TNCC WRITTEN EXAM QUESTIONS AND
ANSWERS
What6is6the6best6measure6of6the6adequacy6of6cellular6perfusion6and6helps6predict6the6out
come6of6resuscitation?6-6ans--Base6deficit6used6in6conjunction6with6serum6lactate
Will6hypocapnia6cause6vasoconstriction6or6vasodilation,6especially6in6the6cerebral6vascul
ature?6-6ans--Vasoconstriction
What6results6from6tissue6hypo6perfusion6and6oxygen6deficit?6-6ans--Metabolic6acidosis
What6type6of6shock6results6in6generalized6vasodilation?6-6ans--Neurogenic6shock
Spinal6cord6injuries6at6C3-C56causes6loss6of6what6nerves6function,6resulting6in6what?6-
6ans--Phrenic6nerve;6paralyzed6diaphragm6and6inability6to6breath
Extremity6elevation6AT6the6level6of6the6heart6is6beneficial6for6what6type6of6injury?6-6ans--
Compartment6Syndrome
What6is6a6high6risk6of6frostbite?6-6ans--Thrombus6formation
What6two6medications6can6be6administered6to6maintain6perfusion6after6a6frostbite6injury6
along6with6rewarming?6-6ans--Tissue6plasminogen6activator6or6non6steroidal6anti-
inflammatory6medication6(NSAIDS)
An6rise6in6diastolic6blood6pressures6is6a6sign6of6increasing6what?6-6ans--
Peripheral6resistance
What6position6will6benefit6the6airway6and6work6of6breathing6for6the6bariatric6patient?6-
6ans--Reverse6Trendelenburg
Which6phase6of6a6blast6results6from6flying6debris,6projectiles,6and6bomb6fragments6causi
ng6lacerations6or6penetrating6injuries?6-6ans--Secondary6Phase
, What6phase6of6a6blast6results6from6any6explosion-
related6illness6or6injury6including6hyperglycemia,6hypertension,6angina,6asthma,6COPD,6
or6sepsis?6-6ans--Quaternary6Phase
What6phase6of6a6blast6results6from6individuals6being6thrown6by6the6blast6and6impacting6
walls,6ground,6or6any6hard6object?6-6ans--Tertiary6Phase
What6phase6of6a6blast6results6from6impact6of6the6over6and6under6pressurization6wave6wit
h6body6surfaces.6Injuries6include6blast6lung,6tympanic6membrane6rupture,6abdominal6he
morrhage,6globe6rupture,6and6mild6traumatic6brain6injury?6-6ans--Primary6Phase
Signs6of6what6include6muscle6pain6or6weakness,6dark6red6or6brown6urine,6general6weakn
ess6or6malaise,6and6elevated6creatinine6kinase6levels?6-6ans--Rhabdomyolosis
Signs6of6what6include6anxiety,6pleuritic6chest6pain,6dyspnea,6hypoxemia,6hemoptysis,6co
ugh,6orthopnea,6adventitious6lung6sounds,6decreased6lung6sounds,6jugular6vein6distentio
n,6or6hypotension?6-6ans--Pulmonary6Embolus
Signs6of6what6include6headache,6nausea6and6vomiting,6amnesia,6behavioral6changes,6al
tered6level6of6consciousness?6-6ans--Increased6intracranial6pressure
Signs6of6what6include6asymmetric6pupillary6reactivity,6unilateral6dilation,6widening6pulse6
pressure,6abnormal6motor6posturing,6bradycardia,6and6decreased6respiratory6effort?6-
6ans--Late6signs6of6increased6ICP6with6Herniation6Syndrome
What6is6caused6by6the6tear6of6the6bridging6veins6or6middle6meningeal6artery?6-6ans--
Subdural6and6Epidural6Hematoma
Affect6concentration,6memory,6sleep,6mode,6and6libido.6Causes6headaches,6dizziness6a
nd6nausea.6-6ans--Postconcussive6Syndrome/6Mild6Traumatic6Brain6Injury
Signs6and6symptoms6similar6to6early6signs6of6increased6ICP6but6do6not6worsen.6-6ans--
Postconcussive6Syndrome/6Mild6Traumatic6Brain6Injury
Cerebral6Perfusion6Pressure6=6______-______6-6ans--MAP6-6ICP
What6is6the6range6for6CO26to6maximize6perfusion?6-6ans--35-45
Does6hypoventilation6cause6dilation6or6constriction?6Increase6or6decrease6ICP?6-6ans--
Dilation6and6increase6in6ICP6due6to6high6CO2
Hyperventilation6cause6dilation6or6constriction?6-6ans--Constriction6d/t6low6CO2
Pupils6with6pressure6on6cranial6nerve6-6ans--Fixed6and6dilated
Pupils6with6opiates6vs6stimulants6-6ans--small;6large
ANSWERS
What6is6the6best6measure6of6the6adequacy6of6cellular6perfusion6and6helps6predict6the6out
come6of6resuscitation?6-6ans--Base6deficit6used6in6conjunction6with6serum6lactate
Will6hypocapnia6cause6vasoconstriction6or6vasodilation,6especially6in6the6cerebral6vascul
ature?6-6ans--Vasoconstriction
What6results6from6tissue6hypo6perfusion6and6oxygen6deficit?6-6ans--Metabolic6acidosis
What6type6of6shock6results6in6generalized6vasodilation?6-6ans--Neurogenic6shock
Spinal6cord6injuries6at6C3-C56causes6loss6of6what6nerves6function,6resulting6in6what?6-
6ans--Phrenic6nerve;6paralyzed6diaphragm6and6inability6to6breath
Extremity6elevation6AT6the6level6of6the6heart6is6beneficial6for6what6type6of6injury?6-6ans--
Compartment6Syndrome
What6is6a6high6risk6of6frostbite?6-6ans--Thrombus6formation
What6two6medications6can6be6administered6to6maintain6perfusion6after6a6frostbite6injury6
along6with6rewarming?6-6ans--Tissue6plasminogen6activator6or6non6steroidal6anti-
inflammatory6medication6(NSAIDS)
An6rise6in6diastolic6blood6pressures6is6a6sign6of6increasing6what?6-6ans--
Peripheral6resistance
What6position6will6benefit6the6airway6and6work6of6breathing6for6the6bariatric6patient?6-
6ans--Reverse6Trendelenburg
Which6phase6of6a6blast6results6from6flying6debris,6projectiles,6and6bomb6fragments6causi
ng6lacerations6or6penetrating6injuries?6-6ans--Secondary6Phase
, What6phase6of6a6blast6results6from6any6explosion-
related6illness6or6injury6including6hyperglycemia,6hypertension,6angina,6asthma,6COPD,6
or6sepsis?6-6ans--Quaternary6Phase
What6phase6of6a6blast6results6from6individuals6being6thrown6by6the6blast6and6impacting6
walls,6ground,6or6any6hard6object?6-6ans--Tertiary6Phase
What6phase6of6a6blast6results6from6impact6of6the6over6and6under6pressurization6wave6wit
h6body6surfaces.6Injuries6include6blast6lung,6tympanic6membrane6rupture,6abdominal6he
morrhage,6globe6rupture,6and6mild6traumatic6brain6injury?6-6ans--Primary6Phase
Signs6of6what6include6muscle6pain6or6weakness,6dark6red6or6brown6urine,6general6weakn
ess6or6malaise,6and6elevated6creatinine6kinase6levels?6-6ans--Rhabdomyolosis
Signs6of6what6include6anxiety,6pleuritic6chest6pain,6dyspnea,6hypoxemia,6hemoptysis,6co
ugh,6orthopnea,6adventitious6lung6sounds,6decreased6lung6sounds,6jugular6vein6distentio
n,6or6hypotension?6-6ans--Pulmonary6Embolus
Signs6of6what6include6headache,6nausea6and6vomiting,6amnesia,6behavioral6changes,6al
tered6level6of6consciousness?6-6ans--Increased6intracranial6pressure
Signs6of6what6include6asymmetric6pupillary6reactivity,6unilateral6dilation,6widening6pulse6
pressure,6abnormal6motor6posturing,6bradycardia,6and6decreased6respiratory6effort?6-
6ans--Late6signs6of6increased6ICP6with6Herniation6Syndrome
What6is6caused6by6the6tear6of6the6bridging6veins6or6middle6meningeal6artery?6-6ans--
Subdural6and6Epidural6Hematoma
Affect6concentration,6memory,6sleep,6mode,6and6libido.6Causes6headaches,6dizziness6a
nd6nausea.6-6ans--Postconcussive6Syndrome/6Mild6Traumatic6Brain6Injury
Signs6and6symptoms6similar6to6early6signs6of6increased6ICP6but6do6not6worsen.6-6ans--
Postconcussive6Syndrome/6Mild6Traumatic6Brain6Injury
Cerebral6Perfusion6Pressure6=6______-______6-6ans--MAP6-6ICP
What6is6the6range6for6CO26to6maximize6perfusion?6-6ans--35-45
Does6hypoventilation6cause6dilation6or6constriction?6Increase6or6decrease6ICP?6-6ans--
Dilation6and6increase6in6ICP6due6to6high6CO2
Hyperventilation6cause6dilation6or6constriction?6-6ans--Constriction6d/t6low6CO2
Pupils6with6pressure6on6cranial6nerve6-6ans--Fixed6and6dilated
Pupils6with6opiates6vs6stimulants6-6ans--small;6large
