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TNCC 9th Edition final exam test - 100 questions & correct and verified answers. Graded A+, Exams of Nursing

The University of ManchesterNursing

TNCC 9th Edition final exam test 100 questions with correct and verified answers. Graded A+ 1. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - Correct answer C. Notify the physician" 2. "A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what is the priority intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - Correct answer A. Initiate transfer to a trauma center"

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TNCC 9th Edition final
exam test
100 questions with correct and verified
answers. Graded A+
1. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the
following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam. - Correct answer C. Notify the physician"
2. "A patient is brought to the emergency department of a rural hospital following a high-speed motor
vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey,
what is the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter - Correct answer A. Initiate transfer to a trauma center"
3. "An adult who fell from a second story roof is brought to the emergency department by private
vehicle. The patient is confused with unlabored respirations and has strong, palpable radial pulses.
There is an open wound in proximity to an obvious deformity of the left lower extremity. What is the
priority intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen.
D. Log roll the patient onto a spine board - Correct answer A. Initiate cervical spine stabilization"
4. "An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg
(4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
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Download TNCC 9th Edition final exam test - 100 questions & correct and verified answers. Graded A+ and more Exams Nursing in PDF only on Docsity!

TNCC 9th Edition final

exam test

100 questions with correct and verified

answers. Graded A+

  1. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - Correct answer C. Notify the physician"
  2. "A patient is brought to the emergency department of a rural hospital following a high-speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what is the priority intervention? A. Initiate transfer to a trauma center B. Attempt family notification C. Obtain additional imaging studies D. Place an indwelling urinary catheter - Correct answer A. Initiate transfer to a trauma center"
  3. "An adult who fell from a second story roof is brought to the emergency department by private vehicle. The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an open wound in proximity to an obvious deformity of the left lower extremity. What is the priority intervention? A. Initiate cervical spine stabilization B. Apply a splint to the lower extremity C. Put the patient on portable oxygen. D. Log roll the patient onto a spine board - Correct answer A. Initiate cervical spine stabilization"
  4. "An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the cerebral blood flow?

A. Decrease the rate of manual ventilation. B. Initiate another fluid bolus. C. Recheck endotracheal tube placement. D. Increase the amount of oxygen delivered. - Correct answer A. Decrease the rate of manual ventilation."

  1. "An adult patient is brought to the emergency department following a vehicle "roll-over" with prolonged extrication. Assessment reveals swelling and bruising to the right proximal thigh and a weak pedal pulse. Skin is pale, cool, and moist. What is the most appropriate initial intervention? A. Application of a tourniquet to the affected extremity B. Application of a pelvic binder C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa) - Correct answer B. Application of a pelvic binder"
  2. You are treating a 27-year old male in respiratory distress who was involved in a house fire. Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should you begin fluid resuscitation? A) 1000 mL/hr B) 500 mL/hr C) 250 mL/hr D) 125 mL/hr - Correct answer B) 500 mL/hr"
  3. "A patient has been in the ED for several hours waiting to be admitted. He sustained multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with which of the following conditions? A) acute lung injury B) fat embolism C) PTX D) pulmonary contusion - Correct answer B) fat embolism"
  4. "Which pulse pressure description is an indication of early hypovolemic shock? A) widened B) narrowed C) bounding D) weak - Correct answer B) narrowed"
  5. "Which of the following considerations is most important when caring for a geriatric trauma patient? A) head to to exam B) medical history C) incontinence

A) compensated B) Progressive C) irreversible D) decompensated - Correct answer A) compensated"

  1. "Why is a measure of serum lactate obtained in the initial assessment of the trauma patient? a) to measure oxygenation and ventilation b) to quantify the base deficit for the adequacy of cellular perfusion c) to gauge end-organ perfusion and tissue hypoxia d) to determine the underlying cause of shock - Correct answer c) to gauge end-organ perfusion and tissue hypoxia"
  2. "EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance? A) Alert with no neurologic deficits B) Multiple abrasions to the extremities C) Multiple requests of water D) Smell of alcohol on breath - Correct answer D) Smell of alcohol on breath"
  3. "Which of the following occurs during the third impact of a motor vehicle crash? A) The driver of the vehicle collides with the steering wheel B) the vehicle collides with a tree C) the aorta is torn at its attachment with the ligamentum arteriosum D) the airbag deploys and strikes the front seat passenger - Correct answer C) the aorta is torn at its attachment with the ligamentum arteriosum"
  4. "A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority interventions? A) initiate transfer to a trauma center B) provide report to the operating room nurse C) Obtained imaging studies D) Place a gastric tube - Correct answer A) initiate transfer to a trauma center"
  5. "Which of the following injuries is LEAST likely to be promptly identified? A) spleen B) lung C) bowel D) brain - Correct answer C) bowel"
  6. "Patients with a crush injury should be monitored for which of the following conditions?

A) Hypernatremia B) Hypercalcemia C) Dysrhythmias D) polyuria - Correct answer C) Dysrhythmias"

  1. "What finding raises suspicion of complete spinal cord injury? A) Weakness in the lower extremities B) Priapism C) voluntary anal sphincter tone D) intact reflexes distal to the injury - Correct answer B) Priapism"
  2. "A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs? A) Bradycardia and ipsilateral absences of motor function B) Tachycardia and respiratory depression C) Tachycardia and absent motor function below the level of injury D) Bradycardia and absent motor function below the level of the injury - Correct answer D) Bradycardia and absent motor function below the level of the injury"
  3. "A 5-year old child presents to the ED with bruises to the upper arms 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 nursing intervention? A) report your suspicion of the maltreatment in accordance with local regulations B) apply ice to the bruises and consult wound care C) engage in therapeutic communication to determine the MOI D) provide the family with injury prevention recourses - Correct answer A) report your suspicion of the maltreatment in accordance with local regulations"
  4. "A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? A) apply a sling and elevate the extremity to the level of the heart. B) apply a splint and elevate above the level of the heart C) Apply a sling and elevate the extremity above the level of the heart D) apply a splint and elevate the extremity to the level of the heart. - Correct answer B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART"
  5. "A patient with lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A) elevating the extremity above the level of the heart B) repositioning and apply ice C) Elevating the extremity to the level of the heart
  1. "Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The patient is awake and crying with increased work of breathing and pale skin. which of the following interventions has the highest priority? A) padding the upper back while stabilizing the cervical spine B) applying a tight-fitting NRB mask with an attached resevior C) establishing intravenous access and administering a 20mL/kg bolus D) preparing for drug assisted intubation - Correct answer A) padding the upper back while stabilizing the cervical spine"
  2. "A 35-year old male presents with facial trauma after bring struck in the face with a baseball. a tear- drop shaped left pupil is noted on exam. What type of injury is suspected? A) oculomotor nerve palsy B) globe rupture C) Uncal herniation D) retinal detachment - Correct answer B) globe rupture"
  3. "Which of the following is true about the log roll maneuver? A) it causes less spinal motion than the lift and slide maneuver B) it is recommended for patients with unstable pelvic fractures C) it can worsen cord damage from an unstable spinal injury D) it does not increases the risk of life threatening hemorrhage from unstable injuries - Correct answer C) it can worsen cord damage from an unstable spinal injury"
  4. "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 patient is asking to have the cervical color removed. when is it appropriate to remove the cervical collar? A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan B) after physician evaluation if the patient has not neurologic abnormalities on exam C) after palpation of the spine if the patient has no point tenderness the the vertebral column D) after physical examination if the patient has not neck pain with movement - Correct answer A) after a physical examination if the patient has no radiologic abnormalities on a computed tomography scan"
  5. "If a patient has received multiple transfusions of banked blood preserved with citrate, which electrolyte is most likely to drop and require supplementation? A) potassium B) magnesium C) sodium D) calcium - Correct answer D) calcium"
  6. "Tearing of the bridging veins is most frequently associated with which brain injury? A) epidural hematoma

B) subdural hematoma C) diffuse axonal injury D) intracerebral hematoma - Correct answer B) subdural hematoma"

  1. "A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the CT scanner will be out of service for several of hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma teams communication? A) Brief B) loop C) debrief D) huddle - Correct answer D) huddle"
  2. "An intubated trauma patient is being transferred to a tertiary care center. After moving the patient to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is the priority interventions? A) call for a portable CXR stat B) chest to make sure the ventilator is plugged in C) suction the ET tube D) confirm ET tube placement - Correct answer D) confirm ET tube placement"
  3. "What factor contributes most the kinetic energy of a body in motion? A) acceleration B) mass C) velocity D) inertia - Correct answer C) velocity"
  4. "During the primary survey of an unconscious patient with multi-system trauma, the nurse notes snoring respirations. Which priority nursing interventions should be performed next? A) open the airway with the head-tilt/chin lift maneuver B) auscultate bilateral breath sounds to assess ventilatory status C) assist respirations using a BVM D) insert an oropharyngeal airway if there is no gag reflex - Correct answer D) insert an oropharyngeal airway if there is no gag reflex"
  5. "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 future disaster. Which phase of the disaster life cycle does this describe? A) mitigation B) preparedness C) response D) recovery - Correct answer A) mitigation"

C) straight cath for urine sample D) ice and elevation of the scrotum - Correct answer C) straight cath for urine sample"

  1. "Which of the following is possible complication of positive-pressure ventilation? A) worsening pneumothorax B) worsening flail chest C) reabsorption of pleural air D) negative intrapleural pressure - Correct answer A) worsening pneumothorax"
  2. "Which of the following is NOT considered goal-directed therapy of cardiogenic shock? A) controlled fluid boluses B) antidysrhythmic administration C) pericardiocentesis D) cardiac cath - Correct answer C) pericardiocentesis"
  3. "What bedside monitoring parameters are used to assess for adequacy of oxygenation and effectiveness of ventilation? A) pulse oximetry and capnogaphy B) respiratory rate and capnography C) pulse oximetry and respiratory rate D) capnography and capnometry - Correct answer A) pulse oximetry and capnogaphy"
  4. "Which of the following values indicates the need for alcohol withdrawal interventions? A) CIWA-Ar of 36 B) GCS 13 C) ETCo2 of 48 mm Hg D) heart rate of 45 beats/min - Correct answer A) CIWA-Ar of 36"
  5. "An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respiratory, 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? A) Ventilate with a BVM B) Prepare for cricothyroidotomy C) administer reversal medications D) contact anesthesia for assistance - Correct answer A) Ventilate with a BVM"
  6. "The trauma nurse knows that placing a bariatric patients in a "ramped position" provides better visualization during the insertion of which device? A) Intraosseous line B) orogastric tube C) ET tube

D) urinary catheter - Correct answer C) ET tube"

  1. "You are caring for a patient who was involved in a MVA and is 32 weeks pregnant. Findings of your secondary survey include abd pain on palpation, fundal high at the costal margin, and some dark bloody show. Varying, accelerations and decelerations are noted on the cardiotocography. These findings are most consistent with which of the following? A) placental abruption B) preterm labor C) uterine rupture D) fetal demise - Correct answer A) placental abruption"
  2. A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent headache and nausea and was diagnosed with a small subdural hematoma. The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn't sleep because a young child kept coming into the room. What is the most likely cause for these signs and symptoms? a. increase intracranial pressure b. alcohol withdrawal c. rhabdomyolysis d. pulmonary embolus - Correct answer b. alcohol withdrawal"
  3. "Treatment for frostbite can include which of the following interventions? a. warm the affected part over 30-60 minutes b. use gentle friction to improve circulation c. administer tissue plasminogen activator d. leave all of the blisters intact - Correct answer c. administer tissue plasminogen activator"
  4. "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 and management for this patient? a. maintain adequate respiratory status. b. administer balanced resuscitation fluid c. perform serial assessments of neurologic function d. maintain core temperature - Correct answer a. maintain adequate respiratory status"
  5. "Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment are examples of which phase of injury? a. primary b. secondary c. tertiary d. quaternary - Correct answer b. secondary"
  6. "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 behaviors would indicate this nurse is coping well? a. They are talking about taking the emergency nursing certification examination.

d. Cover the open wound with sterile saline dressings - Correct answer b. Initiate direct pressure"

  1. "What is the best position for maintaining an open airway in the obese patient? a. Prone b. Supine c. Reverse Trendelenburg d. Right lateral recumbent - Correct answer c. Reverse Trendelenburg"
  2. "Understanding the kinematic concepts associated with the mechanism of injury and energy transfer can initially assist the trauma care provider in which of the following? a. Anticipating the types of injuries that may be present b. Deciding whether law enforcement should be notified c. Determining needed laboratory tests d. Predicting the need for a surgical procedure - Correct answer a. Anticipating the types of injuries that may be present"
  3. "What is the leading cause of preventable death for the trauma patient in the prehospital environment? a. Airway compromise b. Ineffective ventilation c. Secondary head injury d. Uncontrolled external hemorrhage - Correct answer d. Uncontrolled external hemorrhage"
  4. "A adult patient with a knife injury to the neck has an intact airway and is hemodynamically stable. They complain of difficulty swallowing and speaking. In the primary survey, further assessment is indicated next for which of the following conditions? a. Damage to the cervical spine b. An expanding pneumothorax c. Laceration of the carotid artery d. Injury to the thyroid gland - Correct answer a. Damage to the cervical spine"
  5. "What is the best measure of the adequacy of cellular perfusion and can help to predict the outcome of resuscitation? a. End-tidal carbon dioxide b. Hematocrit level c. Base deficit d. Oxygen saturation - Correct answer c. Base deficit"
  6. "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 - Correct answer d. Effective communication"
  7. "The nurse is obtaining a history for a patient who presents following sexual assault. This history is completed using which of the following techniques? a. Bring the family in to the interview room. b. Use direct quotes to record information.

c. Obtain information specific only to the assault. d. Provide food and drink to help create rapport. - Correct answer b. Use direct quotes to record information."

  1. "In a patient with severe traumatic brain injury, hypocapnia causes which condition? a. Respiratory acidosis b. Metabolic acidosis c. Neurogenic shock d. Cerebral vasoconstriction - Correct answer d. Cerebral vasoconstriction"
  2. "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. - Correct answer b. Apply gentle pressure over the iliac crests, downward and medially."
  3. An adult patient who sustained a severe head trauma has been intubated and has been manually ventilated via a bag mask device at a rate of 18 breaths per minute. The patient has received one intravenous fluid bolus of 500 ML of warmed isotonic crystalloid solution. The PaCO2 is 30 and a pulse ox symmetry is 92%. BP is 142/70. What is the most important intervention to manage the cerebral blood flow? - Correct answer decrease the rate of manual ventilation"
  4. "An older patient with a history of anticoagulant use presents after a fall at home the previous day. She denies LLC. She has a hematoma to her for head and complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms? - Correct answer Subdural hematoma"
  5. "An adult who fell from a second story roof is brought to the emergency department by private vehicle. The patient is confused with an labored, respirations. It has strong, palpable, radial pulses. There is an open wound in proximity to Novios, deformity of the left lower extremity. What is the priority intervention? - Correct answer Stabilize the C-spine"
  6. "A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop shaped left people is noted on exam. What type of injury is suspected? - Correct answer Globe rupture"
  7. "An adult patient with a restraint passenger involved in a high-speed motor vehicle collision. The patient complained of generalized abdominal and left leg pain. A fast examines negative for fluid in the abdominal cavity. While awaiting impatient bed placement, the patient develops increase abdominal pain with rebound tenderness, fever, in an elevated white blood cell count. These findings are most consistent with an injury to which organ? - Correct answer Small bowel"
  8. "Which of the following is true about use of the focused assessment sonography for trauma exam for a patient with abdominal trauma? - Correct answer It can be used in hypotensive patients too unstable for computed tomographic scan."
  1. "A 36-year-old patient has a deformity of the left wrist after a fall. The patient is reluctant to move her hand due to pain. Which of the following is the most appropriate intervention? - Correct answer Apply splint and elevate above the level of the heart"
  2. "What is the rationale for obtaining a serum lactate level during the initial assessment of a trauma patient - Correct answer Gauges end-organ perfusion and tissue hypoxia"
  3. "A patient with a lower extremity fracture, complains of severe pain and tightness in his calf, minimally by pain medication's. Which of the following is a priority, nursing intervention? - Correct answer Elevating the extremity to the level of the heart"
  4. "A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would indicate sacral sparing? - Correct answer voluntary anal sphincter tone"
  5. "Following a motor vehicle collision, a patient presents with decreased level of consciousness and respirations that are intermittently accompanied by snoring. It has been determined that it is safe to insert a nasopharyngeal airway. What is most important to consider when preparing to insert the nasopharyngeal airway? - Correct answer gastric distention"
  6. "A patient arrives at the emergency department following a motor vehicle collision. Prehospital personnel report significant damage to the vehicle. The patient is alert and agitated with a strong odor of alcohol and appears intoxicated. After physician evaluation, under what circumstance can an order to remove the rigid cervical collar be anticipated? - Correct answer no imaging abnormalities of the neck"
  7. "You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant. Findings of your secondary survey include abdominal pain with rigidity on palpation, fundal height at the costal margin, and dark bloody vaginal discharge. Varying accelerations and decelerations are noted on cardiotocography. These findings are most consistent with which of the following? - Correct answer Placental abruption"
  8. "An adult patient is brought to the emergency department following a vehicle "roll-over" with prolonged extrication. Assessment reveals swelling and bruising to the right proximal thigh and a weak pedal pulse. Skin is pale, cool, and moist. What is the most appropriate initial intervention? - Correct answer paradoxical chest movement"