TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
A 5-u
year old child presents to the ED with bruises to the upper arms and buttocks in various sta
u u u u u u u u u u u u u u u u u
ges of healing and multiple small, clean, round burns to the back. There are no abnormaliti
u u u u u u u u u u u u u u u
es found based on the pediatric assessment triangle or primary survey. Which of the follow
u u u u u u u u u u u u u u
ing is the priority nursing intervention?
u u u u u
Answer: A - u u
ANSA) report your suspicion of the maltreatment in accordance with local regulations ***
u u u u u u u u u u u u u
B) Apply ice to the bruises and consult wound care
u u u u u u u u u
C) Engage in therapeutic communication to determine the MOI
u u u u u u u u
D) Provide the family with injury prevention recourse
u u u u u u u
A 20-
u
year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycl
u u u u u u u u u u u u u u u u u
e cross bars which performing an aerial BMX maneuver. Secondary assessment reveals l
u u u u u u u u u u u u
ower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurs
u u u u u u u u u u u u u
e questions?
u
Answer: C - ANSA) Fast exam u u u u u
B) CT scan
u u
C) Straight Cath for urine sample ***
u u u u u u
D) Ice and elevation of the scrotum
u u u u u u
A 35-
u
year old male presents with facial trauma after being struck in the face with a baseball. A te
u u u u u u u u u u u u u u u u u
ar-drop shaped left pupil is noted on exam. What type of injury is suspected?
u u u u u u u u u u u u u
Answer: B - ANSA) oculomotor nerve palsyu u u u u u
B) Globe rupture ***
u u u
C) Uncial herniation
u u
D) Retinal detachment
u u
A 36-
u
year old female has a deformity of the left wrist after a fall. She is reluctant to move her han
u u u u u u u u u u u u u u u u u u u
d due to pain. Which of the following is the most appropriate intervention?
u u u u u u u u u u u u
Answer: B - ANSA) apply a sling and elevate the extremity to the level of the heart.
u u u u u u u u u u u u u u u u
B) Apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
u u u u u u u u u u u u
C) Apply a sling and elevate the extremity above the level of the heart
u u u u u u u u u u u u u
D) Apply a splint and elevate the extremity to the level of the heart.
u u u u u u u u u u u u u
,TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
A 49-
u
year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic,
u u u u u u u u u u u u u u u u
and bil lower extremity pain Vital signs are stable. The nurse can anticipate all of these neg
u u u u u u u u u u u u u u u u
ative fast exam accept which of the following?
u u u u u u u
Answer: A u
The FAST exam is done at the bedside to identify pathological fluid in the abdominal and p
u u u u u u u u u u u u u u u u
elvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage a
u u u u u u u u u u u u u
nd can be repeated if clinical changes or hemodynamic changes occur. A negative FAST s
u u u u u u u u u u u u u u
tudy does not rule out injury and may warrant a follow-
u u u u u u u u u u
up computed tomography scan. Serial FAST exams can identify increasing abdominal flui
u u u u u u u u u u u
d collections from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspirati
u u u u u u u u
on is performed by the surgical team to rapidly identify the presence of hemorrhage in patie
u u u u u u u u u u u u u u u
nts who are hemodynamically unstable after trauma. -
u u u u u u u
uANSA) diagnostic peritoneal lavage *** u u u u
B) Serial fast exams
u u u
C) Abdominal and pelvic CT scans
u u u u u
D) Serial abdominal assessments
u u u
A 56-year-
u
male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o
u u u u u u u u u u u u u u u u u u u u
neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
u u u u u u u u u u u u u u u
BP 98/71 u
HR 125 beats/minu u
RR 26 breaths/min
u u
SpO2 94% on high flow O2 via NRB mask
u u u u u u u u
Which of the following is the priority intervention for this patient?
u u u u u u u u u u
Answer: C - ANSA) Expedite transport to the CT scanner
u u u u u u u u u
B) prepare the patient for spinal radiographs
u u u u u u
C) expedite transfer to the closest trauma center ***
u u u u u u u u
D) notify the patients family
u u u u
A passenger is brought to the emergency department of a rural hospital following a high-
u u u u u u u u u u u u u u
speed MVC. When significant abdominal and pelvic injuries are noted in the primary surve
u u u u u u u u u u u u u
y, which of the following is the priority interventions?
u u u u u u u u
Answer: A - ANSA) initiate transfer to a trauma center **
u u u u u u u u u u
B) provide report to the operating room nurse
u u u u u u u
,TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
C) Obtained imaging studies
u u u
D) Place a gastric tube
u u u u
A patient arrives with a large open chest wound after being assault ed with a machete, Pre
u u u u u u u u u u u u u u u u
hospital providers placed a nonporous dressing over the chest wound and tapes it on 3 sid
u u u u u u u u u u u u u u u
es. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis
u u u u u u u u u u u u
, and decreasing blood pressure. Which of the following is the MOST appropriate interventi
u u u u u u u u u u u u u
ons?
Answer: C - ANSA) needle decompression u u u u u
B) tube thoracostomy
u u u
C) dressing removal **
u u u
D) surgical repair
u u
A patient has been in the ED for several hours waiting to be admitted. He sustained multipl
u u u u u u u u u u u u u u u u
e rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain.
u u u u u u u u u u u u u u u u u u u
His wife reported suddenly becoming anxious and confused. Upon reassessment, the pati
u u u u u u u u u u u
ent is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting s
u u u u u u u u u u u u u u u
igns of symptoms commonly associated with which of the following conditions?
u u u u u u u u u u
Answer: B - ANSA) acute lung injury u u u u u u
B) fat embolism ***
u u u
C) PTX u
D) pulmonary contusion
u u
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab valu
u u u u u u u u u u u u u u u u u u
es is expected with a musculoskeletal complication associated with this presentation?
u u u u u u u u u u
Answer: A - ANSA) elevated creatine kinase *** u u u u u u u
B) decreased potassium level
u u u
C) decreased WBCu u
D) elevated GFR u u
A patient is thrown against a car during a tornado and presents with obvious bilateral femor
u u u u u u u u u u u u u u u
al fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the f
u u u u u u u u u u u u u u u u
ollowing interventions would be most appropriate for this patient based on the disaster tria
u u u u u u u u u u u u u
ge principle? u
Answer: A - u u
ANSA) initiate two large caliber intravenous lines for Ringers lactate solution administratio
u u u u u u u u u u u u
n *** u
B) Administer Dilaudid for pain control and provide comfort care
u u u u u u u u u
C) Place the patient in an observation area for care within the next few hours
u u u u u u u u u u u u u u
, TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
D) Contact the command center for the personnel to notify next of kin.
u u u u u u u u u u u u
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotensi
u u u u u u u u u u u u u
on and which other clinical signs?
u u u u u
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
u u u u u u u u u u
B) Tachycardia and respiratory depression
u u u u
C) Tachycardia and absent motor function below the level of injury
u u u u u u u u u u
D) Bradycardia and absent motor function below the level of the injury ***
u u u u u u u u u u u u
A patient with lower extremity fracture complains of severe pain and tightness in his calf, mi
u u u u u u u u u u u u u u u
nimally relieved by pain medications. Which of the following is the priority nursing interventi
u u u u u u u u u u u u u
on?
Answer: C - ANSA) elevating the extremity above the level of the heart
u u u u u u u u u u u u
B) repositioning and apply ice
u u u u
C) Elevating the extremity to the level of the heart ***
u u u u u u u u u u
D) Preparing the patient for ultrasound
u u u u u
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT s
u u u u u u u u u u u u u u u u u u
canner will be out of service for several of hours. The team gathers to plan accordingly. Whi
u u u u u u u u u u u u u u u u
ch of the following terms best describes this trauma teams communication?
u u u u u u u u u u
Answer: D - ANSA) Brief u u u u
B) loop
u
C) debrief
u
D) huddle ***
u u
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival we
u u u u u u u u u u u u u u u
re BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. C
u u u u u u u u u u u u u u u u u u
urrent vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demon
u u u u u u u u u u u u u u u
strating signs and symptoms of which stage of shock?
u u u u u u u u u
Answer: A - ANSA) compensated ** u u u u u
B) Progressive
u
C) irreversible
u
D) decompensated
u
An elderly patient with a history of anticoagulant use presents after a fall at home that day.
u u u u u u u u u u u u u u u u u
she denies any loss of consciousness. She has a hematoma to her forehead and complain
u u u u u u u u u u u u u u
s of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?
u u u u u u u u u u u u u u
Answer: D - ANSA) epidural hematoma u u u u u
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
A 5-u
year old child presents to the ED with bruises to the upper arms and buttocks in various sta
u u u u u u u u u u u u u u u u u
ges of healing and multiple small, clean, round burns to the back. There are no abnormaliti
u u u u u u u u u u u u u u u
es found based on the pediatric assessment triangle or primary survey. Which of the follow
u u u u u u u u u u u u u u
ing is the priority nursing intervention?
u u u u u
Answer: A - u u
ANSA) report your suspicion of the maltreatment in accordance with local regulations ***
u u u u u u u u u u u u u
B) Apply ice to the bruises and consult wound care
u u u u u u u u u
C) Engage in therapeutic communication to determine the MOI
u u u u u u u u
D) Provide the family with injury prevention recourse
u u u u u u u
A 20-
u
year old male presents to the ED c/o severe lower abd pain after landing hard on the bicycl
u u u u u u u u u u u u u u u u u
e cross bars which performing an aerial BMX maneuver. Secondary assessment reveals l
u u u u u u u u u u u u
ower abd tenderness and scrotal ecchymosis. Which of the following orders would the nurs
u u u u u u u u u u u u u
e questions?
u
Answer: C - ANSA) Fast exam u u u u u
B) CT scan
u u
C) Straight Cath for urine sample ***
u u u u u u
D) Ice and elevation of the scrotum
u u u u u u
A 35-
u
year old male presents with facial trauma after being struck in the face with a baseball. A te
u u u u u u u u u u u u u u u u u
ar-drop shaped left pupil is noted on exam. What type of injury is suspected?
u u u u u u u u u u u u u
Answer: B - ANSA) oculomotor nerve palsyu u u u u u
B) Globe rupture ***
u u u
C) Uncial herniation
u u
D) Retinal detachment
u u
A 36-
u
year old female has a deformity of the left wrist after a fall. She is reluctant to move her han
u u u u u u u u u u u u u u u u u u u
d due to pain. Which of the following is the most appropriate intervention?
u u u u u u u u u u u u
Answer: B - ANSA) apply a sling and elevate the extremity to the level of the heart.
u u u u u u u u u u u u u u u u
B) Apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
u u u u u u u u u u u u
C) Apply a sling and elevate the extremity above the level of the heart
u u u u u u u u u u u u u
D) Apply a splint and elevate the extremity to the level of the heart.
u u u u u u u u u u u u u
,TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
A 49-
u
year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic,
u u u u u u u u u u u u u u u u
and bil lower extremity pain Vital signs are stable. The nurse can anticipate all of these neg
u u u u u u u u u u u u u u u u
ative fast exam accept which of the following?
u u u u u u u
Answer: A u
The FAST exam is done at the bedside to identify pathological fluid in the abdominal and p
u u u u u u u u u u u u u u u u
elvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage a
u u u u u u u u u u u u u
nd can be repeated if clinical changes or hemodynamic changes occur. A negative FAST s
u u u u u u u u u u u u u u
tudy does not rule out injury and may warrant a follow-
u u u u u u u u u u
up computed tomography scan. Serial FAST exams can identify increasing abdominal flui
u u u u u u u u u u u
d collections from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspirati
u u u u u u u u
on is performed by the surgical team to rapidly identify the presence of hemorrhage in patie
u u u u u u u u u u u u u u u
nts who are hemodynamically unstable after trauma. -
u u u u u u u
uANSA) diagnostic peritoneal lavage *** u u u u
B) Serial fast exams
u u u
C) Abdominal and pelvic CT scans
u u u u u
D) Serial abdominal assessments
u u u
A 56-year-
u
male patient involved in a MVC is brought to the ED of a rural critical access facility. He c/o
u u u u u u u u u u u u u u u u u u u u
neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
u u u u u u u u u u u u u u u
BP 98/71 u
HR 125 beats/minu u
RR 26 breaths/min
u u
SpO2 94% on high flow O2 via NRB mask
u u u u u u u u
Which of the following is the priority intervention for this patient?
u u u u u u u u u u
Answer: C - ANSA) Expedite transport to the CT scanner
u u u u u u u u u
B) prepare the patient for spinal radiographs
u u u u u u
C) expedite transfer to the closest trauma center ***
u u u u u u u u
D) notify the patients family
u u u u
A passenger is brought to the emergency department of a rural hospital following a high-
u u u u u u u u u u u u u u
speed MVC. When significant abdominal and pelvic injuries are noted in the primary surve
u u u u u u u u u u u u u
y, which of the following is the priority interventions?
u u u u u u u u
Answer: A - ANSA) initiate transfer to a trauma center **
u u u u u u u u u u
B) provide report to the operating room nurse
u u u u u u u
,TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
C) Obtained imaging studies
u u u
D) Place a gastric tube
u u u u
A patient arrives with a large open chest wound after being assault ed with a machete, Pre
u u u u u u u u u u u u u u u u
hospital providers placed a nonporous dressing over the chest wound and tapes it on 3 sid
u u u u u u u u u u u u u u u
es. He is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis
u u u u u u u u u u u u
, and decreasing blood pressure. Which of the following is the MOST appropriate interventi
u u u u u u u u u u u u u
ons?
Answer: C - ANSA) needle decompression u u u u u
B) tube thoracostomy
u u u
C) dressing removal **
u u u
D) surgical repair
u u
A patient has been in the ED for several hours waiting to be admitted. He sustained multipl
u u u u u u u u u u u u u u u u
e rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain.
u u u u u u u u u u u u u u u u u u u
His wife reported suddenly becoming anxious and confused. Upon reassessment, the pati
u u u u u u u u u u u
ent is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting s
u u u u u u u u u u u u u u u
igns of symptoms commonly associated with which of the following conditions?
u u u u u u u u u u
Answer: B - ANSA) acute lung injury u u u u u u
B) fat embolism ***
u u u
C) PTX u
D) pulmonary contusion
u u
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab valu
u u u u u u u u u u u u u u u u u u
es is expected with a musculoskeletal complication associated with this presentation?
u u u u u u u u u u
Answer: A - ANSA) elevated creatine kinase *** u u u u u u u
B) decreased potassium level
u u u
C) decreased WBCu u
D) elevated GFR u u
A patient is thrown against a car during a tornado and presents with obvious bilateral femor
u u u u u u u u u u u u u u u
al fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the f
u u u u u u u u u u u u u u u u
ollowing interventions would be most appropriate for this patient based on the disaster tria
u u u u u u u u u u u u u
ge principle? u
Answer: A - u u
ANSA) initiate two large caliber intravenous lines for Ringers lactate solution administratio
u u u u u u u u u u u u
n *** u
B) Administer Dilaudid for pain control and provide comfort care
u u u u u u u u u
C) Place the patient in an observation area for care within the next few hours
u u u u u u u u u u u u u u
, TNCC 9TH EDITION REAL EXAM ACTUAL VERIFIED EXAM TEST BANK 150+ QUEST
u u u u u u u u u u u
IONS AND ANSWERS VERIFIED ANSWER |RATED A+
u u u u u u
D) Contact the command center for the personnel to notify next of kin.
u u u u u u u u u u u u
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotensi
u u u u u u u u u u u u u
on and which other clinical signs?
u u u u u
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
u u u u u u u u u u
B) Tachycardia and respiratory depression
u u u u
C) Tachycardia and absent motor function below the level of injury
u u u u u u u u u u
D) Bradycardia and absent motor function below the level of the injury ***
u u u u u u u u u u u u
A patient with lower extremity fracture complains of severe pain and tightness in his calf, mi
u u u u u u u u u u u u u u u
nimally relieved by pain medications. Which of the following is the priority nursing interventi
u u u u u u u u u u u u u
on?
Answer: C - ANSA) elevating the extremity above the level of the heart
u u u u u u u u u u u u
B) repositioning and apply ice
u u u u
C) Elevating the extremity to the level of the heart ***
u u u u u u u u u u
D) Preparing the patient for ultrasound
u u u u u
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT s
u u u u u u u u u u u u u u u u u u
canner will be out of service for several of hours. The team gathers to plan accordingly. Whi
u u u u u u u u u u u u u u u u
ch of the following terms best describes this trauma teams communication?
u u u u u u u u u u
Answer: D - ANSA) Brief u u u u
B) loop
u
C) debrief
u
D) huddle ***
u u
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival we
u u u u u u u u u u u u u u u
re BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. C
u u u u u u u u u u u u u u u u u u
urrent vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demon
u u u u u u u u u u u u u u u
strating signs and symptoms of which stage of shock?
u u u u u u u u u
Answer: A - ANSA) compensated ** u u u u u
B) Progressive
u
C) irreversible
u
D) decompensated
u
An elderly patient with a history of anticoagulant use presents after a fall at home that day.
u u u u u u u u u u u u u u u u u
she denies any loss of consciousness. She has a hematoma to her forehead and complain
u u u u u u u u u u u u u u
s of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?
u u u u u u u u u u u u u u
Answer: D - ANSA) epidural hematoma u u u u u
