TNCC 9TH EDITION EXAM LATEST UPDATED
300+ QUESTIONS AND CORRECT DETAILED
ANSWERS.
Primary concern when a person cannot stop coughing/clearing their throat following
house fire/smoke? - ANSWER- Airway/Intubate
,Lab of cellular perfusion - ANSWER- Base Excess (Less than -6 is BAD)
Multiple people are in the ER of different ages who all go to the same church. They all
have the same symptoms. What is the most likely cause? - ANSWER- Biologic
Suspected shock type with a spinal cord injury - ANSWER- Distributive Shock (Includes
neurogenic)
Patient has GCS of 3, unequal pupils (one sluggish, one blown), and is posturing. What
is the cause? - ANSWER- Herniation
Middle Meningeal Artery - ANSWER- Epidural Hematoma (results from collection of
blood that forms between dura mater and skull)
Prior to having a concussion (TBI), the patient had a brain injury that was not fully
healed. What is the cause? - ANSWER- 2nd Impact Syndrome
Bowel sounds heard in the L chest. What is this a symptom of? - ANSWER- Ruptured
diaphragm
Symptoms of __________________: include muffled heart sounds and hypotension -
ANSWER- Pericardiocentesis
How should you dress a severed limb? - ANSWER- Sterile gauze with normal saline
THEN put ice on it
Amylase level looks at _____________ - ANSWER- Pancreas
What should you do if your patient has hyphema (collection of blood inside the front part
of the eye?) - ANSWER- Sit HOB up to 30 degrees
Principle that people have to take action after suffering a loss in order to decrease
severity, seriousness, or painfulness - ANSWER- Mitigation
What organ is most at risk following a gunshot - ANSWER- Liver
8 year old child with longitudinal thigh lacerations - ANSWER- Sign of child abuse
Bleeding around belly button - ANSWER- Cullen's Sign
What would cause an inaccurate reading from an 02 saturation probe? - ANSWER-
Carboxyhemoglobin (increase FiO2 to 100%)
General study of forces and their effects on living tissue and the human body -
ANSWER- Biomechanics
,Study of energy transfer as it applies to identifying actual or potential injuries -
ANSWER- Kinematics
Refers to the separation of tissue resulting from a sound and/or hydraulic wave force-
the effect is a crushing pressure wave which creates a temporary cavity, followed by a
rapid and violent closing of the cavity. - ANSWER- Cavitation
This rapid motion can lead to crushing, tearing, and shearing forces on tissue -
ANSWER- Cavitation
Used in OR; does not provide protection against aspiration and not recommended in
patients who have eaten recently. It is a supraglottic airway. - ANSWER- Laryngeal
Mask Airway
Single tube retroglottic device inserted into the esophagus and traps the glottis opening
between an esophageal cuff and an oropharyngeal cuff. Designed with 2 ports/lumens
each with a separate cuff. Does NOT provide protection against aspiration and is not
indicated in children. It is a retroglottic airway. - ANSWER- King Tube
Types of Shock (4) - ANSWER- Hypovolemic, Obstructive, Cardiogenic, Distributive
Hemorrhage is the leading cause. Can result from vomiting, diarrhea, and burn trauma.
Decreased circulating volume --> decreased preload. Therapy includes replacing the
type of volume that was lost. - ANSWER- Hypovolemic Shock
Results from hypo perfusion of tissue due to an obstruction in either the vasculature or
heart. Therapy aimed at relieving the obstruction and improving perfusion. - ANSWER-
Obstructive Shock
Two classic examples of obstructive shock - ANSWER- Cardiac tamponade and tension
pneumothorax
Results from pump failure in the presence of adequate intravascular volume. Lack of
CO and end-organ perfusion secondary to a decrease in myocardial contractility and/or
valvular insufficiency. Therapy includes inotropic support, antidysrhythmic medications,
and correction or treatment of underlying cause. - ANSWER- Cardiogenic Shock
Results from the misdistribution of an adequate circulating blood volume with the loss of
vascular tone or increased permeability. Treatment is to provide volume replacement,
increase systemic vascular resistance with medications (pressors) and possible
antibiotics. - ANSWER- Distributive Shock
Examples that can cause distributive shock - ANSWER- Anaphylactic shock, septic
shock, neurogenic shock
___________________: Impairs thrombin production and platelet function
, _____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSWER- Trauma
Triad of Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
Stages of Shock (3) - ANSWER- 1. Compensated
2. Decompensated vs Progressive
3. Irreversible
Complete craniofacial separation involving maxilla, zygoma, orbits, and bones of the
cranial base. Assessment findings include: massive facial edema, mobility and
depression of zygomatic bones, ecchymoses, diplopia, and open bite or malocclusion. -
ANSWER- LeFort III
Transverse maxillary bone fracture that occurs above the level of the teeth from the
maxilla. Assessment findings include: independent moment of the maxilla from the rest
of the face, slight swelling of the maxillary area, lip laceration or fractured teeth,
malocclusion. - ANSWER- LeFort I
Pyramidal maxillary bone fracture involving the mid-face area. The apex of the fracture
transverses the bridge of the nose. Assessment findings include: massive facial edema,
nasal swelling with obvious fracture of the nasal bones, malocclusion, CSF rhinorrhea -
ANSWER- LeFort II
Can be caused by blunt trauma. Air escapes from the injured lung into the pleural
space, and negative intrapleural pressure is lost resulting in partial or complete collapse
of the lung. S & S: dyspnea, tachypnea, decreased/absent breath sounds on injured
side, chest pain. Treatment: based on size, symptoms, and stability. Chest tube may be
placed to evacuate pleural air and maintain lung expansion - ANSWER- Pneumothorax
Air enters the intrapleural space but cannot escape on expiration. The increasing
intrathoracic pressure causes the lung on the injured side to collapse. If pressure is not
relieved, the mediastinum can shift toward the uninjured side compressing the
heart/great vessels/and opposite lung. S & S: anxiety, severe restlessness, severe
respiratory distress, significantly diminished or absent breath sounds on injured side,
hypotension, distended neck/head/upper extremity veins, tracheal deviation, or a shift
toward uninjured side. Treatment: Needle thoracentesis and chest tube insertion -
ANSWER- Tension Pneumothorax
Collection of blood in pericardial sac. Mechanism of injury is typically penetrating
trauma. Compresses the heart and decreases ability of the ventricles to fill causing
decreased SV and CO. S & S: hypotension, muffled heart sounds, distended neck
300+ QUESTIONS AND CORRECT DETAILED
ANSWERS.
Primary concern when a person cannot stop coughing/clearing their throat following
house fire/smoke? - ANSWER- Airway/Intubate
,Lab of cellular perfusion - ANSWER- Base Excess (Less than -6 is BAD)
Multiple people are in the ER of different ages who all go to the same church. They all
have the same symptoms. What is the most likely cause? - ANSWER- Biologic
Suspected shock type with a spinal cord injury - ANSWER- Distributive Shock (Includes
neurogenic)
Patient has GCS of 3, unequal pupils (one sluggish, one blown), and is posturing. What
is the cause? - ANSWER- Herniation
Middle Meningeal Artery - ANSWER- Epidural Hematoma (results from collection of
blood that forms between dura mater and skull)
Prior to having a concussion (TBI), the patient had a brain injury that was not fully
healed. What is the cause? - ANSWER- 2nd Impact Syndrome
Bowel sounds heard in the L chest. What is this a symptom of? - ANSWER- Ruptured
diaphragm
Symptoms of __________________: include muffled heart sounds and hypotension -
ANSWER- Pericardiocentesis
How should you dress a severed limb? - ANSWER- Sterile gauze with normal saline
THEN put ice on it
Amylase level looks at _____________ - ANSWER- Pancreas
What should you do if your patient has hyphema (collection of blood inside the front part
of the eye?) - ANSWER- Sit HOB up to 30 degrees
Principle that people have to take action after suffering a loss in order to decrease
severity, seriousness, or painfulness - ANSWER- Mitigation
What organ is most at risk following a gunshot - ANSWER- Liver
8 year old child with longitudinal thigh lacerations - ANSWER- Sign of child abuse
Bleeding around belly button - ANSWER- Cullen's Sign
What would cause an inaccurate reading from an 02 saturation probe? - ANSWER-
Carboxyhemoglobin (increase FiO2 to 100%)
General study of forces and their effects on living tissue and the human body -
ANSWER- Biomechanics
,Study of energy transfer as it applies to identifying actual or potential injuries -
ANSWER- Kinematics
Refers to the separation of tissue resulting from a sound and/or hydraulic wave force-
the effect is a crushing pressure wave which creates a temporary cavity, followed by a
rapid and violent closing of the cavity. - ANSWER- Cavitation
This rapid motion can lead to crushing, tearing, and shearing forces on tissue -
ANSWER- Cavitation
Used in OR; does not provide protection against aspiration and not recommended in
patients who have eaten recently. It is a supraglottic airway. - ANSWER- Laryngeal
Mask Airway
Single tube retroglottic device inserted into the esophagus and traps the glottis opening
between an esophageal cuff and an oropharyngeal cuff. Designed with 2 ports/lumens
each with a separate cuff. Does NOT provide protection against aspiration and is not
indicated in children. It is a retroglottic airway. - ANSWER- King Tube
Types of Shock (4) - ANSWER- Hypovolemic, Obstructive, Cardiogenic, Distributive
Hemorrhage is the leading cause. Can result from vomiting, diarrhea, and burn trauma.
Decreased circulating volume --> decreased preload. Therapy includes replacing the
type of volume that was lost. - ANSWER- Hypovolemic Shock
Results from hypo perfusion of tissue due to an obstruction in either the vasculature or
heart. Therapy aimed at relieving the obstruction and improving perfusion. - ANSWER-
Obstructive Shock
Two classic examples of obstructive shock - ANSWER- Cardiac tamponade and tension
pneumothorax
Results from pump failure in the presence of adequate intravascular volume. Lack of
CO and end-organ perfusion secondary to a decrease in myocardial contractility and/or
valvular insufficiency. Therapy includes inotropic support, antidysrhythmic medications,
and correction or treatment of underlying cause. - ANSWER- Cardiogenic Shock
Results from the misdistribution of an adequate circulating blood volume with the loss of
vascular tone or increased permeability. Treatment is to provide volume replacement,
increase systemic vascular resistance with medications (pressors) and possible
antibiotics. - ANSWER- Distributive Shock
Examples that can cause distributive shock - ANSWER- Anaphylactic shock, septic
shock, neurogenic shock
___________________: Impairs thrombin production and platelet function
, _____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSWER- Trauma
Triad of Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
Stages of Shock (3) - ANSWER- 1. Compensated
2. Decompensated vs Progressive
3. Irreversible
Complete craniofacial separation involving maxilla, zygoma, orbits, and bones of the
cranial base. Assessment findings include: massive facial edema, mobility and
depression of zygomatic bones, ecchymoses, diplopia, and open bite or malocclusion. -
ANSWER- LeFort III
Transverse maxillary bone fracture that occurs above the level of the teeth from the
maxilla. Assessment findings include: independent moment of the maxilla from the rest
of the face, slight swelling of the maxillary area, lip laceration or fractured teeth,
malocclusion. - ANSWER- LeFort I
Pyramidal maxillary bone fracture involving the mid-face area. The apex of the fracture
transverses the bridge of the nose. Assessment findings include: massive facial edema,
nasal swelling with obvious fracture of the nasal bones, malocclusion, CSF rhinorrhea -
ANSWER- LeFort II
Can be caused by blunt trauma. Air escapes from the injured lung into the pleural
space, and negative intrapleural pressure is lost resulting in partial or complete collapse
of the lung. S & S: dyspnea, tachypnea, decreased/absent breath sounds on injured
side, chest pain. Treatment: based on size, symptoms, and stability. Chest tube may be
placed to evacuate pleural air and maintain lung expansion - ANSWER- Pneumothorax
Air enters the intrapleural space but cannot escape on expiration. The increasing
intrathoracic pressure causes the lung on the injured side to collapse. If pressure is not
relieved, the mediastinum can shift toward the uninjured side compressing the
heart/great vessels/and opposite lung. S & S: anxiety, severe restlessness, severe
respiratory distress, significantly diminished or absent breath sounds on injured side,
hypotension, distended neck/head/upper extremity veins, tracheal deviation, or a shift
toward uninjured side. Treatment: Needle thoracentesis and chest tube insertion -
ANSWER- Tension Pneumothorax
Collection of blood in pericardial sac. Mechanism of injury is typically penetrating
trauma. Compresses the heart and decreases ability of the ventricles to fill causing
decreased SV and CO. S & S: hypotension, muffled heart sounds, distended neck
