TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the
CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
Answer: D - ANSWER-A) Brief
B) loop
C) debrief
D) huddle ***
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?
(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
Answer: A - ANSWER-A) 2280 mL ***
B) 3840 mL
C) 4560 mL
D) 7680 mL
Which of the following assessment findings differentiates a tension PTX from a simple
PTX?
answer: D
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. -
ANSWER-A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration ***
,TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
Which of the following considerations is most important when caring for a geriatric
trauma patient?
Answer: B - ANSWER-A) head to to exam
B) medical history **
C) incontinence
D) falls
An intubated trauma patient is being transferred to a tertiary care center. After moving
the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which
of the following is the priority interventions?
Answer: D - ANSWER-A) call for a portable CXR stat
B) chest to make sure the ventilator is plugged in
C) suction the ET tube
D) confirm ET tube placement
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
Answer: c - ANSWER-a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival
were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and
dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient
is demonstrating signs and symptoms of which stage of shock?
Answer: A - ANSWER-A) compensated **
B) Progressive
C) irreversible
D) decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home that
day. she denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?
Answer: D - ANSWER-A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
,TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse to
prepare the patient for radiologic spine clearance?
Answer: D - ANSWER-A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSWER-A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the
primary survey, which of the following is the priority interventions?
Answer: A - ANSWER-A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C - ANSWER-A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?
Answer: C - ANSWER-A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B - ANSWER-A) Weakness in the lower extremities
B) Priapism ***
, TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
Answer: D - ANSWER-A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in
various stages of healing and multiple small, clean, round burns to the back. There are
no abnormalities found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
Answer: A - ANSWER-A) report your suspicion of the maltreatment in accordance with
local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
A patient with lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medications. Which of the following is the priority nursing
intervention?
Answer: C - ANSWER-A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
Answer: B - ANSWER-A) apply a sling and elevate the extremity to the level of the
heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
Which of the following is a late sign of increased intracranial pressure?
Answer: C
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the
CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
Answer: D - ANSWER-A) Brief
B) loop
C) debrief
D) huddle ***
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?
(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
Answer: A - ANSWER-A) 2280 mL ***
B) 3840 mL
C) 4560 mL
D) 7680 mL
Which of the following assessment findings differentiates a tension PTX from a simple
PTX?
answer: D
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. -
ANSWER-A) increased work of breathing
B) unilaterally diminished breath sounds
C) pleuritic chest pain
D) hypotension that worsens with inspiration ***
,TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
Which of the following considerations is most important when caring for a geriatric
trauma patient?
Answer: B - ANSWER-A) head to to exam
B) medical history **
C) incontinence
D) falls
An intubated trauma patient is being transferred to a tertiary care center. After moving
the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which
of the following is the priority interventions?
Answer: D - ANSWER-A) call for a portable CXR stat
B) chest to make sure the ventilator is plugged in
C) suction the ET tube
D) confirm ET tube placement
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
Answer: c - ANSWER-a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival
were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and
dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient
is demonstrating signs and symptoms of which stage of shock?
Answer: A - ANSWER-A) compensated **
B) Progressive
C) irreversible
D) decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home that
day. she denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?
Answer: D - ANSWER-A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
,TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse to
prepare the patient for radiologic spine clearance?
Answer: D - ANSWER-A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSWER-A) The driver of the vehicle collides with the steering wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the
primary survey, which of the following is the priority interventions?
Answer: A - ANSWER-A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C - ANSWER-A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?
Answer: C - ANSWER-A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B - ANSWER-A) Weakness in the lower extremities
B) Priapism ***
, TNCC FINAL EXAM 2 LATEST VERSION 2024 COTAINS 200+
QUESTION AND CORRECT ANSWERS ALREADY GRADED
A+.
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
Answer: D - ANSWER-A) Bradycardia and ipsilateral absences of motor function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A 5-year old child presents to the ED with bruises to the upper arms and buttocks in
various stages of healing and multiple small, clean, round burns to the back. There are
no abnormalities found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
Answer: A - ANSWER-A) report your suspicion of the maltreatment in accordance with
local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
A patient with lower extremity fracture complains of severe pain and tightness in his calf,
minimally relieved by pain medications. Which of the following is the priority nursing
intervention?
Answer: C - ANSWER-A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most appropriate intervention?
Answer: B - ANSWER-A) apply a sling and elevate the extremity to the level of the
heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
Which of the following is a late sign of increased intracranial pressure?
Answer: C
