TNCC Physical Assessments 2023.pdf

TNCCm9THmEDITIONmREALmEXAMmACTUALmVERIFIEDmEXAMmTESTmBANKm150+mQU
ESTIONSmANDmANSWERSmVERIFIEDmANSWERm|ALREADYmGRADEDmA+


Am5-
yearmoldmchildmpresentsmtomthemEDmwithmbruisesmtomthemuppermarmsmandmbuttocksminmvario
usmstagesmofmhealingmandmmultiplemsmall,mclean,mroundmburnsmtomthemback.mTheremaremnom
abnormalitiesmfoundmbasedmonmthempediatricmassessmentmtrianglemormprimarymsurvey.mWh
ichmofmthemfollowingmismthemprioritymnursingmintervention?

Answer:mAm-
mANSA)mreportmyourmsuspicionmofmthemmaltreatmentminmaccordancemwithmlocalmregulations

m***

B)mapplymicemtomthembruisesmandmconsultmwoundmcare
C)mengageminmtherapeuticmcommunicationmtomdeterminemthemMOI
D)mprovidemthemfamilymwithminjurympreventionmresourse

Am20-
yearmoldmmalempresentsmtomthemEDmc/omseveremlowermabdmpainmaftermlandingmhardmonmthem
bicyclemcrossmbarsmwhichmperformingmanmaerialmBMXmmaneuver.mSecondarymassessment
mrevealsmlowermabdmtendernessmandmscrotalmecchymosis.mWhichmofmthemfollowingmordersm

wouldmthemnursemquestions?

Answer:mCm-mANSA)mFastmexam
B)mCTmscan
C)mstraightmcathmformurinemsamplem***
D)micemandmelevationmofmthemscrotum

Am35-
yearmoldmmalempresentsmwithmfacialmtraumamaftermbringmstruckminthemfacemwithmambaseball.
mamtear-dropmshapedmleftmpupilmismnotedmonmexam.mWhatmtypemofminjurymism suspected?




Answer:mBm-mANSA)moculomotormnervempalsy
B)mglobemrupturem***
C)muncalmherniation
D)mretinalmdetachment

Am36-
yearmoldmfemalemhasmamdeformitymofmthemleftmwristmaftermamfall.mShemismreluctantmtommovemh
ermhandmduemtompain.mWhichmofmthemfollowingmismthemmostmappropriatemintervention?

Answer:mBm-mANSA)mapplymamslingmandmelevatemthemextremitymtomthemlevelmofmthemheart.
B)mapplymamsplintmandmELEVATEmABOVEmTHEmLEVELmOFmTHEmHEARTm***
C)mApplymamslingmandmelevatemthemextremitymabovemthemlevelmofmthemheart
D)mapplymamsplintmandmelevatemthemextremitymtomthemlevelmofmthemheart.

,TNCCm9THmEDITIONmREALmEXAMmACTUALmVERIFIEDmEXAMmTESTmBANKm150+mQU
ESTIONSmANDmANSWERSmVERIFIEDmANSWERm|ALREADYmGRADEDmA+

Am49-
yearmoldmrestrainedmdriverminvolvedminmamMVCmpresentsmtomthemtraumamcentermc/omabd,mp
elvic,mandmbilmlowermextremitympainmVitalsmsignsmaremstable.mThemnursemcanmanticipatemallm
ofmthesemnegativemfastmexammexceptmwhichmofmthemfollowing?

Answer:mA



ThemFASTmexammismdonematmthembedsidemtomidentifympathologicalmfluidminmthemabdominalm
andmpelvicmcavities.mFASTmexamsmreducemthemusemofmmoreminvasivemdiagnosticmperitonea
lmlavagemandmcanmbemrepeatedmifmclinicalmchangesmormhemodynamicmchangesmoccur.mAmn
egativemFASTmstudymdoesmnotmrulemoutminjurymandmmaymwarrantmamfollow-
upmcomputedmtomographymscan.mSerialmFASTmexamsmcanmidentifymincreasingmabdominal
mfluidmcollectionsmfrommhemorrhage.mDiagnosticmperitonealmlavage/diagnosticmperitonealm

aspirationmismperformedmbymthemsurgicalmteammtomrapidlymidentifymthempresencemofmhemorr
hageminmpatientsmwhomaremhemodynamicallymunstablemaftermtrauma.m-
mANSA)mdiagnosticmperitonealmlavagem***

B)mserialmfastmexams
C)mabdominalmandmpelvicmCTmscans
D)mserialmabdominalmassessments

Am56-year-
mmalempatientminvolvedminmamMVCmismbroughtmtomthemEDmofmamruralmcriticalmaccessmfacility.m

Hemc/omneckmpain,mSOB,mandmdiffusemabdmpain.mHismGCSmism15.mHismvitalsmaremasmfollows:
BPm98/71
HRm125mbeats/min
RRm26mbreaths/min
SpO2m94%monmhighmflowmO2mviamNRBmmask

whichmofmthemfollowingmismthempriorityminterventionmformthismpatient?

Answer:mCm-mANSA)mExpeditemtransportmtomthemCTmscanner
B)mpreparemthempatientmformspinalmradiographs
C)mexpeditemtransfermtomthemclosestmtraumamcenterm***
D)mnotifymthempatientsmfamily

Ampassengermismbroughtmtomthememergencymdepartmentmofmamruralmhospitalmfollowingmamhi
gh-
speedmMVC.mWhenmsignificantmabdominalmandmpelvicminjuriesmaremnotedminmthemprimaryms
urvey,mwhichmofmthemfollowingmismthempriorityminterventions?

Answer:mAm-mANSA)minitiatemtransfermtomamtraumamcenterm**

,TNCCm9THmEDITIONmREALmEXAMmACTUALmVERIFIEDmEXAMmTESTmBANKm150+mQU
ESTIONSmANDmANSWERSmVERIFIEDmANSWERm|ALREADYmGRADEDmA+

B)mprovidemreportmtomthemoperatingmroommnurse
C)mObtainedmimagingmstudies
D)mPlacemamgastricmtube

Ampatientmarrivesmwithmamlargemopenmchestmwoundmaftermbeingmassaultmedmwithmammachete
,mPrehospitalmprovidersmplacedmamnonporousmdressingmovermthemchestmwoundmandmtapesmi
tmonm3msides.mHemismnowmshowingmsignsmofmanxiety,mrestlessness,mseveremrespiratorymdistr
ess,mcyanosis,mandmdecreasingmbloodmpressure.mWhichmofmthemfollowingmismthemMOSTmap
propriateminterventions?

Answer:mCm-mANSA)mneedlemdecompression
B)mtubemthoracostomym
C)mdressingmremovalm**
D)msurgicalmrepair

AmpatientmhasmbeenminmthemEDmformseveralmhoursmwaitingmtombemadmitted.mHemsustainedm
multiplemribmfracturesmandmamfemurmfracturemaftermamfall.mHemhasmbeenmawake,malert,mandmc
/omlegmpain.mHismwifemreportedmsuddenlymbecomingmanxiousmandmconfused.mUponmreasse
ssment,mthempatientmismrestless,mwithmrespiratorymdistressmandmpetechiaemtomhismneck.mthe
mpatientmismexhibitingmsignsmofmsymptomsmcommonlymassociatedmwithmwhichmofmthemfollowi

ngmconditions?

Answer:mBm-mANSA)macutemlungminjury
B)mfatmembolismm***
C)mPTX
D)mpulmonarymcontusion

Ampatientmismfoundmlyingmonmthemfloormaftermfallingm13mhoursmago.mWhichmofmthemfollowingml
abmvaluesmismexpectedmwithmammusculoskeletalmcomplicationmassociatedmwithmthismpresen
tation?

Answer:mAm-mANSA)melevatedmcreatinemkinasem***
B)mdecreasedmpotassiummlevel
C)mdecreasedmWBC
D)melevatedmGFR

Ampatientmismthrownmagainstmamcarmduringmamtornadomandmpresentsmwithmobviousmbilateralm
femoralmfractures.mThempatientmismpale,malert,mdisoriented,mandmhasmdelayedmcapmrefill.mW
hichmofmthemfollowingminterventionsmwouldmbemmostmappropriatemformthismpatientmbasedmonm
themdisastermtriagemprinciple?

, TNCCm9THmEDITIONmREALmEXAMmACTUALmVERIFIEDmEXAMmTESTmBANKm150+mQU
ESTIONSmANDmANSWERSmVERIFIEDmANSWERm|ALREADYmGRADEDmA+

Answer:mAm-
mANSA)minitiatemtwomlargemcalibermintravenousmlinesmformRingersmlactatemsolutionmadminist

rationm***
B)mAdministermDilaudidmformpainmcontrolmandmprovidemcomfortmcare
C)mPlacemthempatientminmanmobservationmareamformcaremwithinmthemnextmfewmhours
D)mContactmthemcommandmcentermformthempersonnelmtomnotifymnextmofmkin.

Ampatientmwithmamcompletemspinalmcordminjuryminmneurogenicmshockmwillmdemonstratemhypo
tensionmandmwhichmothermclinicalmsigns?

Answer:mDm-mANSA)mBradycardiamandmipsilateralmabsencesmofmmotormfunction
B)mTachycardiamandmrespiratorymdepression
C)mTachycardiamandmabsentmmotormfunctionmbelowmthemlevelmofminjury
D)mBradycardiamandmabsentmmotormfunctionmbelowmthemlevelmofmtheminjurym***

Ampatientmwithmlowermextremitymfracturemcomplainsmofmseverempainmandmtightnessminmhismc
alf,mminimallymrelievedmbympainmmedications.mWhichmofmthemfollowingmismthemprioritymnursin
gmintervention?

Answer:mCm-mANSA)melevatingmthemextremitymabovemthemlevelmofmthemheart
B)mrepositioningmandmapplymice
C)mElevatingmthemextremitymtomthemlevelmofmthemheartm***
D)mPreparingmthempatientmformultrasound

AmtraumampatientmismenmroutemtomamruralmED.mRadiologymnotifiesmthemchargemnursemthatmth
emCTmscannermwillmbemoutmofmservicemformseveralmofmhours.mThemteammgathersmtomplanmacc
ordingly.mWhichmofmthemfollowingmtermsmbestmdescribesmthismtraumamteamsmcommunicatio
n?

Answer:mDm-mANSA)mBrief
B)mloop
C)mdebrief
D)mhuddlem***

Amtraumampatientmismrestlessmandmrepeatedlymaskingm"wheremammI?"mvitalmsignsmuponmarriv
almweremBPm100/60mmmmHg,mHRm96mbeats/min,mandmRRm24mbreaths/min.mHermskinmismcool
mandmdry.mCurrentmvitalmsignsmaremBPm104/84mmmHg,mHRm108,mRRm28mbreaths/min.mThem

patientmismdemonstratingmsignsmandmsymptomsmofmwhichmstagemofmshock?m

Answer:mAm-mANSA)mcompensatedm**
B)mProgressive
C)mirreversible
D)mdecompensated