TNCC 9th Edition
A patient arrives at the emergency department by private vehicle after sustaining an
injury to the right lower extremity while using a saw. There is a large gaping wound to
the right thigh area with signifigant bleeding, what is the priority intervention?
a. elevate the etremeity to the level of the heart
b. initate direct pressure
c. apply a tourniquet
d. cover the open wound with sterile saline dressings - correct answerb. initate direct
pressure
A patient fell two weeks ago, striking their head. Today, the patient presented with a
persistent headache and nausea and was diagnosed with a small subdural hematoma.
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports the patient has been anxious, restless, shaky, and vomited twice during
the night. The patient states they couldn't sleep because a young child kept coming into
the room. What is the most likely cause for these signs and symptoms? - correct
answerB: Alcohol withdrawal is a common delayed condition because symptoms are
difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or
vomiting, psychomotor agitation, anxiety, insomnia, transient hallucinations, or seizures
A: Signs of increased intracranial pressure include headache, nausea and vomiting,
amnesia, behavioral changes, and altered level of consciousness..
C: Signs of rhabdomyolysis include muscle pain or weakness, dark red or brown urine,
general weakness or malaise, and elevated creatinine kinase levels.
D: Signs of pulmonary embolus include anxiety, pleuritic chest pain, dyspnea,
hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung
sounds, jugular vein distension, or hypotension.
A patient involved in an MVC has sustained a fracture to the second rib of the anterior
left chest. Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - correct answerb. first and second rib fractures are commonly
associated with great vessel, head and spinal cord and brachial plexus injuries.
a. blunt cardiac injury-sternal fractures;
c. pneumothorax is most commonly associated with sternal fractures, multiple rib
fractures, flail chest
d. Hemothorax is most commonly associated with flail chest of multiple rib fractures
, A patient with a spinal cord injuryt at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management for this patient?
a. maintain adequate respiratory status
b. administer balanced fluid resucscitation
c. perform serial assessment of neurological function
d. maintain core temperature - correct answerA. Maintain respiratory status- injuries at
C3-C5 can cause loss of phrenic nerve function, resulting in a paralyzed diaphragm and
inability to breathe. Maintenance of respiratory function is the highest priority.
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
called in sick for a couple of days and is now back working on the team. Which of the
following behaviors indicate the nurse is coll.
a. they are talking about taking the emergency nurse certification exam
b. they keep requesting to be assigned to the walk-in ambulatory area
c.they are impaiient and snap at thier coworkers.
d. they are thinking about transferring out of the department - correct answera. this is an
indication that the nurse is taking positive steps ti advance thier own practice, a sign of
resilience.
An adult patient sustained a knife injury to the neck. The airway is intact and the patient
is hemodynamically stable. they complain of difficulty swallowing and speaking. What is
the most likely cause of these symptoms.
a. damage to the cervical spine
b. an expanding pneumothorax
c.laceration of the carotid artery
d. injury to the thyroid gland - correct answera. damage to the cervical spine-penetrating
neck trauma may include concurrent injuries to the cervical spine and cord, airway. or
vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the cervical spine.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
b. quaternary - correct answera. the primary phase-impact of the pressurization wave
on body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal
hemmorrhage, globe rupture. and mild traumatic brain injury.
b. the seconday phase results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries.
c. tertiary phase-results from individuals being thrown by the blast and impacting walls,
ground or any hard object.
A patient arrives at the emergency department by private vehicle after sustaining an
injury to the right lower extremity while using a saw. There is a large gaping wound to
the right thigh area with signifigant bleeding, what is the priority intervention?
a. elevate the etremeity to the level of the heart
b. initate direct pressure
c. apply a tourniquet
d. cover the open wound with sterile saline dressings - correct answerb. initate direct
pressure
A patient fell two weeks ago, striking their head. Today, the patient presented with a
persistent headache and nausea and was diagnosed with a small subdural hematoma.
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports the patient has been anxious, restless, shaky, and vomited twice during
the night. The patient states they couldn't sleep because a young child kept coming into
the room. What is the most likely cause for these signs and symptoms? - correct
answerB: Alcohol withdrawal is a common delayed condition because symptoms are
difficult to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or
vomiting, psychomotor agitation, anxiety, insomnia, transient hallucinations, or seizures
A: Signs of increased intracranial pressure include headache, nausea and vomiting,
amnesia, behavioral changes, and altered level of consciousness..
C: Signs of rhabdomyolysis include muscle pain or weakness, dark red or brown urine,
general weakness or malaise, and elevated creatinine kinase levels.
D: Signs of pulmonary embolus include anxiety, pleuritic chest pain, dyspnea,
hypoxemia, hemoptysis, cough, orthopnea, adventitious lung sounds, decreased lung
sounds, jugular vein distension, or hypotension.
A patient involved in an MVC has sustained a fracture to the second rib of the anterior
left chest. Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - correct answerb. first and second rib fractures are commonly
associated with great vessel, head and spinal cord and brachial plexus injuries.
a. blunt cardiac injury-sternal fractures;
c. pneumothorax is most commonly associated with sternal fractures, multiple rib
fractures, flail chest
d. Hemothorax is most commonly associated with flail chest of multiple rib fractures
, A patient with a spinal cord injuryt at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management for this patient?
a. maintain adequate respiratory status
b. administer balanced fluid resucscitation
c. perform serial assessment of neurological function
d. maintain core temperature - correct answerA. Maintain respiratory status- injuries at
C3-C5 can cause loss of phrenic nerve function, resulting in a paralyzed diaphragm and
inability to breathe. Maintenance of respiratory function is the highest priority.
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
called in sick for a couple of days and is now back working on the team. Which of the
following behaviors indicate the nurse is coll.
a. they are talking about taking the emergency nurse certification exam
b. they keep requesting to be assigned to the walk-in ambulatory area
c.they are impaiient and snap at thier coworkers.
d. they are thinking about transferring out of the department - correct answera. this is an
indication that the nurse is taking positive steps ti advance thier own practice, a sign of
resilience.
An adult patient sustained a knife injury to the neck. The airway is intact and the patient
is hemodynamically stable. they complain of difficulty swallowing and speaking. What is
the most likely cause of these symptoms.
a. damage to the cervical spine
b. an expanding pneumothorax
c.laceration of the carotid artery
d. injury to the thyroid gland - correct answera. damage to the cervical spine-penetrating
neck trauma may include concurrent injuries to the cervical spine and cord, airway. or
vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the cervical spine.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
b. quaternary - correct answera. the primary phase-impact of the pressurization wave
on body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal
hemmorrhage, globe rupture. and mild traumatic brain injury.
b. the seconday phase results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries.
c. tertiary phase-results from individuals being thrown by the blast and impacting walls,
ground or any hard object.
