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TNCC ENA 9th Edition Pre TestA 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 - answersB. Initiate direct
pressure
Rationale: The first step inn controlling any bleeding is application of direct pressure.
What technique is most appropriate when obtaining a history from a patient who has
experienced a sexual assault?
A. Sitting next to the patient
B. Ensuring the patient answers all the questions
C. Asking for information only related to the assault
D. Applying active listening - answersD. Applying active listening
Rationale: Therapeutic communication techniques such as active listening decrease
unintentional distress during the interaction.
What is the appropriate technique for palpating the pelvis for stability?
A. Apply gentle pressure over the iliac crests, downward and laterally
B. Apply gentle pressure over the iliac crests, downward and medially
C. Apply firm pressure over the iliac crests, downward and laterally
D. Apply firm pressure over the iliac crests, downward and medially - answersB. Apply
gentle pressure over the iliac crests, downward and medially
Rationale: To assess for pelvic instability, gentle pressure is applied over the iliac
crests, downward and medially.
, 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 would indicate this nurse is coping well?
A. They are talking about taking the emergency nursing certification exam
B. They keep requesting to be assigned to the walk-in/ambulatory area
C. They are impatient and snap at their coworkers
D. They are thinking about transferring out of the emergency department - answersA.
They are talking about taking the emergency nursing certification exam
Rationale: This is an indication the nurse is taking positive steps to advance their own
practice, a sign of resilience. B indicates the nurse is still not ready to return to their
previous level of engagement in their job. C shows signs of burnout, irritability and
frustration. D shows decreased satisfaction with the job, a sign of burnout.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of
94/62 mmHg and a heart rate of 108 beats/minute. Fetal heart tones are 124
beats/minute. The emergency nurse interprets the patient's hemodynamic findings as
an indication of which of the following?
A. Decompensated shock
B. Normal vital signs in pregnancy
C. Compensated shock
D. Supine hypotension syndrome - answersB. Normal vital signs in pregnancy
Rationale: In pregnancy, the resting heart rate increases by 10 to 20 beats/minute. This
is also a small decrease in systolic blood pressure and a larger decrease in diastolic
blood pressure due to a decrease in peripheral resistance. Normal fetal heart rate is
between 120 and 160 beats/minute.
Which of the following is considered a cornerstone of a high-performance trauma team?
A. Individual goals
B. Use of TeamSTEPPS
C. Identification of a single decision maker
D. Effective communication - answersD. Effective communication
Rationale: Skilled communication, cooperation, and coordination are the cornerstones
of high-performance and high-quality trauma care.
In a patient with severe traumatic brain injury, hypocapnia causes which condition?
A. Respiratory acidosis
B. Metabolic acidosis
C. Neurogenic shock
D. Cerebral vasoconstriction - answersD. Cerebral vasoconstriction
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