TNCC 9TH EDITION,
TNCC 9TH EDITION
FINAL TEST, TNCC 9TH
EDITION
,1. An adult patient who sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the
most important intervention to manage the cerebral blood flow?
A. Decrease the rate of manual ventilation
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered.
A. Decrease the rate of manual ventilation
2. Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as amputation of a limb,
paralysis, or loss of sight.
3. What is the most important consideration during the initial assessment when caring for an
older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
, 4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of
the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
5. When should the definitive calculation for intravenous fluid resuscitation rate be performed
for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage of total body
surface area which requires a good skin assessment and is calculated after clothing is removed.
6. In a motor vehicle collision, which injury pathway is most likely to increase the patient's
morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
B. Ejection
7. A patient with a 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?
TNCC 9TH EDITION
FINAL TEST, TNCC 9TH
EDITION
,1. An adult patient who sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the
most important intervention to manage the cerebral blood flow?
A. Decrease the rate of manual ventilation
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered.
A. Decrease the rate of manual ventilation
2. Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as amputation of a limb,
paralysis, or loss of sight.
3. What is the most important consideration during the initial assessment when caring for an
older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
, 4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of
the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
5. When should the definitive calculation for intravenous fluid resuscitation rate be performed
for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage of total body
surface area which requires a good skin assessment and is calculated after clothing is removed.
6. In a motor vehicle collision, which injury pathway is most likely to increase the patient's
morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
B. Ejection
7. A patient with a 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?
