TNCC Written Exam UPDATED ACTUAL Exam Questions and CORRECT Answers
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Course
TNCC
Institution
TNCC
TNCC Written Exam UPDATED ACTUAL
Exam Questions and CORRECT Answers
What are the late signs of breathing compromise? - CORRECT ANSWER- - Tracheal
deviation
- JVD
What are signs of ineffective breathing? - CORRECT ANSWER- - AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion ...
TNCC Written Exam UPDATED ACTUAL
Exam Questions and CORRECT Answers
What are the late signs of breathing compromise? - CORRECT ANSWER- ✔✔- Tracheal
deviation
- JVD
What are signs of ineffective breathing? - CORRECT ANSWER- ✔✔- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing effectively? -
CORRECT ANSWER- ✔✔A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? - CORRECT
ANSWER- ✔✔- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - CORRECT ANSWER- ✔✔- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
,What are the interventions for Effective/Ineffective Circulation? - CORRECT ANSWER-
✔✔- Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
- IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
What are factors that contribute to ineffective ventilation? - CORRECT ANSWER- ✔✔-
AMS
- LOC
- Neurologic injury
- Spinal Cord Injury
- Intracranial Injury
- Blunt trauma
- Pain caused by rib fractures
- Penetrating Trauma
- Preexisting hx of respiratory diseases
- Increased age
,What medications are used during intubation? - CORRECT ANSWER- ✔✔LOAD
Mnemonic:
L = Lidocaine
O = Opioids
A = Atropine
D = Defasiculating agents
What are the Rapid Sequence Intubation Steps? - CORRECT ANSWER-
✔✔PREPARATION:
- gather equipment, staffing, etc.
PREOXYGENATION:
- Use 100% O2 (prevent risk of aspiration).
PRETREATMENT:
- Decrease S/E's of intubation
PARALYSIS WITH INDUCTION:
- Pt has LOC, then administer neuromuscular blocking agent
PROTECTION AND POSITIONING:
- Apply pressure over cricoid cartilage (minimizes likelihood of vomiting and aspiration
PLACEMENT WITH PROOF
- Each attempt NOT to exceed 30 seconds, max of 3 attempts. Ventilate pt 30-60 seconds
between attempts.
- After intubation, inflate the cuff
- Confirm tube placement w/exhaled CO2 detector.
POSTINTUBATION MANAGEMENT:
- Secure ET tube
- Set ventilator settings
- Obtain Chest x-ray
- Continue to medicate
- Recheck VS and pulse oxtimetry
, What is a Combitube? - CORRECT ANSWER- ✔✔A dual-lumen, dual-cuff airway that can
be placed blindly into the esophagus to establish an airway. If inadvertently placed into
trachea, it can be used as a temporary ET tube. There are only two sizes: small adult and
larger adult.
What is a Laryngeal Mask Airway? - CORRECT ANSWER- ✔✔Looks like an ET tube but is
equipped with an inflatable, elliptical, silicone rubber collar at the distal end. It is designed to
cover the supraglottic area.
ILMA, does not require laryngoscopy and visualization of the chords.
What is Needle Cricothyrotomy - CORRECT ANSWER- ✔✔Percutaneous transtracheal
ventilation. (temporary)
What is Surgical Cricothyrotomy? - CORRECT ANSWER- ✔✔Making an incision in
cricothyroid membrane and placing a cuffed endo or trach tube into trachea. This is indicated
when other methods of airway management have failed and pt cannot be adequately
ventilated and oxygenated.
Complications include:
- Aspiration
- Hemorrhage or hematoma formation or both
- Lac to trachea or esophagus
- Creation of a false passage
- Laryngeal stenosis
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