TNCC already passed
Effective communication
•Skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care - ansWhat is the key to a high-performance
trauma team?
Reprioritize circulation before airway or breathing.
•The across-the-room observation is done at the beginning of the primary survey to rapidly
assess the need to reprioritize circulation before airway or breathing. This is done if
uncontrolled external hemorrhage is identified - ansThe across-the-room observation step in
the initial assessment provides the opportunity to
Evaluating and anticipating the types of injury that may be present
•Mechanism of injury and energy transfer can assist the provider in evaluating and
anticipating
damage - ansWhen obtaining a history for an injured patient, understanding the kinematic
concepts associated with the mechanism of injury and energy transfer can initially assist the
trauma provider in:
Uncontrolled hemorrhage
•Uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment
to identify uncontrolled hemorrhage is key to the initial assessment process - ansThe major
preventable cause of death in the trauma patient is:
Ventilate at a rate of 10 to 12 breaths/minute
•If ventilation is ineffective, assist ventilations at 10 to 12 breaths/minute or one every 5 to 6
seconds - ansventilation principles associated with a bag-mask device?
Base deficit
•Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and
when used in conjunction with serum lactate helps predict the success of the resuscitation -
ansbest measure of the adequacy of cellular perfusion and helps to predict the outcome
of resuscitation?
Intercostal nerve blocks
•Continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and
effective pain management for the anticoagulated patient - ansWhat is a safe pharmacological
alternative to opioids for rib fracture pain management in the anticoagulated patient?
Cerebral vasoconstriction
, •Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the
cerebral vasculature - ansIn a patient with severe traumatic brain injury, hypocapnia causes:
Damage to the spinal cord
*Penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other common
concurrent injury is to the spinal cord - ansA patient with a knife injury to the neck has an
intact airway and is hemodynamically stable. He complains of difficulty swallowing and
speaking. Further assessment is indicated next for which of the following conditions?
Apply gentle pressure over the iliac crests downward and medially
*To assess for pelvic instability, gentle pressure is applied over the iliac crests downward and
medially - ansWhat is the appropriate technique for palpating the pelvis for stability?
Maintain adequate respiratory status
*Spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function, resulting in a
paralyzed diaphragm and inability to breathe - ansA patient with a spinal cord injury at C5 is
being cared for in the emergency department while awaiting transport to a trauma center.
Which of the following represents the highest priority for ongoing assessment and
management?
Initiate direct pressure
*The first step in controlling any bleeding is direct pressure. If that is not adequate, the
application of a tourniquet may be needed - ansBased on proper bleeding control techniques,
what is the first step to stop the bleeding of a penetrating injury to the lower extremity?
Administer tissue plasminogen activator
*With frostbite, thrombus formation is a risk. Tissue plasminogen activator or nonsteroidal
antiinflammatory medication can be administered (p. 215).
-Tissue plasminogen activator has been effective in maintaining perfusion and decreasing the
need for amputation when administered within 24 hours of rewarming - ansTreatment for
frostbite includes:
Normal vital signs in pregnancy
*In pregnancy, the resting heart rate increases by 10 to 20 beats/minute and a small decrease
in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease
in peripheral resistance (p. 294).
-Normal fetal heart rate is between 120 and 160 beats/minute - ansA 30-week pregnant
trauma patient's vital signs include a blood pressure of 94/62 mm Hg and a heart rate of 108
beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the
patient's hemodynamic findings as an indication of which of the following?
Cooperation with the assessment
Effective communication
•Skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care - ansWhat is the key to a high-performance
trauma team?
Reprioritize circulation before airway or breathing.
•The across-the-room observation is done at the beginning of the primary survey to rapidly
assess the need to reprioritize circulation before airway or breathing. This is done if
uncontrolled external hemorrhage is identified - ansThe across-the-room observation step in
the initial assessment provides the opportunity to
Evaluating and anticipating the types of injury that may be present
•Mechanism of injury and energy transfer can assist the provider in evaluating and
anticipating
damage - ansWhen obtaining a history for an injured patient, understanding the kinematic
concepts associated with the mechanism of injury and energy transfer can initially assist the
trauma provider in:
Uncontrolled hemorrhage
•Uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment
to identify uncontrolled hemorrhage is key to the initial assessment process - ansThe major
preventable cause of death in the trauma patient is:
Ventilate at a rate of 10 to 12 breaths/minute
•If ventilation is ineffective, assist ventilations at 10 to 12 breaths/minute or one every 5 to 6
seconds - ansventilation principles associated with a bag-mask device?
Base deficit
•Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and
when used in conjunction with serum lactate helps predict the success of the resuscitation -
ansbest measure of the adequacy of cellular perfusion and helps to predict the outcome
of resuscitation?
Intercostal nerve blocks
•Continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and
effective pain management for the anticoagulated patient - ansWhat is a safe pharmacological
alternative to opioids for rib fracture pain management in the anticoagulated patient?
Cerebral vasoconstriction
, •Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the
cerebral vasculature - ansIn a patient with severe traumatic brain injury, hypocapnia causes:
Damage to the spinal cord
*Penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other common
concurrent injury is to the spinal cord - ansA patient with a knife injury to the neck has an
intact airway and is hemodynamically stable. He complains of difficulty swallowing and
speaking. Further assessment is indicated next for which of the following conditions?
Apply gentle pressure over the iliac crests downward and medially
*To assess for pelvic instability, gentle pressure is applied over the iliac crests downward and
medially - ansWhat is the appropriate technique for palpating the pelvis for stability?
Maintain adequate respiratory status
*Spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function, resulting in a
paralyzed diaphragm and inability to breathe - ansA patient with a spinal cord injury at C5 is
being cared for in the emergency department while awaiting transport to a trauma center.
Which of the following represents the highest priority for ongoing assessment and
management?
Initiate direct pressure
*The first step in controlling any bleeding is direct pressure. If that is not adequate, the
application of a tourniquet may be needed - ansBased on proper bleeding control techniques,
what is the first step to stop the bleeding of a penetrating injury to the lower extremity?
Administer tissue plasminogen activator
*With frostbite, thrombus formation is a risk. Tissue plasminogen activator or nonsteroidal
antiinflammatory medication can be administered (p. 215).
-Tissue plasminogen activator has been effective in maintaining perfusion and decreasing the
need for amputation when administered within 24 hours of rewarming - ansTreatment for
frostbite includes:
Normal vital signs in pregnancy
*In pregnancy, the resting heart rate increases by 10 to 20 beats/minute and a small decrease
in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease
in peripheral resistance (p. 294).
-Normal fetal heart rate is between 120 and 160 beats/minute - ansA 30-week pregnant
trauma patient's vital signs include a blood pressure of 94/62 mm Hg and a heart rate of 108
beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets the
patient's hemodynamic findings as an indication of which of the following?
Cooperation with the assessment
