TNCC PRE COURSE STUDY
GUIDE QUESTIONS AND
ANSWERS (LATEST)
What is the TEN-4 mnemonic?
bruising in children under 4 y/o to:
- ear
- neck
- torso
What injuries are more common and should be anticipated in the
obese patient?
- Spinal
- Upper torso
- Upper/lower limb fx
What airway and ventilation differences should be considered
when caring for the obese patient?
- narrowed airway
- larger tongue
- relaxed pharyngeal muscle
- respiratory insufficiency due to chest wall weight, decreased chest
wall compliance
- increased airway resistance
What differences in equipment or its use may be necessary?
- Larger equipment
- Reverse Trendelenburg
- US placed IV
- 2 people to hold bag-mask
,What considerations may be appropriate to keep the patient and
staff safe with obese trauma pt?
- Use assistive transfer devices
- Increase the number of staff for the transfer
What are some ways to provide sensitive care to obese patients?
- Appropriate size equipment/clothing
- Sensitive to wording used when speaking to pt
What are some anatomic or physiologic differences in the older
adult that can affect the components of the primary survey and
should be considered when caring for these patients?
Decreased gag reflex
Dentures
Changes in spinal curvature
Neurological changes
Decreased muscle mass
Increased comorbidities
What are the common MOIs in older adults? Why?
Most common - falls
- also MVC/pedestrian collisions, burns, penetrating injuries
Why?
- slow reaction time
- reduced visual acuity/attention
- hearing impairment
- poor balance/increased sway
What comorbidities or other factors should be considered when
providing care for older trauma patient?
Cardiac disease
Stroke
, Neurological disease
Neuropathy
Medications
Why are older patients at risk for pulmonary complications
especially when there is tenderness in chest area and pain on
movement or inspiration?
Ineffective respiratory effect
Atelectasis
Increased work breathing
What considerations are there when evaluating vitals in older
trauma patient?
baseline changes in respiration and pulse my be present
Why is it critical to perform frequent reevaluation and
reassessment of the primary survey in the older adult?
to quickly identify changes that indicate deterioration in condition -
elderly have limited physiological reserves
What are signs of elder maltreatment?
Bruising in unusual locations
Burns
multiple Fx
markings/scars on wrists/ankles
bald patches/hematomas on scalp
soft palate injuries
genital/rectal injury
pressure injury
poor hygiene
Malnutrition
Dehydration
Delayed treatment
GUIDE QUESTIONS AND
ANSWERS (LATEST)
What is the TEN-4 mnemonic?
bruising in children under 4 y/o to:
- ear
- neck
- torso
What injuries are more common and should be anticipated in the
obese patient?
- Spinal
- Upper torso
- Upper/lower limb fx
What airway and ventilation differences should be considered
when caring for the obese patient?
- narrowed airway
- larger tongue
- relaxed pharyngeal muscle
- respiratory insufficiency due to chest wall weight, decreased chest
wall compliance
- increased airway resistance
What differences in equipment or its use may be necessary?
- Larger equipment
- Reverse Trendelenburg
- US placed IV
- 2 people to hold bag-mask
,What considerations may be appropriate to keep the patient and
staff safe with obese trauma pt?
- Use assistive transfer devices
- Increase the number of staff for the transfer
What are some ways to provide sensitive care to obese patients?
- Appropriate size equipment/clothing
- Sensitive to wording used when speaking to pt
What are some anatomic or physiologic differences in the older
adult that can affect the components of the primary survey and
should be considered when caring for these patients?
Decreased gag reflex
Dentures
Changes in spinal curvature
Neurological changes
Decreased muscle mass
Increased comorbidities
What are the common MOIs in older adults? Why?
Most common - falls
- also MVC/pedestrian collisions, burns, penetrating injuries
Why?
- slow reaction time
- reduced visual acuity/attention
- hearing impairment
- poor balance/increased sway
What comorbidities or other factors should be considered when
providing care for older trauma patient?
Cardiac disease
Stroke
, Neurological disease
Neuropathy
Medications
Why are older patients at risk for pulmonary complications
especially when there is tenderness in chest area and pain on
movement or inspiration?
Ineffective respiratory effect
Atelectasis
Increased work breathing
What considerations are there when evaluating vitals in older
trauma patient?
baseline changes in respiration and pulse my be present
Why is it critical to perform frequent reevaluation and
reassessment of the primary survey in the older adult?
to quickly identify changes that indicate deterioration in condition -
elderly have limited physiological reserves
What are signs of elder maltreatment?
Bruising in unusual locations
Burns
multiple Fx
markings/scars on wrists/ankles
bald patches/hematomas on scalp
soft palate injuries
genital/rectal injury
pressure injury
poor hygiene
Malnutrition
Dehydration
Delayed treatment
