TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Which of the following is true about the log roll maneuver?
A) it causes less spinal motion than the lift and slide maneuver
B) it is recommended for patients with unstable pelvic fractures
C) it can worsen cord damage from an unstable spinal injury ***
D) it does not increases the risk of life threatening hemorrhage from unstable injuries - ANSC)
it can worsen cord damage from an unstable spinal injury
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
A) ABC
B) MARCH
C) AVPU
D) VIPP - ANSB) MARCH
Which of the following occurs during the third impact of a motor vehicle crash?
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 - ANSC) the aorta is torn at its
attachment with the ligamentum arteriosum
Which of the following patients warrants referral to a burn center?
A) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
C) a 52-year old diabetic male with partial thickness burn to the left lower leg
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. - ANSC) a
52-year old diabetic male with partial thickness burn to the left lower leg
Which of the following values indicates the need for alcohol withdrawal interventions?
A) CIWA-Ar of 36 ***
B) GCS 13
C) ETCo2 of 48 mm Hg
D) heart rate of 45 beats/min - ANSA) CIWA-Ar of 36
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSB) narrowed
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
,TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
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 - ANSc) to gauge end-organ perfusion and tissue
hypoxia
You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of
your secondary survey include abd pain on palpation, fundal high at the costal margin, and
some dark bloody show. Varying, accelerations and decelerations are noted on the
cardiotocography. These findings are most consistent with which of the following?
A) placental abruption
B) preterm labor
C) uterine rupture
D) fetal demise - ANSA) placental abruption
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 - ANSB) 500 mL/hr
A (AVPU) - ANSAlert. Will be able to maintain airway once clear.
A (Primary Survey) - ANSAirway and alertness with simultaneous cervical spinal stabilization.
Airway Assessment - ANSInspect: tongue obstruction, loose/missing teeth, foreign objects,
blood, vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
Airway Interventions: - ANSSuction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
Alertness Assessment - ANSA-Alert
V-Verbal
P-Painful
U-Unresponsive
B (Primary Survey) - ANSBreathing and Ventilation
,TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Breathing and Ventilation Assessment - ANSInspect: spontaneous breathing, symmetrical rise
and fall, depth/pattern/rate of respirations, accessory muscle use, diaphragmatic breathing,
skin color (normal, pale, flushed, cyanotic), contusions/abrasions/deformities (signs of
underlying injury), open pneumothoraces (sucking chest wound), JVD, tracheal position, signs
of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
midclavicular line and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
pulsations at suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open pneumothorax,
tension pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - ANSBreathing absent: jaw-thrust maneuver, oral
airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or higher. If
ineffective: assist with bag-mask and determine need for definitive airway
C (Primary Survey) - ANSCirculation and Control of Hemorrhage
Cardiogenic Shock - ANSResults from pump failure in the presence of adequate intravascular
volume. There is a lack of cardiac output and end-organ perfusion secondary to a decrease in
myocardial contractility and/or valvular insufficiency.
Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart failure is
a chronic cause.
Blunt cardiac injury may present similar to MI.
Excess of volume administration or increased after load can result in pulmonary edema and
increased myocardial ischemia.
Inotropic support to improve contractility.
Circulation and Control of Hemorrhage Assessment - ANSInspect: Uncontrolled external
bleeding, skin color
Auscultate: Muffled heart sounds - may indicate pericardial tamponade
Palpate: carotid and/or femoral pulses for rate, rhythm, strength
Circulation and Control of Hemorrhage Interventions - ANSControl and treat external bleeding:
apply direct pressure, elevate bleeding extremity, apply pressure over arterial sites, consider
use of a tourniquet.
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
, TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis and
may cause hypothermia. Component therapy, including administering RBC, plasma and
platelets is a balanced approach so that O2 delivery is optimized, acidosis corrected and
coagulopathy prevented.
Classifications of Shock - ANSHypovolemic - decrease in the amount of circulating blood
volume
Obstructive - obstruction in either the vasculature or heart
Cardiogenic - pump failure in the presence of adequate intravascular volume
Distributive - maldistribution of an adequate circulating blood volume (septic, anaphylactic,
neurogenic)
Corneal Abrasion - ANSDamage to the corneal epithelium. Easy to evaluate with fluorescein.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling, irritation
Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain, ophthalmic
NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
(Do NOT patch - increases infection)
Corneal Foreign Body - ANSRoutinely metal, plastic or wood.
Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics, oral
analgesia
Corneal Laceration - ANSInvolves one or more layers of the cornea. Visualized with a slit lamp.
Findings: similar to abrasion, pain out of proportion to findings, decreased vision
Treatment: treat small lacerations similar to an abrasion, larger lacerations need
ophthalmology referral and possible surgery
Cycloplegic agent - ANSCycloplegia is paralysis of the ciliary muscle of the eye, resulting in a
loss of accommodation. Because of the paralysis of the ciliary muscle, the curvature of the
lens can no longer be adjusted to focus on nearby objects.
D (Primary Survey) - ANSDisability (Neurologic Status)
Disability Assessment - ANSAssess GCS on arrival and repeat per policy.
Assess pupils for equality, shape and reactivity (PERRL)
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Which of the following is true about the log roll maneuver?
A) it causes less spinal motion than the lift and slide maneuver
B) it is recommended for patients with unstable pelvic fractures
C) it can worsen cord damage from an unstable spinal injury ***
D) it does not increases the risk of life threatening hemorrhage from unstable injuries - ANSC)
it can worsen cord damage from an unstable spinal injury
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
A) ABC
B) MARCH
C) AVPU
D) VIPP - ANSB) MARCH
Which of the following occurs during the third impact of a motor vehicle crash?
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 - ANSC) the aorta is torn at its
attachment with the ligamentum arteriosum
Which of the following patients warrants referral to a burn center?
A) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
C) a 52-year old diabetic male with partial thickness burn to the left lower leg
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. - ANSC) a
52-year old diabetic male with partial thickness burn to the left lower leg
Which of the following values indicates the need for alcohol withdrawal interventions?
A) CIWA-Ar of 36 ***
B) GCS 13
C) ETCo2 of 48 mm Hg
D) heart rate of 45 beats/min - ANSA) CIWA-Ar of 36
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSB) narrowed
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
,TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
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 - ANSc) to gauge end-organ perfusion and tissue
hypoxia
You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of
your secondary survey include abd pain on palpation, fundal high at the costal margin, and
some dark bloody show. Varying, accelerations and decelerations are noted on the
cardiotocography. These findings are most consistent with which of the following?
A) placental abruption
B) preterm labor
C) uterine rupture
D) fetal demise - ANSA) placental abruption
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 - ANSB) 500 mL/hr
A (AVPU) - ANSAlert. Will be able to maintain airway once clear.
A (Primary Survey) - ANSAirway and alertness with simultaneous cervical spinal stabilization.
Airway Assessment - ANSInspect: tongue obstruction, loose/missing teeth, foreign objects,
blood, vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
Airway Interventions: - ANSSuction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
Alertness Assessment - ANSA-Alert
V-Verbal
P-Painful
U-Unresponsive
B (Primary Survey) - ANSBreathing and Ventilation
,TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Breathing and Ventilation Assessment - ANSInspect: spontaneous breathing, symmetrical rise
and fall, depth/pattern/rate of respirations, accessory muscle use, diaphragmatic breathing,
skin color (normal, pale, flushed, cyanotic), contusions/abrasions/deformities (signs of
underlying injury), open pneumothoraces (sucking chest wound), JVD, tracheal position, signs
of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
midclavicular line and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
pulsations at suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open pneumothorax,
tension pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - ANSBreathing absent: jaw-thrust maneuver, oral
airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or higher. If
ineffective: assist with bag-mask and determine need for definitive airway
C (Primary Survey) - ANSCirculation and Control of Hemorrhage
Cardiogenic Shock - ANSResults from pump failure in the presence of adequate intravascular
volume. There is a lack of cardiac output and end-organ perfusion secondary to a decrease in
myocardial contractility and/or valvular insufficiency.
Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart failure is
a chronic cause.
Blunt cardiac injury may present similar to MI.
Excess of volume administration or increased after load can result in pulmonary edema and
increased myocardial ischemia.
Inotropic support to improve contractility.
Circulation and Control of Hemorrhage Assessment - ANSInspect: Uncontrolled external
bleeding, skin color
Auscultate: Muffled heart sounds - may indicate pericardial tamponade
Palpate: carotid and/or femoral pulses for rate, rhythm, strength
Circulation and Control of Hemorrhage Interventions - ANSControl and treat external bleeding:
apply direct pressure, elevate bleeding extremity, apply pressure over arterial sites, consider
use of a tourniquet.
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
, TNCC FINAL EXAM 7 LATEST VERSIONS 5 2024 CONTAINS 500
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)TEST
BANK |ALREADY GRADED A+|100% COMPLETE PASS
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis and
may cause hypothermia. Component therapy, including administering RBC, plasma and
platelets is a balanced approach so that O2 delivery is optimized, acidosis corrected and
coagulopathy prevented.
Classifications of Shock - ANSHypovolemic - decrease in the amount of circulating blood
volume
Obstructive - obstruction in either the vasculature or heart
Cardiogenic - pump failure in the presence of adequate intravascular volume
Distributive - maldistribution of an adequate circulating blood volume (septic, anaphylactic,
neurogenic)
Corneal Abrasion - ANSDamage to the corneal epithelium. Easy to evaluate with fluorescein.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling, irritation
Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain, ophthalmic
NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
(Do NOT patch - increases infection)
Corneal Foreign Body - ANSRoutinely metal, plastic or wood.
Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics, oral
analgesia
Corneal Laceration - ANSInvolves one or more layers of the cornea. Visualized with a slit lamp.
Findings: similar to abrasion, pain out of proportion to findings, decreased vision
Treatment: treat small lacerations similar to an abrasion, larger lacerations need
ophthalmology referral and possible surgery
Cycloplegic agent - ANSCycloplegia is paralysis of the ciliary muscle of the eye, resulting in a
loss of accommodation. Because of the paralysis of the ciliary muscle, the curvature of the
lens can no longer be adjusted to focus on nearby objects.
D (Primary Survey) - ANSDisability (Neurologic Status)
Disability Assessment - ANSAssess GCS on arrival and repeat per policy.
Assess pupils for equality, shape and reactivity (PERRL)
