TNCC 9th Edition Written Exam Test Prep:
Trauma Nursing Process Questions and Verified
Answers
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of
resuscitation?
Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature?
Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit?
Metabolic acidosis
What type of shock results in generalized vasodilation?
Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what?
Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury?
Compartment Syndrome
What is a high risk of frostbite?
Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along with
rewarming?
Tissue plasminogen activator or non steroidal anti-inflammatory medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what?
Peripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient?
Reverse Trendelenburg
,Which phase of a blast results from flying debris, projectiles, and bomb fragments causing
lacerations or penetrating injuries?
Secondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis?
Quaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls,
ground, or any hard object?
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?
Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or
malaise, and elevated creatinine kinase levels?
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?
Pulmonary Embolus
Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level
of consciousness?
Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure,
abnormal motor posturing, bradycardia, and decreased respiratory effort?
Late signs of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery?
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea.
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen.
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______
MAP - ICP
,What is the range for CO2 to maximize perfusion?
35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP?
Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction?
Constriction d/t low CO2
Pupils with pressure on cranial nerve
Fixed and dilated
Pupils with opiates vs stimulants
small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine
large
Sluggish reaction of pupils is an early sign of what?
Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI
Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP
<15
Goal value for Cerebral Perfusion Pressure (CPP)
>60
Le Fort Fracture
Fracture of the maxilla
What decrease ICP by decreasing cellular edema?
Osmotic diuretics (such as 3% saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms?
Cardiac Tamponade;
1. Hypotension
2. JVD
3. Muffled heart sounds
What is pulsus paradoxus? And what is it a sign of?
, 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?
Obstructive Shock; Cardiac Tamponade
Persistent blood loss following chest tube insertion is a sign of what?
Hemothorax
Ipsilateral diminished breath sounds and chest movement is a sign of what?
Hemothorax
Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high
mechanism of injury.
Thoracic Aortic Disruption
Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what?
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?
Tension Pneumothorax; PEA
Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and alveolar
opacities are signs of what?
Pulmonary Contusion
Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation and
elevated with exhalation are signs of what?
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?
Open Pneumothorax
Hear bowel sounds in chest and Kehr's sign seen with what?
Traumatic Diaphragmatic Tear
Referred pain down the left shoulder; indicative of a ruptured spleen.
Kehr's Sign
Diaphragmatic Tears are seen with what types of injuries?
Penetrating injuries between T4-T12, or rapid deceleration causing severe blunt trauma to the torso.
Trauma Nursing Process Questions and Verified
Answers
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of
resuscitation?
Base deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature?
Vasoconstriction
What results from tissue hypo perfusion and oxygen deficit?
Metabolic acidosis
What type of shock results in generalized vasodilation?
Neurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what?
Phrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury?
Compartment Syndrome
What is a high risk of frostbite?
Thrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along with
rewarming?
Tissue plasminogen activator or non steroidal anti-inflammatory medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what?
Peripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient?
Reverse Trendelenburg
,Which phase of a blast results from flying debris, projectiles, and bomb fragments causing
lacerations or penetrating injuries?
Secondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis?
Quaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls,
ground, or any hard object?
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?
Primary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or
malaise, and elevated creatinine kinase levels?
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?
Pulmonary Embolus
Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered level
of consciousness?
Increased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse pressure,
abnormal motor posturing, bradycardia, and decreased respiratory effort?
Late signs of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery?
Subdural and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea.
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen.
Postconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______
MAP - ICP
,What is the range for CO2 to maximize perfusion?
35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP?
Dilation and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction?
Constriction d/t low CO2
Pupils with pressure on cranial nerve
Fixed and dilated
Pupils with opiates vs stimulants
small; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine
large
Sluggish reaction of pupils is an early sign of what?
Increasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI
Mild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP
<15
Goal value for Cerebral Perfusion Pressure (CPP)
>60
Le Fort Fracture
Fracture of the maxilla
What decrease ICP by decreasing cellular edema?
Osmotic diuretics (such as 3% saline and mannitol)
Becks Triad is a sign of what? And includes what three symptoms?
Cardiac Tamponade;
1. Hypotension
2. JVD
3. Muffled heart sounds
What is pulsus paradoxus? And what is it a sign of?
, 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?
Obstructive Shock; Cardiac Tamponade
Persistent blood loss following chest tube insertion is a sign of what?
Hemothorax
Ipsilateral diminished breath sounds and chest movement is a sign of what?
Hemothorax
Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high
mechanism of injury.
Thoracic Aortic Disruption
Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what?
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?
Tension Pneumothorax; PEA
Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and alveolar
opacities are signs of what?
Pulmonary Contusion
Paradoxical chest wall movement, bony crepitus, rib segment depressed with inhalation and
elevated with exhalation are signs of what?
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?
Open Pneumothorax
Hear bowel sounds in chest and Kehr's sign seen with what?
Traumatic Diaphragmatic Tear
Referred pain down the left shoulder; indicative of a ruptured spleen.
Kehr's Sign
Diaphragmatic Tears are seen with what types of injuries?
Penetrating injuries between T4-T12, or rapid deceleration causing severe blunt trauma to the torso.
