CERTIFICATION SCRIPT 2026
QUESTIONS WITH SOLUTIONS
GRADED A+
◍ 1. Preparation and Triage2. Primary Survery (ABCDE) with resuscitation
adjuncts (F,G)3. Reevaluation (consideration of transfer)4. Secondary
Survey (HI) with reevaluation adjuncts5. Reevaluation and post
resuscitation care6. Definitive care of transfer to an appropriate trauma
nurse.
Answer: Initial Assessment (TNCC)
◍ What is the most reliable method of confirming and montioring correct
placement of an ET tube?.
Answer: Continuous waveform capnography
◍ The upper airway consists of....
Answer: Nose, Mouth, Jaw, Oral Cavity, Pharynx, and Larynx
◍ (primary)X- Assess for and control massive hemorrhageA- Across the room
survey, AVPU w/ cervical spine immobilization, airwayB- Breathing and
ventilationC- CirculationD- DisabilityE- Exposure(interventions/ resus
adjuncts)F- Full set of vitals and family presence G- Get adjuncts (LMNO)
L- labs M- monitor cardiac rhythm N- Naso/ orogastric tube (if intubated/
indicated by injury) O- oxygenation ventilation analysis: SpO2,
ETCO2(secondary, complete after fixing problems of primary)H- History
and head to toeI- Inspect posterior service while maintaining cervical
immobilization J- Just keep evaluating (VIPP) V- VS I- Identified injuries
P- Primary assessment P- Pain.
Answer: XABCDEFGHI
,◍ No gas exchange occurs here __________, it's called ____________..
Answer: Nose to terminal bronchioles, anatomical dead space. (2ml/kg of
inspired tidal volume) They conduct airflow towards gas exchange units.
◍ Crycothyroid membrane.
Answer: between thyroid and cricoid, avascular structure that connects the
thyroid and cricoid cartilage. Site of CRiCOTHYROTOMY- an emergency
opening of the airway.
◍ A PaCO2 greater than 45 mmHg indicates:
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis..
Answer: C. Respiratory acidosis
◍ Primary surveyX- Assess for and control massive hemorrhage (see also
"A)A- AAA Across the room survey checking for massive hemorrhage
(re-prioritize to C-ABC; pressure, elevate, tourniquet) Alertness (AVPU)
with simultaneous cervical spinal stabilization Airway (check patency and
intervene w/ suction or insert airway adjunct)B- Breathing and Ventilation
Spontaneous breathing, symmetrical rise and fall of chest, depth, pattern,
rate of respiration, signs of respiratory difficulty, skin color (cyanotic or
pale), wounds, contusions, abrasions, or deformities Auscultate for breath
sounds and heart sounds Palpate bony structures of chest looking for any
deformities, subcutaneous emphysema, or soft tissue injury (bruises or seat
belt marks) If adequate breathing/ ventilation present: 15L NRB and assess
ETCO2 If adequate breathing/ ventilation not present: Open the airway, jaw
thrust with second person, Inser.
Answer: ABCDEFGHI (in- depth)
◍ reorganize care to C-ABC.
Answer: If uncontrolled hemorrhage ..
◍ Used at the beginning of the initial assessment1. A Alert. If the pt is alert he
, or she will be able to maintain his or her airway once it is clear.2. V
responds to verbal stimuli responds to pain. If the patient needs verbal
stimulation to respond, an airway adjunct may be needed to keep the tongue
from obstructing the airway. 3. P responds to pain. If the pt. responds only
to pain, he or she may not be able to maintain his or her airway adjunct may
need to be placed while further assessment is made to determine the need for
intubation. 4. U Unresponsive. If the pt. is unresponsive, announce it loudly
to the team and direct someone to chk in the pt is pulseless while assessing
if the cause of the problem is the airway..
Answer: Airway and AVPU:
◍ ask pt to open his or her mouth.
Answer: While assessing airway the patient is alert and responds to verbal
stimuli you should..
◍ jaw thrust maneuver to open airway and assess for obstruction. If pt has a
suspected CSI, the jaw thrust procedure should be done by two providers.
One provider can maintain c-spine and the other can perform the jaw thrust
maneuver..
Answer: While assessing airway pt is unable to open mouth, responds only
to pain, or is unresponsive you should..
◍ 1. The tongue obstructing the airway2. loose or missing teeth3. foreign
objects4. blood, vomit, or secretions'5. edema6. burns or evidence of
inhalation injuryAuscultiate or listen for:1. Obstructive airway sounds such
as snoring or gurgling2. Possible occlusive maxillofacial bony deformity3.
Subcutaneous emphysema.
Answer: Inspect the mouth for:
◍ 1. Check the presence of adequate rise and fall of the chest with assisted
ventilation2. Absence of gurgling on auscultation over the epigastrium 3.
Bilateral breath sounds present on auscultation 4. Presence of carbon
dioxide (CO2) verified by a CO2 device or monitor.
Answer: If the pt has a definitive airway in what should you do?
◍ 1. Suction the airway2, Use care to avoid stimulating the gag reflex3. If the
, airway is obstructed by blood or vomitus secretions, use a rigid suction
deviceIf foreign body is noted, remove it carefully with forceps or another
appropriate method.
Answer: If Airway is not patent
◍ PaCO2 normal range.
Answer: 35-45 mm Hg Less than 35 likely means hyperventilation
◍ Tracheal deviation AWAY from the affected side, decreased breath sounds,
and hyperresonance... What's happening?.
Answer: Tension pneumothorax
◍ 1. Apnea2. GCS 8 or less3. Maxillary fractures4. Evidence of inhalation
injury (facial burns)5. Laryngeal or tracheal injury or neck hematoma6.
High risk of aspiration and patients inability to protect the airway7.
Compromised or ineffective ventilation.
Answer: Following conditions might require a definitive airway
◍ Breathing: To assess breathing expose the chest:1. Inspect for a.
spontaneous breathing b. symmetrical rise and fall c. depth, pattern, and rate
of respiration d. signs of difficulty breathing such as accessory muscle use e.
skin color (normal, pale, flushed, cyanotic) f. contusions, abrasions,
deformities (flail chest) g. open pneumothoraces (sucking chest wounds) h.
JVD i. signs of inhalation injury (singed nasal hairs, carbonaceous sputum).
Answer: B
◍ In a tension pneumothorax tracheal deviation goes in what direction?.
Answer: AWAY from affected side.
◍ tracheal deviation and jvd.
Answer: Late signs of tension pneumo:
◍ 1. equal breath sounds bilaterally at the second intercostal space
midclavicular line and the bases for fifth intercostal space at the axillary
line.
Answer: Auscultate the chest for: