TNCC Final Exam Test 2022 Open Book

TNCC Final Exam Test 2022 Open Book 1.Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a)to measure oxygenation and ventilation b)to quantify the base deficit for the adequacy of cellular perfusionc)*to gauge end-organ perfusion and tissue hypoxia ** d)to determine the underlying cause of shock 2.A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vitalsigns are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs andsymptoms of which stage of shock?A)compensated ** B)Progressive C)irreversible D)decompensated 3.An elderly patient with a history of anticoagulant use presents after a fall at home that day. shedenies any loss of consciousness. She has a hematoma to her forehead and complains ofheadache, dizziness, and nausea. Which is a most likely cause of her symptoms? A)epidural hematoma B)diffuse axonal injury C)post-concussive syndromeD)subdural hematoma *** 4.EMS brings a patient who fell riding his bicycle. Using the American College of Surgeonsscreening guidelines, which assessment finding would prompt the nurse to prepare the patientfor radiologic spine clearance? TNCC Final Exam Test 2022 Open Book 50 CORRECTLY ANSWERED QUESTIONS A) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath *** 5. Which of the following occurs during the third impact of a motor vehicle crash? A) The driver of the vehicle collides with the steering wheel B) the vehicle collides with a tree C) the aorta is torn at its attachment with the ligamentum arteriosum D) the airbag deploys and strikes the front seat passenger *** 6. A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority interventions? A) initiate transfer to a trauma center ** B) provide report to the operating room nurse C) Obtained imaging studies D) Place a gastric tube 7. Which of the following injuries is LEAST likely to be promptly identified? A) spleen B) lung C) bowel *** D) brain 8. Patients with a crush injury should be monitored for which of the following conditions? A) Hypernatremia B) Hypercalcemia C) Dysrhthmias ** D) polyuria 9. What finding raises suspicion of complete spinal cord injury? A) Weakness in the lower extremities B) Priapism *** C) voluntary anal sphincter tone D) intact reflexes distal to the injury 10. A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? A) Bradycardia and ipsilateral absences of motor function B) Tachycardia and respiratory depression C) Tachycardia and absent motor function below the level of injury D) Bradycardia and absent motor function below the level of the injury *** 11. A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various stages of healing and multiple small, clean, round burns to the back. There are no abnormalities found based on the pediatric assessment triangle or primary survey. Which of the following is the priority nursing intervention? A) report your suspicion of the maltreatment in accordance with local regulations *** B) apply ice to the bruises and consult wound care C) engage in therapeutic communication to determine the MOI D) provide the family with injury prevention resourse 12. A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A) elevating the extremity above the level of the heart B) repositioning and apply ice C) Elevating the extremity to the level of the heart *** D) Preparing the patient for ultrasound 13. A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? A) apply a sling and elevate the extremity to the level of the heart. B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART *** C) Apply a sling and elevate the extremity above the level of the heart D) apply a splint and elevate the extremity to the level of the heart. 14. Which of the following is a late sign of increased intracranial pressure? Cushing Response Widening pulse pressure Reflex bradycardia Decreased RR - A) Restlessness or drowsiness B) Nausea and vomiting C) Decreased respiratory effort** D) amnesia and anxiety 15. Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage? A) ABC B) MARCH*** C) AVPU D) VIPP 16. A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principle? A) initiate two large caliber intravenous lines for Ringers lactate solution administration *** B) Administer Dilaudid for pain control and provide comfort care C) Place the patient in an observation area for care within the next few hours D) Contact the command center for the personnel to notify next of kin. 20. Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? A) padding the upper back while stabilizing the cervical spine *** B) applying a tight-fitting NRB mask with an attached resevior C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation 21. Which of the following is a component of the trauma triad of death? hypothermia, metabolic acidosis, coagulopathy - A) Acidosis ** B) hyperthermia C) hemorrhage D) sepsis 22. A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is suspected? A) oculomotor nerve palsy B) globe rupture *** C) uncal herniation D) retinal detachment 23. Which of the following is true about the log roll maneuver? A) it causes less spinal motion than the lift and slide manuever B) it is recommended for patients with unstable pelvic fractures C) it can worsen cord damage from an unstable spinal injury *** D) it does not increases the risk of life threatening hemorrhage from unstable injuries