TNCC final exam test open book,QUESTIONS WITH CORRECT
SOLUTIONS
You are treating a 27-year old male in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you
begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr
B) 500 mL/hr
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib
fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife
reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with
respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly
associated with which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion
B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak
B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls
B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration
D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of
the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration
due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and
cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the
patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper
extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to
calculate the total BSA burned, how much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL
A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis
A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o
neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
SOLUTIONS
You are treating a 27-year old male in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you
begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr
B) 500 mL/hr
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib
fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife
reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with
respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly
associated with which of the following conditions?
A) acute lung injury
B) fat embolism
C) PTX
D) pulmonary contusion
B) fat embolism
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak
B) narrowed
Which of the following considerations is most important when caring for a geriatric trauma patient?
A) head to to exam
B) medical history
C) incontinence
D) falls
B) medical history
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration
D) hypotension that worsens with inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side. Hypotension due to compression of
the heart and great vessels is consistent with obstructive shock. Hypotension worsens with inspiration
due to increased intrathoracic pressure. Late signs include distended neck veins, tracheal deviation, and
cyanosis.
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is calculating the
patient's fluid resuscitation needs. He has painful red blistering to the entire surface of both upper
extremities and superficial burns to the anterior chest. Using the modified Lund and Browder chart to
calculate the total BSA burned, how much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL
A) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
(half of fluids given in first 8 hours) = 2280 mL
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis
A) Acidosis
hypothermia, metabolic acidosis, coagulopathy
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o
neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
