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TNCC Test Prep for Final Exam| Latest Solutions
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TNCC Test Prep for Final Exam| Latest Solutions1. Expedite transfer to the closest trauma center: A 56 y/o M pt involved in a
motor vehicle crash is brought to the ED of a rural critical access facility. He
complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP
98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of the
following is the priority intervention for this patient?
2. a pertinent medical hx is crucial: Which of the following considerations is themost
important when caring for a geriatric trauma pt?
3. Mitigation: Following a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of afuture disaster .
Which phase of the disaster life cycle does this describe?
4. Multiple requests for water: EMS brings a pt who fell while riding his bicycle. Using
the American College of Surgeobs screening guidelines, which assessment finding would
prompt the RN to prepare the pt for a radiologic spine clearance?
5. hemoglobin does not readily release O2 for use by the tissues: What is the effect of
hypothermia on the oxyhemoglobin dissociation curve?
6. acidosis: Which of the following is a component of the trauma triad of death?
7. Complete: EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F(36.2
C). The pt exhibits urinary incontinence and priapism. These assessment findings are
most consistent with which of the following types of spinal cord injury?
8. flucuation in the water seal chamber: Which of the following is an expectedfinding
in a pt with a tube thoracstomy connected to a chest drainage system?
9. insert an oropharyngeal airway if there is no gag reflex: During the primarysurvey
of an unconscious pt with multi-system trauma, the nurse notes snoring respirations.
What priority nursing interventions should be preformed next?
10. globe rupture: A 35 y/o M presents with facial trauma after being struck in theface
with a baseball. A teardrop-shaped left pupil is noted on exam. What type ofinjury is
suspected?
11. compensated: A trauma pt is restless and repeatedly asking "where am i?" VS upon
arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR
108, RR 28. The pt is demonstrating s/sx of which stage of shock?
12. ventilate with a bag mask device: An unresponsive trauma pt has an oropharygeal
airway in place, shallow and labored respirations, and dusky skin. The trauma team has
administered medications for drug-assisted intubation and attempted intubation but was
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,unsuccessful. What is the most appropriate immedi-ate next step?
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,13. within 24 hrs of trauma: When is the tertiary survey completed fora traumapt?
14. pressure: An intubated and sedated pt in the ED has multiple extremity injurieswith
the potential for causing compartment syndrome. What is the most reliable indication of
compartment syndrome in a patient who is unconscious?
15. worsening pneumothorax: Which of the following is possible complication of
positive-pressure ventilation?
16. pelvic stability: the most reassuring finding for a male pt with hip pain after afall is
which of the following?
17. narrowed: Which of the following pulse pressures indicate early hypovolemic
shock?
18. dysrhythmias: Patients with a crush injury should be monitored for which ofthe
following conditions?
19. subdural hematoma: Tearing of the bridging veins is most frequently associ-ated
with which brain injury?
20. straight cath for urine sample: A 20 y/o M presents to the ED complaining ofsevere
lower abd pain after landing hard on the bicycle cross bars while preformingan aerial BMX
maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis.
Which of the following orders would the RN question?
21. placental abruption: You are caring for a pt who was involved in a MVC andis 32
weeks pregnant. Findings of your secondary survey include abd pain on palpation,
fundal ht at the costal margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cariocgraphy. These findings are most consistent with which
of the following?
22. it can worsen cord damage from an unstable spinal injury: Which of the
following is true about the log-roll?
23. defusings: All of these are considered a critical communication point in traumacare
EXCEPT which of the following?
24. pulse oximetry and capnography: What bedside monitoring parameters areused to
assess for adequacy of O2 and effectiveness of ventilation?
25. padding the upper back while stabilizing the cervical spine: Caregivers carry in a
2 y/o into the ED who fell out of a second-story window. The pt is awakeand crying with
increased work of breathing and pale skin. Which of the followinginterventions has the
highest priority?
26. bowel: Which of the following injuries is LEAST likely to be promptly identified?
3/4
, 27. Initiate transfer to a trauma center: A pt is brought to the ED of a rural hospital
following a high-speed MVC. When significant abd and pelvic injuries arenoted in the
primary survey, which of the following is the priority interventions?
28. bardycardia and absent motor function below the level of injury: A pt witha
complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs?
29. apply splint and elevate above the level of the heart: a 37 y/o F has a deformity of
the L wrist after a fall. She is reluctant to move her hand due to pain.Which of the
following is the most appropriate intervention?
30. the aorta is torn at its attachment with the ligamentum arteriosum: whichof the
following occurs during the third impact of a motor vehicle crash?
31. Report your suspicion of maltreatment in accordance with local regula- tions: a
5 y/o child presents to the ED with bruises to the upper arm and buttocksin various stages
of healing and multiple small, clean, round burns to the back. There are no abnormalities
found based on the pediatric assessment triangle or primary survey. Which of the
following is the priority survey. Which of the followingis the priority nursing
intervention?
32. to guage end-organ perfusion and tissue hypoxia: Why is a measure ofserum
lactate obtained in the initial assessment of a trauma patient?
33. elevating the extremity to the level of the heart: A pt with a lower extremity
fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention?
34. velocity: What factor contributes most to the kinetic energy of a body in
motion?
35. subdural hematoma: An elderly patient with a history of anticoagulant use presents
after a fall at home today. She denies any loss of consciousness. She hasa hematoma to her
forehead and complains of headache, dizziness, and nausea.What is the most likely cause
of her symptoms?
36. fat embolism: a pt has been in the ED for several hrs waiting to be admitted. He
sustained multiple rib fractures and a femur fracture after a fall. He has been awake,alert, and
complaining of leg pain. His wife reported that he suddenly became anxious and
confused. Upon reassessment, the pt is restless with respiratory distress and petechiae to
his neck. The pt is exhibiting s/sx most commonly associated with which of the
following conditions?
37. nausea and vomiting: Which of the following is a late sign of increased
intracranial pressure?
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