved in a motor vehicle collision is being brought to the ED with abdominal, pelvic, and bilateral lower extremity pain. Vital signs are BP 147/78, HR 98 bpm. A FAST exam is negative for fluid in the abdominal and peritoneal cavities. Which of the following should the nurse anticipate? a) diagnostic peritoneal lavage b) angiography c) non-contrast abdominal CT d) serial abdominal assessments - ANSWER-d) serial abdominal assessments The FAST exam is done at the bedside to identify pathological fluid in the abdominal and pelvic cavities and reduces the need for more invasive testing. However, a negative FAST exam does not rule out injury, so serial abdominal assessments should occur. If a CT scan is indicated, it should be done with contrast Continues...