TNCC 9th Edition
TNP2023/75Questions with solved
answers/ Graded A+.
just keep evaluating - vipp - -What does the J stand for at the end of the secondary
survery?
-vital signs, injuries/interventions, primary survey, pain - -What does VIPP stand
for?
-flank - -During the head-to-toe, where would you find Grey-Turner's sign?
-umbilicus - -During the head-to-toe, where would you find Cullen's sign?
-inspecting posterior - -What is sometimes deferred at the end of the head-to-toe?
-AFTER head-to-toe, BEFORE J (VIPP) - -Antibiotics, consults, head CT, imaging,
law enforcement, mandatory reporting, psychosocial support, social services,
splinting, tetanus, and wound care are all interventions that you do AFTER and
before WHAT?
-Medical records, prehospital report, SAMPLE - -What three items are obtained
during the pertinent history assessment?
-Distraction, family presence, padding bony prominences, repositioning,
splinting, verbal reassurance - -What are examples of nonpharmacologic
measures? (must identify at least one during testing)
-all patients - -For whom is capnography highly recommended?
-EKG - -In step M of "Get Adjuncts", what else might be indicated besides cardiac
monitor?
-blankets, room temp increase, warmed fluids, warming lights - -In Step 16 of
"Exposure and Environment", you must name at least one of these interventions:
-In Step 15 of "Exposure and Environment" - -At what point PRIOR TO the head-
to-toe is the patient inspected for obvious injuries?
-glucose - -In Step 13 of "Disability", what is assessed if pt is altered?
-1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - -To
assess circulation, you must do these two main tasks:
-intervene as appropriate and reassess - -What do you do when alterations are
identified in any of the steps in the primary survery?
, -1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise
and fall of the chest w/ assisted ventilations; 3. auscultate over epigastrium for
gurgling AND lungs for bilateral breath sounds - -What three assessments must be
done if the patient is intubated?
-Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous
emphysema, increased work of breathing, symmetrical chest rise and fall, tracheal
deviation/JVD, open wounds/deformities, skin color - -Four of these must be
identified to assess breathing effectiveness:
-cardiac monitor - -What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
-During "Circulation" assessment - -When should 2 IV sites be established?
-assess ETT position by noting the number at teeth/gums AND secure ETT - -If
the patient is intubated and you've already assessed ETT placement, what else
needs to be done with the ETT? (step 10)
-moving patient from assisted ventilation to mechanical - -What should you
verbalize after completing all ETT assessments?
-"Breathing and Ventilation" - -During which part of the primary survey would
you anticipate the need for a chest tube, intubation, decompression of
pneumothorax, oxygen, or BVMs?
-bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization - -Four of these must be
identified to assess patency and protection of the airway:
-Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - -During
which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or
suctioning?
-the need for a second person to provide manual c-spine stabilization - -If c-spine
stabilization is necessary, what need should be stated?
-A.Decrease the rate of manual ventilation. - -An adult patient who sustained a
severe head trauma has been intubated and is being manually ventilated via a bag-
mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm
Hg. What is the most important intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
TNP2023/75Questions with solved
answers/ Graded A+.
just keep evaluating - vipp - -What does the J stand for at the end of the secondary
survery?
-vital signs, injuries/interventions, primary survey, pain - -What does VIPP stand
for?
-flank - -During the head-to-toe, where would you find Grey-Turner's sign?
-umbilicus - -During the head-to-toe, where would you find Cullen's sign?
-inspecting posterior - -What is sometimes deferred at the end of the head-to-toe?
-AFTER head-to-toe, BEFORE J (VIPP) - -Antibiotics, consults, head CT, imaging,
law enforcement, mandatory reporting, psychosocial support, social services,
splinting, tetanus, and wound care are all interventions that you do AFTER and
before WHAT?
-Medical records, prehospital report, SAMPLE - -What three items are obtained
during the pertinent history assessment?
-Distraction, family presence, padding bony prominences, repositioning,
splinting, verbal reassurance - -What are examples of nonpharmacologic
measures? (must identify at least one during testing)
-all patients - -For whom is capnography highly recommended?
-EKG - -In step M of "Get Adjuncts", what else might be indicated besides cardiac
monitor?
-blankets, room temp increase, warmed fluids, warming lights - -In Step 16 of
"Exposure and Environment", you must name at least one of these interventions:
-In Step 15 of "Exposure and Environment" - -At what point PRIOR TO the head-
to-toe is the patient inspected for obvious injuries?
-glucose - -In Step 13 of "Disability", what is assessed if pt is altered?
-1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - -To
assess circulation, you must do these two main tasks:
-intervene as appropriate and reassess - -What do you do when alterations are
identified in any of the steps in the primary survery?
, -1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise
and fall of the chest w/ assisted ventilations; 3. auscultate over epigastrium for
gurgling AND lungs for bilateral breath sounds - -What three assessments must be
done if the patient is intubated?
-Breath sounds, depth/pattern/rate, spontaneous breathing, subcutaneous
emphysema, increased work of breathing, symmetrical chest rise and fall, tracheal
deviation/JVD, open wounds/deformities, skin color - -Four of these must be
identified to assess breathing effectiveness:
-cardiac monitor - -What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section?
-During "Circulation" assessment - -When should 2 IV sites be established?
-assess ETT position by noting the number at teeth/gums AND secure ETT - -If
the patient is intubated and you've already assessed ETT placement, what else
needs to be done with the ETT? (step 10)
-moving patient from assisted ventilation to mechanical - -What should you
verbalize after completing all ETT assessments?
-"Breathing and Ventilation" - -During which part of the primary survey would
you anticipate the need for a chest tube, intubation, decompression of
pneumothorax, oxygen, or BVMs?
-bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization - -Four of these must be
identified to assess patency and protection of the airway:
-Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - -During
which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or
suctioning?
-the need for a second person to provide manual c-spine stabilization - -If c-spine
stabilization is necessary, what need should be stated?
-A.Decrease the rate of manual ventilation. - -An adult patient who sustained a
severe head trauma has been intubated and is being manually ventilated via a bag-
mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm
Hg. What is the most important intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
