Docsity
Log inSign up
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources
Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study
Go to the blog

TNCC 9th Edition Final Test: Trauma Nursing Critical Care, Exams of Nursing

The University of ManchesterNursing

TNCC 9th Edition FINAL TEST. 84 QUESTIONS AND ANSWERS. GRADED A+, Exams of Nursing

Typology: Exams

2023/2024

Available from 07/08/2024

edwin-Starr
edwin-Starr 🇬🇧

3.8

(32)

224 documents

1 / 15

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
TNCC 9th Edition FINAL TEST. 84
QUESTIONS AND ANSWERS. GRADED A+,
Exams of Nursing
1. 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 should be avoided with a suspected spine injury prior to imaging
D. It decreases the risk of hemorrhage from unstable pelvic injuries
2. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority
intervention?
A. Initiate two intravenous access sites
B. Place the patient on supplemental oxygen
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding
3. A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is
a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is
most consistent with an injury to the diaphragm?
A. Severe left-sided abdominal pain
B. Pain radiating to the left shoulder.
C. Bowel sounds heard in the left lower chest
D. Decreased breath sounds on the left side
4. A patient is thrown against a car during a tornado and presents with obvious bilateral femur
fractures. The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the
following interventions would be most appropriate for this patient based on the disaster triage
principles?
A. Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
B. Administer intravenous medications for pain.
C. Place the patient in an observation area for care within the next few hours.
D. Contact the command center for personnel to notify next of kin.
5. A 35-year-old male 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?
A. Oculomotor nerve palsy
B. Globe rupture
C. Retrobulbar hematoma
D. Retinal detachment
1
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff

Partial preview of the text

Download TNCC 9th Edition Final Test: Trauma Nursing Critical Care and more Exams Nursing in PDF only on Docsity!

TNCC 9th Edition FINAL TEST. 84

QUESTIONS AND ANSWERS. GRADED A+,

Exams of Nursing

  1. 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 should be avoided with a suspected spine injury prior to imaging D. It decreases the risk of hemorrhage from unstable pelvic injuries
  2. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority intervention? A. Initiate two intravenous access sites B. Place the patient on supplemental oxygen C. Apply direct pressure to the wound D. Use a tourniquet to control the bleeding
  3. A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most consistent with an injury to the diaphragm? A. Severe left-sided abdominal pain B. Pain radiating to the left shoulder. C. Bowel sounds heard in the left lower chest D. Decreased breath sounds on the left side
  4. A patient is thrown against a car during a tornado and presents with obvious bilateral femur fractures. The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the following interventions would be most appropriate for this patient based on the disaster triage principles? A. Initiate two large-caliber intravenous lines for isotonic crystalloid administration. B. Administer intravenous medications for pain. C. Place the patient in an observation area for care within the next few hours. D. Contact the command center for personnel to notify next of kin.
  5. A 35-year-old male 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? A. Oculomotor nerve palsy B. Globe rupture C. Retrobulbar hematoma D. Retinal detachment
  1. 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. The patient 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? A. Needle decompression B. Tube thoracostomy C. Dressing removal D. Surgical repair
  2. A driver involved in a high-speed motor vehicle collision arrives in the emergency department. The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and complaining of chest pain with ecchymosis noted to the chest. The patient is tachycardic and hypotensive with no evidence of uncontrolled bleeding. Cardiac monitor shows premature ventricular contractions. Which of the following is the most appropriate intervention for this patient? A. Rapid fluid boluses B. Tranexamic acid administration C. Inotropic support D. Hemostatic resuscitation
  3. 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. Initiate another fluid bolus. B. Recheck endotracheal tube placement. C. Decrease the rate of manual ventilation. D. Increase the amount of oxygen delivered.
  4. A patient with a 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 leg above the level of the heart B. Elevating the leg to the level of the heart C. Repositioning the leg and applying ice D. Preparing the patient for ultrasound of the leg
  5. A patient has been in the emergency department for several hours waiting to be admitted. They sustained multiple rib fractures and a femur fracture after a fall. The patient has been awake, alert, and complaining of leg pain. Their spouse reported that the patient suddenly became anxious and confused. Upon reassessment, the patient is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and symptoms most commonly associated with which of the following conditions? A. Fat embolism B. Acute lung injury C. Pneumothorax

A. Intracerebral hemorrhage B. Epidural hematoma C. Post-concussive syndrome D. Diffuse axonal injury

  1. A patient is diagnosed with a T12 spinal cord injury following a 20- foot fall. Which finding is consistent with spinal shock? A. Loss of reflexes B. Bradycardia C. Widened pulse pressure D. Warm skin
  2. An unconscious patient arrives following a motor vehicle collision. The patient is on a backboard with a cervical collar in place and one intravenous line running. Respirations are shallow and there is active brisk bleeding from a large leg wound. What is the priority intervention for this patient? A. Check for a patent airway B. Control the bleeding C. Start a second intravenous line D. Ventilate with a bag-mask device
  3. An obese trauma patient requires intubation. Assuming there are no contraindications, which position will provide the best visualization for insertion of the endotracheal tube? A. Reverse Trendelenburg B. Lying on side C. Ramped D. Supine
  4. Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing intervention? A. Hold all pain medications B. Notify the provider of the change C. Repeat the GCS in 30 minutes D. Place the patient in Trendelenburg position
  5. Which of the following situations could cause functional grief? A. Inability to live at home B. Amputation of a limb C. Loss of one's self-image D. Destruction of the patient's car
  6. A patient arrives following prolonged exposure of their left hand to the cold. The patient is awake and alert and complains of a tingling sensation to the fingers. Assessment reveals swelling and

bright red skin to the left hand and a 1-inch round clear blister to the dorsum of that hand. Which of the following nursing interventions is most appropriate for this patient? A. Massage the injured areas to promote circulation B. Drain and debride the blister on the hand C. Immerse in water between 37.5oC and 39.5oC (99.5oF to 103.1oF). D. Gently rewarm over 15 to 30 minutes

  1. A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during a staffing crisis. The nurse expresses anger stating that the patients did not receive quality care and begins exhibiting aggression toward colleagues. This is most consistent with which condition? A. Compassion fatigue B. Vicarious trauma C. Secondary traumatic stress D. Moral injury
  2. What is the rationale for obtaining a serum lactate level during the initial assessment of a trauma patient? A. Measures oxygenation and ventilation B. Assesses the degree of alkalosis and base deficit C. Gauges end-organ perfusion and tissue hypoxia D. Determines the underlying cause of shock
  3. What is the most important consideration during the initial assessment when caring for an older adult who has sustained serious injuries? A. They are likely to be fearful in the emergency department B. Medical history including current medications C. Availability of support systems after discharge D. Accessibility to a primary care physician
  4. Following a gun shot wound, pre-hospital providers report diminished breath sounds bilaterally. Upon emergency department arrival, the patient is unresponsive with shallow respirations and an O2 sat of 88%. What is the priority intervention for this patient? A. Administer 15 L oxygen via nonrebreather mask B. Attach patient to a CO2 detector C. Prepare for a definitive airway D. Assist ventilation with a bag-mask device
  5. Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is concerned about injury to which organ? A. Transverse colon B. Pancreas C. Liver D. Spleen

C. Should only be done at a burn center D. During the primary survey

  1. Which of the following is true about use of the focused assessment sonography for trauma exam for a patient with abdominal trauma? A. It has a higher sensitivity than diagnostic peritoneal lavage for fluid detection B. It can be used in hypotensive patients too unstable for computed tomography scan C. It can detect as little as 30 mL of fluid in the abdominal cavity D. It has high sensitivity in pediatric patients for identifying fluid in the peritoneum
  2. What is the priority intervention for a child who has been diagnosed with an atlanto-occipital dislocation following a high-speed motor vehicle collision? A. Initiating a second large caliber intravenous line B. Maintaining spinal motion restriction C. Placing the patient on pulse oximetry D. Turning the patient to remove the backboard
  3. During the primary survey of an unconscious patient with multisystem trauma, the nurse notes snoring respirations. Which priority nursing intervention should be performed next? A. Open the airway with the head-tilt/chin-lift maneuver B. Auscultate bilateral breath sounds C. Assist respirations using a bag-mask device D. Insert an oropharyngeal airway if there is no gag reflex
  4. A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these findings? A. Rhabdomyolysis B. Fat embolism C. Disseminated intravascular coagulopathy D. Multiple organ dysfunctions syndrome
  5. A patient is brought to the emergency department following a snowmobile crash with prolonged exposure time prior to transport. The patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24 breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per non-rebreather mask. Other findings include ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based on these findings, what is the most appropriate intervention? A. Initiate warming measures B. Titrate oxygen to 6 L per nasal cannula C. Bolus with 500 mL isotonic crystalloids D. Vigorously massage the extremities
  6. Which of the following is a late sign of increased intracranial pressure? A. Restlessness

B. Vomiting C. Decreased respiratory effort D. Narrowing pulse pressure

  1. Based on fall mechanism, which patient warrants prehospital transfer to a trauma center? A. A 35-year-old lands on a wooden porch from an 8-foot ladder B. A 2-year-old lands on grass from a second-story balcony C. A 14-year-old forcefully pushed onto cement from standing D. A 50-year-old lands on a carpeted floor after tripping
  2. The trauma nurse is caring for an unrestrained driver who struck their head on the windshield following a high-speed MVC. The patient has been diagnosed with an anterior spinal cord injury at the level of C6. Which assessment finding would be most concerning? A. Distension of the bladder B. Incontinence of stool C. Increasing work of breathing D. Inability to move the legs
  3. While caring for a child who has been injured, what nursing intervention is consistent with a family-center approach? A. Identifying a single family member to speak with B. Having the family make all the care decisions C. Allowing family to participate in the care of the patient D. Limiting dissemination of complex information
  4. A patient who sustained severe injuries was brought to the emergency department following a high-speed motor vehicle collision. Interventions for hypovolemic shock have been initiated. What component of the trauma triad of death is most likely to have begun at the time of injury? A. Acidosis B. Hypothermia C. Hypocalcemia D. Coagulopathy
  5. An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural critical access facility. They complain of neck pain, shortness of breath, and diffuse abdominal pain. The Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, and SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is the priority intervention for this patient? A. Expedite transport to the CT scanner B. Prepare the patient for spinal radiographs C. Expedite transfer to the closest trauma center D. Notify the patient's family
  6. A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness burns to both upper extremities and chest with a total body surface area burned of 27%. How much intravenous fluid should be administered in the first 8 hours?
  1. An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored respirations, and dusky skin. Medications for drug-assisted intubation have been administered but intubation was unsuccessful. What is the most appropriate next step? A. Ventilate with a bag-mask device B. Prepare for a cricothyroidotomy C. Administer reversal medications D. Contact anesthesia for assistance
  2. A restrained driver involved in a motor vehicle collision is brought to the emergency department with abdominal, pelvic, and bilateral lower extremity pain. Vital signs are BP 114/78 mm Hg, HR 98 beats/minute, RR 22 breaths/minute. A FAST exam is negative for fluid in the abdominal and peritoneal cavities. Which of the following should the nurse anticipate? A. Diagnostic peritoneal lavage B. Angiography C. Non-contrast abdominal CT scan D. Serial abdominal assessments
  3. Which of the following is true of cavitation? A. Energy cause the tissues to accelerate and displace outward B. Once a bullet passes, the tissues always return to its normal location C. Damage occurs only to internal organs and blood vessels D. Hollow organs do not tolerate high-velocity cavitation
  4. An adult patient involved in an assault presents with shortness of breath, BP 88/50 mmHg, heart rate 130 beats/minute. The patient has muffled heart sounds and is cyanotic. What is the priority intervention? A. Needle thoracostomy B. Chest tube insertion C. Pericardiocentesis D. Tracheal intubation 55.A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an indication of the body's response to these findings? A. Reflex hypotension B. Increased respiratory effort C. Reflex tachycardia D. Widening pulse pressure
  5. A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the water seal chamber during inspiration and expiration. What is the best action for the nurse to take? A. Clamp the chest tube B. Return to the emergency department C. Assist ventilation with bag-mask device

D. Continue to intensive care unit

  1. In a motor vehicle collision, which injury pathway is most likely to increase the patients morbidity and mortality? A. Rotational B. Ejection C. Lateral D. Rollover
  2. Which of the following assessment findings differentiates a tension pneumothorax from a simple pneumothorax? A. Increased work of breathing B. Unilaterally diminished breath sounds C. Tachycardia D. Hypotension
  3. An 85 year old is brought to the emergency department by a family member for fever and cough. There are multiple bruises in various stages of healing on the upper extremities and the back. Based on these findings what is the most appropriate initial question to facilitate screening for abuse? A. How did you get these bruises? B. How long have you had these bruises? C. Did someone hurt you? D. Who takes care of you?
  4. Caregivers carry a 2 year old into the emergency department who fell out of a second story window. The patient is awake and crying with increased work of breathing and pale skin. Which intervention has the highest priority? A. Stabilizing the cervical spine B. Applying a nonrebreather mask C. Establishing intravenous access D. Preparing for drug-assisted intubation
  5. 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 circumstances can an order to remove the rigid cervical collar be anticipated? A. No imaging abnormalities of the neck B. No neurological abnormalities on examination C. No point tenderness to cervical spine D. Absence of neck pain with movement
  6. What intravascular solution is most commonly used for patients who have sustained burns? A. Lactated ringer’s B. Normal saline

B. Pulse oximetry reading C. Severe facial injuries D. Smell of alcohol on breath

  1. 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
  2. A trauma patient is en route to a rural emergency department Radiology notifies the charge nurse that the computed tomography (ct) scanner will be out of service for several hours. The team gathers to plan accordingly. Which of the following terms best describes this trauma team’s communication? A. Brief B. Closed loop C. Debrief D. Huddle
  3. A seriously injured patient is noted to have weak, thready pulse and cool, clammy skin. There is instability of the pelvis on palpating and blood on the urinary meatus. A pelvic binder is appropriately applied and balanced fluid resuscitation is being managed by the team. What is most likely to be ordered next? A. Insert a urinary catheter B. Bolus with 2L isotonic crystalloid solution C. Diagnostic peritoneal lavage D. Insertion of a Supra public catheter
  4. Patients with a crush injury should be monitored for which of the following conditions? A. Hypermatremia B. Hypercalcemia C. Dysrhythmias D. Polyuria
  5. Which commonly prescribed medication may worsen a complication that is associated with massive transfusion? A. Lisinopril B. Metformin C. Metoprolol D. Diltiazem
  6. A 36-year-old patient has a deformity of the left wrist after a fall. The patient is reluctant to move their 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 the extremity 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

  1. 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
  2. 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? A. Mitigation B. Preparedness C. Response D. Recovery
  3. A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP 110/60 mm Hg, HR 96 beats/minute, and RR 24 breaths/minute. Skin is cool and moist. Current vital signs are BP 86/68 mm Hg, HR 118 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs and symptoms of which stage of shock? A. Compensated B. Refractory C. Irreversible D. Decompensated
  4. An adult arrives at the emergency department with superficial burns to the extremities following a house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the most likely cause of these symptoms? A. Capillary leak syndrome B. Rhabdomyolysis C. Carbon monoxide poisoning D. Hypothermia
  5. 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 traction splint to the affected extremity 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)