TNCC Written Exam
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome
of resuscitation? - ANSBase deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral
vasculature? - ANSVasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - ANSMetabolic acidosis
What type of shock results in generalized vasodilation? - ANSNeurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? -
ANSPhrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? -
ANSCompartment Syndrome
What is a high risk of frostbite? - ANSThrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along
with rewarming? - ANSTissue plasminogen activator or non steroidal anti-inflammatory
medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - ANSPeripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient? -
ANSReverse Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments causing
lacerations or penetrating injuries? - ANSSecondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - ANSQuaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls,
ground, or any hard object? - ANSTertiary 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? - ANSPrimary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or
malaise, and elevated creatinine kinase levels? - ANSRhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough,
orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or
hypotension? - ANSPulmonary Embolus
, Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered
level of consciousness? - ANSIncreased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse
pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? -
ANSLate signs of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery? - ANSSubdural
and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and
nausea. - ANSPostconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. -
ANSPostconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - ANSMAP - ICP
What is the range for CO2 to maximize perfusion? - ANS35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - ANSDilation
and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - ANSConstriction d/t low CO2
Pupils with pressure on cranial nerve - ANSFixed and dilated
Pupils with opiates vs stimulants - ANSsmall; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - ANSlarge
Sluggish reaction of pupils is an early sign of what? - ANSIncreasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - ANSMild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - ANS<15
Goal value for Cerebral Perfusion Pressure (CPP) - ANS>60
Le Fort Fracture - ANSFracture of the maxilla
What decrease ICP by decreasing cellular edema? - ANSOsmotic diuretics (such as 3% saline
and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - ANSCardiac
Tamponade;
1. Hypotension
What is the best measure of the adequacy of cellular perfusion and helps predict the outcome
of resuscitation? - ANSBase deficit used in conjunction with serum lactate
Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral
vasculature? - ANSVasoconstriction
What results from tissue hypo perfusion and oxygen deficit? - ANSMetabolic acidosis
What type of shock results in generalized vasodilation? - ANSNeurogenic shock
Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? -
ANSPhrenic nerve; paralyzed diaphragm and inability to breath
Extremity elevation AT the level of the heart is beneficial for what type of injury? -
ANSCompartment Syndrome
What is a high risk of frostbite? - ANSThrombus formation
What two medications can be administered to maintain perfusion after a frostbite injury along
with rewarming? - ANSTissue plasminogen activator or non steroidal anti-inflammatory
medication (NSAIDS)
An rise in diastolic blood pressures is a sign of increasing what? - ANSPeripheral resistance
What position will benefit the airway and work of breathing for the bariatric patient? -
ANSReverse Trendelenburg
Which phase of a blast results from flying debris, projectiles, and bomb fragments causing
lacerations or penetrating injuries? - ANSSecondary Phase
What phase of a blast results from any explosion-related illness or injury including
hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - ANSQuaternary Phase
What phase of a blast results from individuals being thrown by the blast and impacting walls,
ground, or any hard object? - ANSTertiary 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? - ANSPrimary Phase
Signs of what include muscle pain or weakness, dark red or brown urine, general weakness or
malaise, and elevated creatinine kinase levels? - ANSRhabdomyolosis
Signs of what include anxiety, pleuritic chest pain, dyspnea, hypoxemia, hemoptysis, cough,
orthopnea, adventitious lung sounds, decreased lung sounds, jugular vein distention, or
hypotension? - ANSPulmonary Embolus
, Signs of what include headache, nausea and vomiting, amnesia, behavioral changes, altered
level of consciousness? - ANSIncreased intracranial pressure
Signs of what include asymmetric pupillary reactivity, unilateral dilation, widening pulse
pressure, abnormal motor posturing, bradycardia, and decreased respiratory effort? -
ANSLate signs of increased ICP with Herniation Syndrome
What is caused by the tear of the bridging veins or middle meningeal artery? - ANSSubdural
and Epidural Hematoma
Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and
nausea. - ANSPostconcussive Syndrome/ Mild Traumatic Brain Injury
Signs and symptoms similar to early signs of increased ICP but do not worsen. -
ANSPostconcussive Syndrome/ Mild Traumatic Brain Injury
Cerebral Perfusion Pressure = ______-______ - ANSMAP - ICP
What is the range for CO2 to maximize perfusion? - ANS35-45
Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - ANSDilation
and increase in ICP due to high CO2
Hyperventilation cause dilation or constriction? - ANSConstriction d/t low CO2
Pupils with pressure on cranial nerve - ANSFixed and dilated
Pupils with opiates vs stimulants - ANSsmall; large
Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - ANSlarge
Sluggish reaction of pupils is an early sign of what? - ANSIncreasing ICP
Glasgow Coma Score with Mild, Moderate, and Severe TBI - ANSMild = 13-15
Moderate = 9-12
Severe = 3-8
Goal value for ICP - ANS<15
Goal value for Cerebral Perfusion Pressure (CPP) - ANS>60
Le Fort Fracture - ANSFracture of the maxilla
What decrease ICP by decreasing cellular edema? - ANSOsmotic diuretics (such as 3% saline
and mannitol)
Becks Triad is a sign of what? And includes what three symptoms? - ANSCardiac
Tamponade;
1. Hypotension
