TNCC practice

The physician notes the patient, with facial trauma has an "eight ball hemorrhage". This probably occured from:

A direct blow to the eye.

A closed crush injury, with an obvious fracture of the left mid-shaft tibia, pain of 8/10 has been medicated. What should not be done?

Apply traction splint, provide non-pharmacolofic comfort measures, such as ice, verbal reassurance.

A 32 year old cage fighter received a chop to his anterior throat, causing a spontaneous tension pneumothorax. When checking FOCA 3 hours after chest tube insertion, bubbling is noted in the water seal chamber. Your next assessment of intervention:

Assess bilateral breath sounds.

A 17 year old male, gunshot wound to the right chest has decreased breath sounds, tachypnea, dullness with percussion of right chest. You will anticipate:

Autotransfusion.

The most important feature of decontamination is

Avoiding contamination of you and coworkers

Respiratory rate of 6 shallow. Oxygen delivery will be by:

Bag-mask device with 100% oxygen.

Which of the following is the best measure of the adequacy of cellular perfusion and helps to predict the outcome of resuscitation?

Base deficit

The suspected perpetrator of domestic violence refuses to leave her domestic's partner's bedside. Your best response, at this time is:

Call security of law enforcement.

In a patient with severe traumatic brain injury, hypocapnia causes:

Cerebral vasoconstriction

An actively bleeding patient (left groin), has 2 large bore IVs, with strong central pulses, tachycardia and thready radial pulses needs:

Control of bleeding..

An example of acceleration/deceleration injury is:

Coup/contrecoup

A patient is diagnosed with small subdural hematoma with a history of a trip and fall in which he hit his head on the sink two weeks ago. He is waiting for an inpateint bed. The nurse shift report indicates that he did not sleep last night and has been very anxious. As the nurse begins an assessment, he vomits and states he couldn't sleep because a young child kept coming in this room during the night. What is a likely cause for these signs and symptoms?

ETOH withdrawal

What is the key to a high performing trauma team?

Effective communication

When palpating for a central pulse on a 35 year old blunt chest trauma, a rate of 25 beats per minute is discovered. You will

Establish two large bore intravenous sites

LeFort fractures almost always will:

Have malocclusion.

ICP:22 MAP:62 CPP:?

Inadequate: 40

A suspected laceration of the middle meningeal artery with significant bleeding:

May require immediate surgical intervention.

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?

Monitor respiratory status

Muffled heart tones, hypotension and narrowing pulse pressure produces what type of shock?

Obstructive.

The hospital adminstrator has informed you to actioate the incident command system

Open & activate your disaster manual

A 38 year old male, sustained a baseball bat head injury. Glasgow Coma Scale 13. His spine is cleared by the practitioner. Due to emesis, his head was turned to side. He has a dilated, unresponsive pupil. Emesis has stopped after administration of ondansetron, 4mg IV. Next:

Place head midline, anticipate hyperosmolar diuretics.

The trauma surgeon has elected to perform a diagnostic peritoneal lavage. The patient has two patent IVs and is currently hemodynamically stables. Your best intervention:

Prepare to insert gastric tube & folet catheter

A closed-head injury with a blood pressure of 86/42 (57), pulse of 72, respirations:14, regular, Spo2:86% on 100% oxygen, non-rebreather mask. AVPU:responds to painful stimuli. PERRL. Your options:

Reverse Trendelenburg (T-Bird), increase IVF rate observe for improvement.

A 48 year old female stab wound to left upper abdomen. Chest x-ray reveals gastric tube is in her left chest. Most likely cause:

Ruptured diaphragm.

A trauma nurse cared for a child with devasting burns 2 weeks ago. She 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?

She is talking about getting certification as emergency nurse

A 66 year old male fell 8 feet from a ladder. Tearing abdominal pain, paraplegia, blanched feet, increasing hypertension in upper extremity blood pressure, decreased level of consciousness. Your priority:

Start second large bore IV.

During the Inital Assessment, a non bleeding, open fracture of the femur is noted. Your inital intervention will be:

Test for distal neurovascular status.

Fracture of C-4, hypotension, pulse of 43 is distributive shock because

The is a loss of sympathetic tone

when checking an 87 year old female who sustained a ground level fall with a loss of consciousness, rectal sphincter tone is absent. This means:

There may be a spinal cord injury.

According to the World Health Organization pain relief ladder, adjuvant medications are:

Treatment for symptoms associated with pain

As base deficit increases, metabolic acidosis increases.

True

A trauma patient's hemoglobin and hematocrit are 6.1/19.1. Labs ordered to this point: CBC, CHEM panel, COAGs, U/A. Your next action will be:

Type & crossmatch.

35% burns with singed eyebrows and soot in mouth requires RSI. During the LOAD phase the inital neuromuscular blocking agent of choice is:

Vecuronium.

Which of the following accurately describes ventilation principles associated with a bag-mask device?

Ventilate at a rate of 10-12 breaths/minute

Treatment for frostbite includes:

aspirin

The across-the-room observation step in the inital assessment provides the opportunity to:

assess for uncontrolled bleeding and intervene

While performing an assessment on a 13 month-old involved in a motor vehicle collision, the nurse identifies which of the following findings from the patient as a potential sign of mental status changes?

cooperates with assessment

A patient with a knife injury to the neck has an intact airway and is hemodynamically stable. He complains of difficulty swallowing and speaking. Further assessment is indicated next for which of the following conditions?

damage to spinal cord

What is the first step to stop a hemorrhage associated with an amputated extremity?

direct pressure/tourniquet

What is the appropriate technique to palpate the pelvis for stability?

medial and downward gentle pressure over iliac wings

A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/72 mmHg and a heart rate of 108 beats/min. Fetal heart tones are 124 beats/min. The emergency nurse interprets the patient's hemodynamic findings as an indication of which of the following?

normal vital signs

When obtaining a history for an injured patient, determining energy transfer through biochemical data help the nurse to:

prepare for and anticipate injuries

What is the best position to maintain an open airway in the bariatric patient?

reverse trandelenberg

Following a bomb explosion, fragmentation injuries from the bomb or objects in the enviroment are examples of which phase of injury?

secondary

The major preventable cause of death in the trauma patient is:

uncontrolled bleeding

The nurse is obtaining a history for a patient who presents following sexual assault. This history is completed using which of the following techniques?

use direct quotes to record information