TNCC test prepA, TNCC Notes for Written Exam,
TNCC , , TNCC EXAM, TNCC 8th Edition..Question
And Answers Verified 100% Correct
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - CORRECT
ANSWER Which of the following patients warrants referral to a burn center?
dressing removal - ANSWER A patient arrives with a large open chest wound after
being assaulted with a machete. Prehospital providers placed a nonporous dressing
over the chest wound and taped it on three sides. he is now showing signs of anxiety,
restlessness, severe respiratory distress, cyanosis and decreasing blood pressure.
Which of the following is the MOST appropriate immediate intervention?
after a physical examination if the pt has no radiologic abnormalities on CT - ANSWER
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports
significant damage to the drivers side of the car. The pt is asking to have the cervical
collar removed. When it is appropriate to remove the cervical collar?
MARCH - ANSWER Which of the following mnemonics can help the nurse prioritize
care for a trauma patient with massive uncontrolled hemorrhage?
What is the best measure of the adequacy of cellular perfusion and helps predict the
outcome of resuscitation? - answer Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral
vasculature? - answer
Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - answer Metabolic
acidosis
What type of shock results in generalized vasodilation? - answer Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? -
answer Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? -
answer Compartment
Syndrome
,What is a high risk of frostbite? - answer Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury
along with rewarming? - answer Tissue plasminogen activator or non steroidal anti-
inflammatory medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - answer Peripheral
resistance
What position will benefit the airway and work of breathing for the bariatric patient? -
answer Reverse
Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries? - answer Secondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - answer Quaternary
Phase
What phase of a blast results from individuals being thrown by the blast and impacting
walls, ground, or any hard object? - answer Tertiary Phase
What phase of a blast results from impact of the over and under pressurization wave
with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal
hemorrhage, globe rupture, and mild traumatic brain injury? - answer Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general
weakness or malaise, and elevated creatinine kinase levels? - answer Rhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis,
cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein
distention, or hypotension? - answer Pulmonary Embolus
Signs of what include headache, nausea and vomiting, amnesia, behavioral changes,
altered level of consciousness? - answer Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse
pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? -
answer Late signs of increased ICP with Herniation Syndrome
,What is caused by the tear of the bridging veins or middle meningeal artery? - answer
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness
and nausea. - answer Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. - answer
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - answer MAP - ICP
What is the range for CO2 to maximize perfusion? - answer 35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? -
answer Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - answer Constriction d/t low CO2
Pupils with pressure on cranial nerve - answer Fixed and dilated
Pupils with opiates vs stimulants - answer small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - answer
large
Sluggish reaction of pupils is an early sign of what? - answer Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - answer Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - answer <15
Goal value for Cerebral Perfusion Pressure (CPP) - answer >60
Le Fort Fracture - answer Fracture of the maxilla
What decrease ICP by decreasing cellular edema? - answer Osmotic diuretics (such as
3% saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - answer Cardiac
Tamponade;
, 1. Hypotension
2. JVD
3. Muffled heart sounds
What is pulsus paradoxus? And what is it a sign of? - answer Drop in blood pressure
with inspiration, sign of cardiac tamponade
Tachycarida, weak pulses, hypotension, cool periphery, delayed cap refill, anxiety and
agitation are signs of what type of shock? Seen with what? - answer Obstructive
Shock; Cardiac Tamponade
Persistent blood loss following chest tube insertion is a sign of what? - answer
Hemothorax
Ipsilateral diminished breath sounds and chest movement is a sign of what? - answer
Hemothorax
Tearing chest/back pain, unequal blood pressure and pulses are a sign of what?
Caused by a high mechanism of injury. - answer Thoracic Aortic Disruption
Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of
what? - answer Myocardial contusion from Blunt Cardiac Injury
Decreased/absent breath sounds ipsilaterally, JVD, hypotension, and tracheal deviation
to the contralateral side (late sign) is seen with what? Can lead to what? - answer
Tension Pneumothorax; PEA
Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and
alveolar opacities are signs of what? - answer Pulmonary Contusion
Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation
and elevated with exhalation are signs of what? - answer Flail Chest (caused by chest
wall injury)
Open wound on chest wall resulting in sucking sound, decreased breath sounds, chest
movement, and hyper-resonance ipsilaterally, subcutaneous emphysema, and
tachycardia are signs of what? - answer Open Pneumothorax
Hear bowel sounds in chest and Kehr's sign seen with what? - answer Traumatic
Diaphragmatic Tear
Referred pain down the left shoulder; indicative of a ruptured spleen. - answer Kehr's
TNCC , , TNCC EXAM, TNCC 8th Edition..Question
And Answers Verified 100% Correct
a 52 y/o diabetic male with a partial thickness burn to the left lower leg - CORRECT
ANSWER Which of the following patients warrants referral to a burn center?
dressing removal - ANSWER A patient arrives with a large open chest wound after
being assaulted with a machete. Prehospital providers placed a nonporous dressing
over the chest wound and taped it on three sides. he is now showing signs of anxiety,
restlessness, severe respiratory distress, cyanosis and decreasing blood pressure.
Which of the following is the MOST appropriate immediate intervention?
after a physical examination if the pt has no radiologic abnormalities on CT - ANSWER
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports
significant damage to the drivers side of the car. The pt is asking to have the cervical
collar removed. When it is appropriate to remove the cervical collar?
MARCH - ANSWER Which of the following mnemonics can help the nurse prioritize
care for a trauma patient with massive uncontrolled hemorrhage?
What is the best measure of the adequacy of cellular perfusion and helps predict the
outcome of resuscitation? - answer Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral
vasculature? - answer
Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - answer Metabolic
acidosis
What type of shock results in generalized vasodilation? - answer Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? -
answer Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? -
answer Compartment
Syndrome
,What is a high risk of frostbite? - answer Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury
along with rewarming? - answer Tissue plasminogen activator or non steroidal anti-
inflammatory medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - answer Peripheral
resistance
What position will benefit the airway and work of breathing for the bariatric patient? -
answer Reverse
Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries? - answer Secondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - answer Quaternary
Phase
What phase of a blast results from individuals being thrown by the blast and impacting
walls, ground, or any hard object? - answer Tertiary Phase
What phase of a blast results from impact of the over and under pressurization wave
with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal
hemorrhage, globe rupture, and mild traumatic brain injury? - answer Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general
weakness or malaise, and elevated creatinine kinase levels? - answer Rhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis,
cough, orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein
distention, or hypotension? - answer Pulmonary Embolus
Signs of what include headache, nausea and vomiting, amnesia, behavioral changes,
altered level of consciousness? - answer Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse
pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? -
answer Late signs of increased ICP with Herniation Syndrome
,What is caused by the tear of the bridging veins or middle meningeal artery? - answer
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness
and nausea. - answer Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. - answer
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - answer MAP - ICP
What is the range for CO2 to maximize perfusion? - answer 35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? -
answer Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - answer Constriction d/t low CO2
Pupils with pressure on cranial nerve - answer Fixed and dilated
Pupils with opiates vs stimulants - answer small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - answer
large
Sluggish reaction of pupils is an early sign of what? - answer Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - answer Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - answer <15
Goal value for Cerebral Perfusion Pressure (CPP) - answer >60
Le Fort Fracture - answer Fracture of the maxilla
What decrease ICP by decreasing cellular edema? - answer Osmotic diuretics (such as
3% saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - answer Cardiac
Tamponade;
, 1. Hypotension
2. JVD
3. Muffled heart sounds
What is pulsus paradoxus? And what is it a sign of? - answer Drop in blood pressure
with inspiration, sign of cardiac tamponade
Tachycarida, weak pulses, hypotension, cool periphery, delayed cap refill, anxiety and
agitation are signs of what type of shock? Seen with what? - answer Obstructive
Shock; Cardiac Tamponade
Persistent blood loss following chest tube insertion is a sign of what? - answer
Hemothorax
Ipsilateral diminished breath sounds and chest movement is a sign of what? - answer
Hemothorax
Tearing chest/back pain, unequal blood pressure and pulses are a sign of what?
Caused by a high mechanism of injury. - answer Thoracic Aortic Disruption
Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of
what? - answer Myocardial contusion from Blunt Cardiac Injury
Decreased/absent breath sounds ipsilaterally, JVD, hypotension, and tracheal deviation
to the contralateral side (late sign) is seen with what? Can lead to what? - answer
Tension Pneumothorax; PEA
Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and
alveolar opacities are signs of what? - answer Pulmonary Contusion
Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation
and elevated with exhalation are signs of what? - answer Flail Chest (caused by chest
wall injury)
Open wound on chest wall resulting in sucking sound, decreased breath sounds, chest
movement, and hyper-resonance ipsilaterally, subcutaneous emphysema, and
tachycardia are signs of what? - answer Open Pneumothorax
Hear bowel sounds in chest and Kehr's sign seen with what? - answer Traumatic
Diaphragmatic Tear
Referred pain down the left shoulder; indicative of a ruptured spleen. - answer Kehr's
