TNCC test prepA
serial FAST exams
a 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic, and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT which of the following?
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 are noted in the primary survey, which of the following is the priority interventions?
bardycardia and absent motor function below the level of injury
A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs?
increased work of breathing?
which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax?
the aorta is torn at its attachment with the ligamentum arteriosum
which of the following occurs during the third impact of a motor vehicle crash?
pelvic stability
the most reassuring finding for a male pt with hip pain after a fall is which of the following?
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?
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?
defusings
All of these are considered a critical communication point in trauma care EXCEPT which of the following?
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 has a hematoma to her forehead and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms?
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 awake and crying with increased work of breathing and pale skin. Which of the following interventions has the highest priority?
insert an oropharyngeal airway if there is no gag reflex
During the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing interventions should be preformed next?
after a physical examination if the pt has no radiologic abnormalities on CT
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to remove the cervical collar?
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?
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?
dysrhythmias
Patients with a crush injury should be monitored for which of the following conditions?
subdural hematoma
Tearing of the bridging veins is most frequently associated with which brain injury?
endotracheal tube
The trauma nurse knows that placing a bariatric patient in a ramped position providers better visualization during the insertion of which device?
pulse oximetry and capnography
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of ventilation?
velocity
What factor contributes most to the kinetic energy of a body in motion?
hemoglobin does not readily release O2 for use by the tissues
What is the effect of hypothermia on the oxyhemoglobin dissociation curve?
within 24 hrs of trauma
When is the tertiary survey completed fora trauma pt?
a pertinent medical hx is crucial
Which of the following considerations is the most important when caring for a geriatric trauma pt?
MARCH
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive uncontrolled hemorrhage?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg
Which of the following patients warrants referral to a burn center?
narrowed
Which of the following pulse pressures indicate early hypovolemic shock?
to guage end-organ perfusion and tissue hypoxia
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient?
placental abruption
You are caring for a pt who was involved in a MVC and is 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?
500 mL/hr
You are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred due to the need for emergent intubation. At what rate should you begin fluid resuscitation?
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?
dressing removal
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital providers placed a nonporous dressing over the chest wound and taped it on three sides. he is now showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood pressure. Which of the following is the MOST appropriate immediate intervention?
pressure
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing compartment syndrome. What is the most reliable indication of compartment syndrome in a patient who is unconscious?
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 unsuccessful. What is the most appropriate immediate next step?
advanced age
Which of the following is most likely to contribute to inadequate oxygenation and ventilation?
worsening pneumothorax
Which of the following is possible complication of positive-pressure ventilation?
it can worsen cord damage from an unstable spinal injury
Which of the following is true about the log-roll?
nausea and vomiting
Which of the following is a late sign of increased intracranial pressure?
flucuation in the water seal chamber
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest drainage system?
straight cath for urine sample
A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would the RN question?
globe rupture
A 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
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?
Report your suspicion of maltreatment in accordance with local regulations
a 5 y/o child presents to the ED with bruises to the upper arm and buttocks in 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 following is the priority nursing intervention?
bowel
Which of the following injuries is LEAST likely to be promptly identified?
identifying individuals who made mistakes during the traumatic event
Which of the following is NOT considered a benefit of debriefings?
pericardiocentesis
Which of the following is NOT considered goal-directed therapy for cardiogenic shock?
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 a future disaster . Which phase of the disaster life cycle does this describe?
acidosis
Which of the following is a component of the trauma triad of death?
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?
calcium
if a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation?
