TNCC TEST 2023-2024 ACTUAL FINAL EXAM TEST BANK OVER 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|RATED A+
Findings: Cullen sign (ecchymosis around the umbilicus or RUQ), tenderness, guarding or rigidity RUQ, 9-
12 rib FXs, elevated LFT
Graded I-VI, I = minor trauma
Nonoperative management is standard of care in hemodynamically stable patient. Observed with serial
abdominal exams.
Findings of contrast extravasation may be embolized by IR.
For surgical patients - fluid resuscitation is essential. Risks of surgery include disruption of the natural
tamponade process due to the evacuation of large amounts of blood resulting in hypovolemia.
Hypovolemic Shock - ansCaused by a decrease in the amount of circulating blood volume.
In trauma typically results from hemorrhage, but can result in a precipitous loss of volume, ie vomiting
or diarrhea.
Burn trauma can result in hypovolemic shock from damage to the cell membranes leading to plasma and
protein leakage. of body water, results in inadequate perfusion.
Hyperventilation can cause increased intrathoracic pressure resulting in compression of the heart and
decreased cardiac output.
Initial Assessment - ans1. Preparation and Triage
2. Primary Survey
3. Reevaluation
4. Secondary Survey
,TNCC TEST 2023-2024 ACTUAL FINAL EXAM TEST BANK OVER 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|RATED A+
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
Intraocular Foreign Body - ans*TRUE EMERGENCY AND EARLY INTERVENTION IS ESSENTIAL.
Postop infection, retinal detachment and vision loss are common complications.
lid injury - ans
Liver - ansLargest solid organ of the body. RUQ, 6th to 10th ribs. Encased by Glisson capsule with blood
vessels, lymphatics and nerves. Filters 1.7L of blood per minute.
The liver filters out toxins, takes the nutrients and returns the blood to the heart via the hepatic veins.
Hepatocyte cells are capable of regeneration allowing the liver to repair its own tissue.
Functions: Store and metabolize lipids, transport nutrients, produce glucose and bilirubin, convert
ammonia to urea, secrete electrolytes, lipids, lecithin, cholesterol and bile. Metabolizes vitamin K and
produces thrombin and fibrinogen (all necessary for clotting).
Obstructive Shock - ansResults from hypo perfusion of the tissue due to an obstruction in either the
vasculature or heart.
,TNCC TEST 2023-2024 ACTUAL FINAL EXAM TEST BANK OVER 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|RATED A+
Tension pneumothorax - increased thoracic pressure leads to displacement of the vena cava,
obstruction to atrial filling, decreased preload and decreased cardiac output.
Cardiac tamponade - impedes diastolic expansion and filling leads to decreased preload, strokes volume
and cardiac output and ultimately end organ perfusion.
P (AVPU) - ansPainful. Responds only to painful stimuli.
(Airway adjunct may be needed while determining need for intubation)
A adult patient with a knife injury to the neck has an intact airway and is hemodynamically stable. They
complain of difficulty swallowing and speaking. In the primary survey, further assessment is indicated
next for which of the following conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland – ans a. Damage to the cervical spine
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 significant
bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings – ans b. Initiate 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,
, TNCC TEST 2023-2024 ACTUAL FINAL EXAM TEST BANK OVER 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|RATED A+
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?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus - ansb. alcohol withdrawal
A patient involved in a 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 - ansb. Brachial plexus injury
A patient with a spinal cord injury 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 resuscitation fluid
c. perform serial assessments of neurologic function
d. maintain core temperature - ansa. maintain adequate respiratory status
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 would indicate
this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
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