TNCC 9th Edition TNP Questions And Answers.
—What does the J stand for at the end of the secondary survery? - answer;-just keep
evaluating - vipp
—What does VIPP stand for? - answer;-vital signs, injuries/interventions, primary
survey, pain
—During the head-to-toe, where would you find Grey-Turner's sign? - answer;-flank
—During the head-to-toe, where would you find Cullen's sign? - answer;-umbilicus
-What is sometimes deferred at the end of the head-to-toe? - answer;-inspecting
posterior
-Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting,
psychosocial support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT? - answer;-AFTER head-to-toe,
BEFORE J (VIPP)
-What three items are obtained during the pertinent history assessment? - answer;-
Medical records, prehospital report, SAMPLE
-What are examples of nonpharmacologic measures? (must identify at least one during
testing) - answer;-Distraction, family presence, padding bony prominences,
repositioning, splinting, verbal reassurance
-For whom is capnography highly recommended? - answer;-all patients
-In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? -
answer;-EKG
-In Step 16 of "Exposure and Environment", you must name at least one of these
interventions: - answer;-blankets, room temp increase, warmed fluids, warming lights
-To assess circulation, you must do these two main tasks: - answer;-1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
-What do you do when alterations are identified in any of the steps in the primary
survery? - answer;-intervene as appropriate and reassess
-What three assessments must be done if the patient is intubated? - answer;-1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs
for bilateral breath sounds
-Four of these must be identified to assess breathing effectiveness: - answer;-Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
, TNCC 9th Edition TNP Questions And Answers.
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
-What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which
credit is given in the LMNOP section? - answer;-cardiac monitor
-When should 2 IV sites be established? - answer;-During "Circulation" assessment
-If the patient is intubated and you've already assessed ETT placement, what else
needs to be done with the ETT? (step 10) - answer;-assess ETT position by noting the
number at teeth/gums AND secure ETT
-What should you verbalize after completing all ETT assessments? - answer;-moving
patient from assisted ventilation to mechanical
-During which part of the primary survey would you anticipate the need for a chest tube,
intubation, decompression of pneumothorax, oxygen, or BVMs? - answer;-"Breathing
and Ventilation"
-Four of these must be identified to assess patency and protection of the airway: -
answer;-bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization
-During which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? -
answer;-Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - answer;-the need for
a second person to provide manual c-spine stabilization
*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? - answer;-A.Decrease the rate of manual ventilation.
An older adult presents to the emergency department with complaints of dizziness,
headache, and nausea. The patient was involved in a motor vehicle collision 10 days
ago. There was no loss of consciousness and a hematoma is noted to the forehead.
The patient is currently on anticoagulant therapy. What is most likely the cause of their
symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
, TNCC 9th Edition TNP Questions And Answers.
C.Diffuse axonal injury
D.Post-concussive syndrome - answer;-post-concussive syndrome
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - answer;-C.Elevating the leg to the
level of the heart
A patient involved in a high-speed rollover is complaining of increased difficulty
breathing. There is a small penetrating wound to the sixth intercostal space in the left
lateral chest. Which finding is most consistent with an injury to the diaphragm? -
answer;-Bowel sounds heard in the left lower chest
A ruptured diaphragm is a potentially life-threatening injury. The patient will most likely
have decreased breath sounds on the affected side along with pain, which may radiate
to the left shoulder. However, these signs do not specifically implicate an injury to the
diaphragm. Auscultation of bowel sounds in the chest indicates that abdominal contents
have herniated up into the chest through a defect in the diaphragm.
*A patient has been in the emergency department for several hours waiting to be
admitted. They sustained multiple rib fractures and a femur fracture after a fall. The
patient has been awake, alert, and complaining of leg pain. Their spouse reported that
the patient suddenly became anxious and confused. Upon reassessment, the patient is
restless, with respiratory distress and petechiae to his neck. The patient is exhibiting
signs and symptoms most commonly associated with which of the following conditions?
A. Acute lung injury
B. Fat embolism
C. Pneumothorax
D. Pulmonary contusion - answer;-B. Fat embolism
*Three adults present at different times during a one-hour period with a high fever,
fatigue, and headache. All three patients have a rash which started on their mouth, face,
and arms with progression to the chest and abdomen. They all visited the same grocery
store within the last week. What is the most appropriate intervention from triage for
these patients?
A. Move them to a decontamination area
B. Mask the patients and send them to the waiting room
C. Immediately initiate isolation precautions
—What does the J stand for at the end of the secondary survery? - answer;-just keep
evaluating - vipp
—What does VIPP stand for? - answer;-vital signs, injuries/interventions, primary
survey, pain
—During the head-to-toe, where would you find Grey-Turner's sign? - answer;-flank
—During the head-to-toe, where would you find Cullen's sign? - answer;-umbilicus
-What is sometimes deferred at the end of the head-to-toe? - answer;-inspecting
posterior
-Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting,
psychosocial support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT? - answer;-AFTER head-to-toe,
BEFORE J (VIPP)
-What three items are obtained during the pertinent history assessment? - answer;-
Medical records, prehospital report, SAMPLE
-What are examples of nonpharmacologic measures? (must identify at least one during
testing) - answer;-Distraction, family presence, padding bony prominences,
repositioning, splinting, verbal reassurance
-For whom is capnography highly recommended? - answer;-all patients
-In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? -
answer;-EKG
-In Step 16 of "Exposure and Environment", you must name at least one of these
interventions: - answer;-blankets, room temp increase, warmed fluids, warming lights
-To assess circulation, you must do these two main tasks: - answer;-1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
-What do you do when alterations are identified in any of the steps in the primary
survery? - answer;-intervene as appropriate and reassess
-What three assessments must be done if the patient is intubated? - answer;-1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of
the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND lungs
for bilateral breath sounds
-Four of these must be identified to assess breathing effectiveness: - answer;-Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema,
, TNCC 9th Edition TNP Questions And Answers.
increased work of breathing, symmetrical chest rise and fall, tracheal deviation/JVD,
open wounds/deformities, skin color
-What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which
credit is given in the LMNOP section? - answer;-cardiac monitor
-When should 2 IV sites be established? - answer;-During "Circulation" assessment
-If the patient is intubated and you've already assessed ETT placement, what else
needs to be done with the ETT? (step 10) - answer;-assess ETT position by noting the
number at teeth/gums AND secure ETT
-What should you verbalize after completing all ETT assessments? - answer;-moving
patient from assisted ventilation to mechanical
-During which part of the primary survey would you anticipate the need for a chest tube,
intubation, decompression of pneumothorax, oxygen, or BVMs? - answer;-"Breathing
and Ventilation"
-Four of these must be identified to assess patency and protection of the airway: -
answer;-bony deformity, loose teeth, edema, inhalation injury, sounds, tongue
obstruction, burns, fluids, foreign objects, vocalization
-During which part of the primary survey would there be anticipation for intubation,
insertion of OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? -
answer;-Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - answer;-the need for
a second person to provide manual c-spine stabilization
*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? - answer;-A.Decrease the rate of manual ventilation.
An older adult presents to the emergency department with complaints of dizziness,
headache, and nausea. The patient was involved in a motor vehicle collision 10 days
ago. There was no loss of consciousness and a hematoma is noted to the forehead.
The patient is currently on anticoagulant therapy. What is most likely the cause of their
symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
, TNCC 9th Edition TNP Questions And Answers.
C.Diffuse axonal injury
D.Post-concussive syndrome - answer;-post-concussive syndrome
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - answer;-C.Elevating the leg to the
level of the heart
A patient involved in a high-speed rollover is complaining of increased difficulty
breathing. There is a small penetrating wound to the sixth intercostal space in the left
lateral chest. Which finding is most consistent with an injury to the diaphragm? -
answer;-Bowel sounds heard in the left lower chest
A ruptured diaphragm is a potentially life-threatening injury. The patient will most likely
have decreased breath sounds on the affected side along with pain, which may radiate
to the left shoulder. However, these signs do not specifically implicate an injury to the
diaphragm. Auscultation of bowel sounds in the chest indicates that abdominal contents
have herniated up into the chest through a defect in the diaphragm.
*A patient has been in the emergency department for several hours waiting to be
admitted. They sustained multiple rib fractures and a femur fracture after a fall. The
patient has been awake, alert, and complaining of leg pain. Their spouse reported that
the patient suddenly became anxious and confused. Upon reassessment, the patient is
restless, with respiratory distress and petechiae to his neck. The patient is exhibiting
signs and symptoms most commonly associated with which of the following conditions?
A. Acute lung injury
B. Fat embolism
C. Pneumothorax
D. Pulmonary contusion - answer;-B. Fat embolism
*Three adults present at different times during a one-hour period with a high fever,
fatigue, and headache. All three patients have a rash which started on their mouth, face,
and arms with progression to the chest and abdomen. They all visited the same grocery
store within the last week. What is the most appropriate intervention from triage for
these patients?
A. Move them to a decontamination area
B. Mask the patients and send them to the waiting room
C. Immediately initiate isolation precautions
