TNCC 9TH REAL PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

TNCC 9TH REAL PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - answer C. Notify the physician 2. A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what is the priority intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - answer A. Initiate transfer to a trauma center 3. An adult who fell from a second story roof is brought to the emergency department by private vehicle. The patient is confused with unlaboured respirations and has strong, palpable radial pulses. There is an open wound in proximity to an obvious deformity of the left lower extremity. What is the priority intervention? A. Initiate cervical spine stabilization B. Apply a splint to the lower extremity C. Put the patient on portable oxygen. D. Log roll the patient onto a spine board - answer A. Initiate cervical spine stabilization 4. An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. 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. 5. An adult patient is brought to the emergency department following a vehicle "roll-over" with prolonged extrication. Assessment reveals swelling and bruising to the right proximal thigh and a weak pedal pulse. Skin is pale, cool, and moist. What is the most appropriate initial intervention? A. Application of a tourniquet to the affected extremity B. Application of a pelvic binder C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa) - answer B. Application of a pelvic binder 6. An adult patient who sustained a severe prolonged extrication has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. 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. 7. An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of their symptoms? A .Intracerebral hemorrhage B. Epidural hematoma C. Diffuse axonal injury D. Post-concussive syndrome - answer post-concussive syndrome 8. A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A. Elevating the leg above the level of the heart B. Repositioning the leg and applying ice C. Elevating the leg to the level of the heart D. Preparing the patient for ultrasound of the leg - answer C. Elevating the leg to the level of the heart 9. A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most consistent with an injury to the diaphragm? A. Severe left-sided abdominal pain B. Bowel sounds heard in the left lower chest C. Pain radiating to the left shoulder. D. Decreased breath sounds on the left side - answer Bowel sounds heard in the left lower chest 10. A patient has been in the emergency department for several hours waiting to be admitted. They sustained multiple rib fractures and a femur fracture after a fall. The patient has been awake, alert, and complaining of leg pain. Their spouse reported that the patient suddenly became anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and symptoms most commonly associated with which of the following conditions? A. Acute lung injury B. Fat embolism C. Pneumothorax D. Pulmonary contusion - answer fat embolism 11. Three adults present at different times during a one-hour period with a high fever, fatigue, and headache. All three patients have a rash which started on their mouth, face, and arms with progression to the chest and abdomen. They all visited the same grocery store within the last week. What is the most appropriate intervention from triage for these patients? A. Move them to a decontamination area B. Mask the patients and send them to the waiting room C. Immediately initiate isolation precautions D. Send them to the waiting room without a mask - answer Immediately initiate isolation precautions 12. A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? A. Oculomotor nerve palsy B. Globe rupture C. Retrobulbar hematoma D. Retinal detachment - answer Globe rupture 13. A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would indicate sacral sparing? A. Involuntary flexion of the great toe B. Priapism C. Voluntary anal sphincter tone D. Numbness to the perianal area - answer Voluntary anal sphincter tone 14. Which blood pressure finding is associated with early or compensated hypovolemic shock? A. Rising systolic B. Rising diastolic C. Decreasing diastolic D. Decreasing systolic - answer B. Rising diastolic 15. Which of the following is true about the log-roll maneuver? A It causes less spinal motion than the lift-and-slide maneuver B. It is recommended for patients with unstable pelvic fractures C. It should be avoided with a suspected spine injury prior to imaging D. It decreases the risk of hemorrhage from unstable pelvic injuries - answer It should be avoided with a suspected spine injury prior to imaging 16. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority intervention? A. Initiate two intravenous access sites B. Place the patient on supplemental oxygen C. Apply direct pressure to the wound D. Use a tourniquet to control the bleeding - answer C. Apply direct pressure to the wound 17. Which of the following situations could cause functional grief? A. Inability to live at home B. Amputation of a limb C. Loss of one's self-image D .Destruction of the patient's car - answer B. Amputation of a limb 18. Using the American College of Surgeons screening guidelines, what assessment finding would prompt the nurse to prepare a patient for cervical spine imaging? A. Alert with no neurologic deficits B. Multiple abrasions to the extremities C. Ecchymosis to the flank D. Responds to verbal stimulation - answer A. Alert with no neurologic deficits 19. An adult was thrown against a concrete wall during a factory explosion and sustained a femur fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred during what level of blast trauma? A. Primary B. Secondary C. Tertiary D. Quaternary - answer C. Tertiary 20. An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the patient is only responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to the face. What is the priority intervention? A. Use a bulb syringe to suction out secretions from the mouth. B. Insert a nasopharyngeal airway to maintain an open airway. C. Use a jaw thrust to open the airway and look for signs of obstruction. D. Ask the patient to open their mouth to inspect the airway. - answer C. Use a jaw thrust to open the airway and look for signs of obstruction.