TNCC Written Exam
- Exams with their
100% correct
answers
Nursing (Walden University)
, lOMoAR cPSD| 64639315
TNCC Written Exam
TNCC Notes for Written Exam,
TNCC Prep, TNCC test prepA 415
Questions with 100% Correct
Answers
What are the late signs of breathing compromise? - Answer--- Tracheal deviation
- JVD
What are signs of ineffective breathing? - Answer--- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated -
Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt
breathing
effectively? - Answer--A tight-fitting nonrebreather mask at 12-
15 lpm.
What intervention should be done if a pt presents with effective circulation? -
Answer---
Insert 2 large caliber
IV's
- Administer warmed isotonic crystalloid solution at an
appropriate rate
What are signs of ineffective circulation? - Answer---
Tachycardia
- AMS
, lOMoAR cPSD| 64639315
- Uncontrolled external
bleeding
- Pale, cool, moist
skin
- Distended or abnormally flattened external jugular
veins
- Distant heart
sounds
What are the interventions for Effective/Ineffective Circulation? - Answer---
Control any
uncontrolled external bleeding
by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points - Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product - IV = surgical cut-down, central line, or
both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
What are factors that contribute to ineffective ventilation? - Answer--- AMS
- LOC
- Neurologic injury
- Spinal Cord Injury
- Intracranial Injury
- Blunt trauma
- Pain caused by rib fractures
- Penetrating Trauma
- Preexisting hx of respiratory diseases - Increased age
, lOMoAR cPSD| 64639315
What medications are used during intubation? - Answer--LOAD Mnemonic:
L = Lidocaine
O = Opioids
A = Atropine
D = Defasiculating agents
What are the Rapid Sequence Intubation Steps? - Answer--PREPARATION:
- gather equipment, staffing, etc.
PREOXYGENATION:
- Use 100% O2 (prevent risk of aspiration).
PRETREATMENT:
- Decrease S/E's of intubation
PARALYSIS WITH INDUCTION:
- Pt has LOC, then administer neuromuscular blocking agent PROTECTION AND
POSITIONING:
- Apply pressure over cricoid cartilage (minimizes likelihood of vomiting and
aspiration
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate pt 30-60 seconds
between attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
What is a Combitube? - Answer--A dual-lumen, dual-cuff airway that can be placed
blindly into the esophagus to establish an airway. If inadvertently placed into trachea, it
can be used as a temporary ET tube. There are only two sizes: small adult and larger
adult.
What is a Laryngeal Mask Airway? - Answer--Looks like an ET tube but is equipped
with an inflatable, elliptical, silicone rubber collar at the distal end. It is designed to
cover the supraglottic area.
- Exams with their
100% correct
answers
Nursing (Walden University)
, lOMoAR cPSD| 64639315
TNCC Written Exam
TNCC Notes for Written Exam,
TNCC Prep, TNCC test prepA 415
Questions with 100% Correct
Answers
What are the late signs of breathing compromise? - Answer--- Tracheal deviation
- JVD
What are signs of ineffective breathing? - Answer--- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated -
Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt
breathing
effectively? - Answer--A tight-fitting nonrebreather mask at 12-
15 lpm.
What intervention should be done if a pt presents with effective circulation? -
Answer---
Insert 2 large caliber
IV's
- Administer warmed isotonic crystalloid solution at an
appropriate rate
What are signs of ineffective circulation? - Answer---
Tachycardia
- AMS
, lOMoAR cPSD| 64639315
- Uncontrolled external
bleeding
- Pale, cool, moist
skin
- Distended or abnormally flattened external jugular
veins
- Distant heart
sounds
What are the interventions for Effective/Ineffective Circulation? - Answer---
Control any
uncontrolled external bleeding
by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points - Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product - IV = surgical cut-down, central line, or
both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
What are factors that contribute to ineffective ventilation? - Answer--- AMS
- LOC
- Neurologic injury
- Spinal Cord Injury
- Intracranial Injury
- Blunt trauma
- Pain caused by rib fractures
- Penetrating Trauma
- Preexisting hx of respiratory diseases - Increased age
, lOMoAR cPSD| 64639315
What medications are used during intubation? - Answer--LOAD Mnemonic:
L = Lidocaine
O = Opioids
A = Atropine
D = Defasiculating agents
What are the Rapid Sequence Intubation Steps? - Answer--PREPARATION:
- gather equipment, staffing, etc.
PREOXYGENATION:
- Use 100% O2 (prevent risk of aspiration).
PRETREATMENT:
- Decrease S/E's of intubation
PARALYSIS WITH INDUCTION:
- Pt has LOC, then administer neuromuscular blocking agent PROTECTION AND
POSITIONING:
- Apply pressure over cricoid cartilage (minimizes likelihood of vomiting and
aspiration
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate pt 30-60 seconds
between attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
What is a Combitube? - Answer--A dual-lumen, dual-cuff airway that can be placed
blindly into the esophagus to establish an airway. If inadvertently placed into trachea, it
can be used as a temporary ET tube. There are only two sizes: small adult and larger
adult.
What is a Laryngeal Mask Airway? - Answer--Looks like an ET tube but is equipped
with an inflatable, elliptical, silicone rubber collar at the distal end. It is designed to
cover the supraglottic area.
