2023-2024 TNCC Final Exam 4 with Answers (1343 Solved Questions)
2023-2024 TNCC Final Exam 4 with Answers helps you familiarize yourself with previous exam formats.
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A a 22 yr old was struck by a vehicle while crossing the street, sustaining multiple fx she
is alert and answering qestions and crying what is the best method for initial pain
assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A a 22 yr old was struck by a vehicle while crossing the street, sustaining multiple fx she
is alert and answering qestions and crying what is the best method for initial pain
assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A a 22 yr old was struck by a vehicle while crossing the street, sustaining multiple fx she
is alert and answering qestions and crying what is the best method for initial pain
assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A a 22 yr old was struck by a vehicle while crossing the street, sustaining multiple fx she
is alert and answering qestions and crying what is the best method for initial pain
assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
B thinning skin and diminished autonomic response in older adult can have what effect
on primary assessment - ANScompromised thermoregulation
B when assessing a pt following a MVC the nurses asks how fsat the car was going -
ANSwhen volocity is doubled speed is quadroupled
B WHich may lead to unreliable pulse ox reading - ANScarboxyhemoglobin
B which of hte following significant assessment findigns is frequently found in a patient
with complete cransiofacial separation involving the maxilla, zygoma, orbits, and bones
of the cranial base. - ANSdiplopia
B which of the following hemodynamic support strategies is the prioririty intervention for
a pt with traumatic pulmonary contusion - ANSjudicios use of IV fluids
Bduring the primary survery which of the following has the greatest priority -
ANScervical spine injury
C 32 wk pregnant lady arrives in er after trapped in a car that flipped. the initial
assessment reveals s/s of shock, vaginal bleeding, a palpable asymmetrical uterus, and
slowing fetal heart tones what is the most likely cause - ANSuterine rupture
C a college student presents to the er stating afterarriving at a party , she awoke in a
dorm rom. she didnt recognize with no memory of the previous evening the trauma
nurse prepare for what exam. - ANSsexual assult
C an adult pt involved in a brush fire arrives to the er. upon initial assessment in the er
the most concerning finding is - ANShoarse voice and repeatedly decides to clear
throat.
C an older adult pt fell in the bathtub 3 days ago. now she is exihibiting decreasd LOC
and difficulty with speaking and walking. which of the following injuries is most effective
- ANSsubdural hematoma
C effective pain management in hte pt iwth rib fxwill promote what - ANScough with
ability to clear secretions
C properly restrained 6 wk old kid was involved in a MVC. after the assessment and
stabilization the pt becomes more difficult to rouse. responding with a weak cry to
painful stimuli. the pupils remain brisk and reactive. the anterior fontanel is soft and flat.
what is the most likely cause and pririty interventions - ANShypoglycemia
C What are the primary benefits of a team approach to trauma care - ANSit provides a
systemic approach to care and organizes care
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
B thinning skin and diminished autonomic response in older adult can have what effect
on primary assessment - ANScompromised thermoregulation
B when assessing a pt following a MVC the nurses asks how fsat the car was going -
ANSwhen volocity is doubled speed is quadroupled
B WHich may lead to unreliable pulse ox reading - ANScarboxyhemoglobin
B which of hte following significant assessment findigns is frequently found in a patient
with complete cransiofacial separation involving the maxilla, zygoma, orbits, and bones
of the cranial base. - ANSdiplopia
B which of the following hemodynamic support strategies is the prioririty intervention for
a pt with traumatic pulmonary contusion - ANSjudicios use of IV fluids
Bduring the primary survery which of the following has the greatest priority -
ANScervical spine injury
C 32 wk pregnant lady arrives in er after trapped in a car that flipped. the initial
assessment reveals s/s of shock, vaginal bleeding, a palpable asymmetrical uterus, and
slowing fetal heart tones what is the most likely cause - ANSuterine rupture
C a college student presents to the er stating afterarriving at a party , she awoke in a
dorm rom. she didnt recognize with no memory of the previous evening the trauma
nurse prepare for what exam. - ANSsexual assult
C an adult pt involved in a brush fire arrives to the er. upon initial assessment in the er
the most concerning finding is - ANShoarse voice and repeatedly decides to clear
throat.
C an older adult pt fell in the bathtub 3 days ago. now she is exihibiting decreasd LOC
and difficulty with speaking and walking. which of the following injuries is most effective
- ANSsubdural hematoma
C effective pain management in hte pt iwth rib fxwill promote what - ANScough with
ability to clear secretions
C properly restrained 6 wk old kid was involved in a MVC. after the assessment and
stabilization the pt becomes more difficult to rouse. responding with a weak cry to
painful stimuli. the pupils remain brisk and reactive. the anterior fontanel is soft and flat.
what is the most likely cause and pririty interventions - ANShypoglycemia
C What are the primary benefits of a team approach to trauma care - ANSit provides a
systemic approach to care and organizes care
Loading page 4...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
C what organ might be injured in left lower rib fx - ANSspleen
C which of the following would be priority intervention for a pt with multiple rib fractures
and chest wall instability follwoing a mvc collision - ANSassist with endotracheal
intubation
C which of the follwoing is a risk factor for DVT in the trauma pt. - ANSpelvic fx
Cthe term worried well when refering to disaster preparedness planning refers to: -
ANSindividuals hwo think they have been affected by the event but are asymptomatic
Cthe trauma nurse would prepare for a definitive airwya for which of the following
condition. - ANSGCS of 8 or ls
D An unrestrained driver is brought into the emergency department following a frontal
impact MVC. she is pale, anxious, and c/o SOB. what is the potential injury -
ANSLumbar fx
D elevated comaprtment pressure can be the result of - ANShemorrhage from within the
muscle
D pt with amputation of an index finger with a knife. amputaiton is brought in with pt. it is
wrapped in sterile gauze with saline and sealed in a plastic bag. the next step
amputation care is - ANSplace the bag on ice
D restrained driver is involved in a severe head on MVC and presnts with a seatbelt
mark along the neck and upper chest area. bilateral decreased breath sounds,
hemoptysis and diffuse sub q emphysemato the neck and upper chest area -
ANStracheobronchial injury
D which of the following diagnostic intervention is most appropriate for the unstable pt
with a suspectedinternal hemorrhage - ANSfocused assessment with sonography for
trauma
D which physiological change in airway of an odler adult pt places the pt at risk for
difficult intubation - ANScervical arthritisA a 22 yr old was struck by a vehicle while
crossing the street, sustaining multiple fx she is alert and answering qestions and crying
what is the best method for initial pain assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
C what organ might be injured in left lower rib fx - ANSspleen
C which of the following would be priority intervention for a pt with multiple rib fractures
and chest wall instability follwoing a mvc collision - ANSassist with endotracheal
intubation
C which of the follwoing is a risk factor for DVT in the trauma pt. - ANSpelvic fx
Cthe term worried well when refering to disaster preparedness planning refers to: -
ANSindividuals hwo think they have been affected by the event but are asymptomatic
Cthe trauma nurse would prepare for a definitive airwya for which of the following
condition. - ANSGCS of 8 or ls
D An unrestrained driver is brought into the emergency department following a frontal
impact MVC. she is pale, anxious, and c/o SOB. what is the potential injury -
ANSLumbar fx
D elevated comaprtment pressure can be the result of - ANShemorrhage from within the
muscle
D pt with amputation of an index finger with a knife. amputaiton is brought in with pt. it is
wrapped in sterile gauze with saline and sealed in a plastic bag. the next step
amputation care is - ANSplace the bag on ice
D restrained driver is involved in a severe head on MVC and presnts with a seatbelt
mark along the neck and upper chest area. bilateral decreased breath sounds,
hemoptysis and diffuse sub q emphysemato the neck and upper chest area -
ANStracheobronchial injury
D which of the following diagnostic intervention is most appropriate for the unstable pt
with a suspectedinternal hemorrhage - ANSfocused assessment with sonography for
trauma
D which physiological change in airway of an odler adult pt places the pt at risk for
difficult intubation - ANScervical arthritisA a 22 yr old was struck by a vehicle while
crossing the street, sustaining multiple fx she is alert and answering qestions and crying
what is the best method for initial pain assessment for this pt - ANSself report scale
A a pt sustrained a penetrating injury of his upper leg. the pre hospital personnel states
a large amount of blood loss before hemostasiswas achieved. he presents to the ER
responding to painful stimuli with moaning. he is tachy 142 b/p 104/96 and RR 24 -
ANSdecompensated
Loading page 5...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A an unrestrained driver was involved in a frontal collision without airbag deployment.
he is hypotensive and tachycardic with shallow respirations, distended JVD and muffled
heart tones the nurse prepare for what - ANSpericardiocentesis
A during assessment of an extremety with suspected pulses are - ANScan be normal
A for a ptwho has undergone recent bariatric surgery, flouroscopy is recommended to
place - ANSNG tube
A identification of vulnerabilities is an example of what phase of disaster management -
ANSmitigation
A in mass casualty "doing the greatest good for the greatest number of people refers to
a situation where - ANSthere may be more patients than resources
A in neurogenic shock, alterations in vital signs include hypotension and which other
abnormal VS - ANSbradycardia
A In the primary survey AVPU is performed to determine if the patient can: - ANSProtect
their aiway
A prego trauma pt develops tachy, hypotension, a rigide board like uterus, and dark, red
vaginal bleeding. she reports constant back pain which is increasing. the most likely
cause of s/s is - ANSplacental abruption
A several groups of people are at higher risk for maltreatment including children, elderly,
prego, and ... - ANSpt's with disability
A the nurse is preparing to cleanse an extensive abrasion contaminated with dirt and
gravel. which of the following intervention is indicated - ANSus copious amounts of NS
A The systemic inflammatory response is a normal part of the body's response to shock
from traumatic injury. what best describes this response - ANSit is activated by tissue
hypoxia and sends neutrophils to injury site
A what is an early assessment finding to increased ICP in pt with a brain injury -
ANSvomiting
A when providing care for the pedicatric pt with burns the post resuscitation care, how
are fluids delivered - ANSparkland formula with maintainence fluidss
A which of hte following nursing interventions would be best for traumitc __________ -
ANSHOB 30 degrees
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
B thinning skin and diminished autonomic response in older adult can have what effect
on primary assessment - ANScompromised thermoregulation
B when assessing a pt following a MVC the nurses asks how fsat the car was going -
ANSwhen volocity is doubled speed is quadroupled
B WHich may lead to unreliable pulse ox reading - ANScarboxyhemoglobin
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A which of the following structures would be hte most affected by teh concept of
caviation - ANSLiver
A which of the following values is within the acceptable limits for trauma pt - ANSend
tidal CO2 of 40
B a pt father arrives in teh ER and needs to be told his son was severely injured in a
MVC and is in surgery, the father si agitated, yelling, and smells of alcohol. in planning
to talk with the father the trauma nurse will - ANSdeliver information regarding the son;s
care in a calm voice
B a pt involved in an MVC develops asymmetric pupillary reactivity, bilateral pupillary
dilation and abnormal motor posturing. what does the nurse suspect as the most likely
cause - ANSherniation syndrome
B a pt with injury to the middle meningeal artery is at risk for which of the following -
ANSepidural hematoma
B an occlusive dressing has been applied to a pt with a penetrating injury to the chest.
upon assessment the nurse notes that the patient is in respiratory distress nad has
absnet breath sounds on hte affected side. what is the priroruty intervention -
ANSremove the dressing to the wound
B an unrestrained driver inlvolved in a MVC in which alcohol was involed. he denies any
pain and numbness and tinlging. according to NEXUS critera which factors indicate
need for radiological - ANSsuspected alcohol abuse
B pt to ER after being pinned to brick retaining wall. knwoing crushing injuries can result
to significant damage to muslces the priority asessment for trauma nruse is for -
ANSmyoglobinemia nd renal failure
B the most common cause of shock in the trauma pt is - ANSloss of circ volume
B the unrestrained fron seat passenger in a MVC develops echymosis around
umbillicus. this assessment finding is most commonly associated with: - ANSbleeding in
the peritoneal cavity
B thinning skin and diminished autonomic response in older adult can have what effect
on primary assessment - ANScompromised thermoregulation
B when assessing a pt following a MVC the nurses asks how fsat the car was going -
ANSwhen volocity is doubled speed is quadroupled
B WHich may lead to unreliable pulse ox reading - ANScarboxyhemoglobin
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
B which of hte following significant assessment findigns is frequently found in a patient
with complete cransiofacial separation involving the maxilla, zygoma, orbits, and bones
of the cranial base. - ANSdiplopia
B which of the following hemodynamic support strategies is the prioririty intervention for
a pt with traumatic pulmonary contusion - ANSjudicios use of IV fluids
Bduring the primary survery which of the following has the greatest priority -
ANScervical spine injury
C 32 wk pregnant lady arrives in er after trapped in a car that flipped. the initial
assessment reveals s/s of shock, vaginal bleeding, a palpable asymmetrical uterus, and
slowing fetal heart tones what is the most likely cause - ANSuterine rupture
C a college student presents to the er stating afterarriving at a party , she awoke in a
dorm rom. she didnt recognize with no memory of the previous evening the trauma
nurse prepare for what exam. - ANSsexual assult
C an adult pt involved in a brush fire arrives to the er. upon initial assessment in the er
the most concerning finding is - ANShoarse voice and repeatedly decides to clear
throat.
C an older adult pt fell in the bathtub 3 days ago. now she is exihibiting decreasd LOC
and difficulty with speaking and walking. which of the following injuries is most effective
- ANSsubdural hematoma
C effective pain management in hte pt iwth rib fxwill promote what - ANScough with
ability to clear secretions
C properly restrained 6 wk old kid was involved in a MVC. after the assessment and
stabilization the pt becomes more difficult to rouse. responding with a weak cry to
painful stimuli. the pupils remain brisk and reactive. the anterior fontanel is soft and flat.
what is the most likely cause and pririty interventions - ANShypoglycemia
C What are the primary benefits of a team approach to trauma care - ANSit provides a
systemic approach to care and organizes care
C what organ might be injured in left lower rib fx - ANSspleen
C which of the following would be priority intervention for a pt with multiple rib fractures
and chest wall instability follwoing a mvc collision - ANSassist with endotracheal
intubation
C which of the follwoing is a risk factor for DVT in the trauma pt. - ANSpelvic fx
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B which of hte following significant assessment findigns is frequently found in a patient
with complete cransiofacial separation involving the maxilla, zygoma, orbits, and bones
of the cranial base. - ANSdiplopia
B which of the following hemodynamic support strategies is the prioririty intervention for
a pt with traumatic pulmonary contusion - ANSjudicios use of IV fluids
Bduring the primary survery which of the following has the greatest priority -
ANScervical spine injury
C 32 wk pregnant lady arrives in er after trapped in a car that flipped. the initial
assessment reveals s/s of shock, vaginal bleeding, a palpable asymmetrical uterus, and
slowing fetal heart tones what is the most likely cause - ANSuterine rupture
C a college student presents to the er stating afterarriving at a party , she awoke in a
dorm rom. she didnt recognize with no memory of the previous evening the trauma
nurse prepare for what exam. - ANSsexual assult
C an adult pt involved in a brush fire arrives to the er. upon initial assessment in the er
the most concerning finding is - ANShoarse voice and repeatedly decides to clear
throat.
C an older adult pt fell in the bathtub 3 days ago. now she is exihibiting decreasd LOC
and difficulty with speaking and walking. which of the following injuries is most effective
- ANSsubdural hematoma
C effective pain management in hte pt iwth rib fxwill promote what - ANScough with
ability to clear secretions
C properly restrained 6 wk old kid was involved in a MVC. after the assessment and
stabilization the pt becomes more difficult to rouse. responding with a weak cry to
painful stimuli. the pupils remain brisk and reactive. the anterior fontanel is soft and flat.
what is the most likely cause and pririty interventions - ANShypoglycemia
C What are the primary benefits of a team approach to trauma care - ANSit provides a
systemic approach to care and organizes care
C what organ might be injured in left lower rib fx - ANSspleen
C which of the following would be priority intervention for a pt with multiple rib fractures
and chest wall instability follwoing a mvc collision - ANSassist with endotracheal
intubation
C which of the follwoing is a risk factor for DVT in the trauma pt. - ANSpelvic fx
Loading page 8...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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Cthe term worried well when refering to disaster preparedness planning refers to: -
ANSindividuals hwo think they have been affected by the event but are asymptomatic
Cthe trauma nurse would prepare for a definitive airwya for which of the following
condition. - ANSGCS of 8 or ls
D An unrestrained driver is brought into the emergency department following a frontal
impact MVC. she is pale, anxious, and c/o SOB. what is the potential injury -
ANSLumbar fx
D elevated comaprtment pressure can be the result of - ANShemorrhage from within the
muscle
D pt with amputation of an index finger with a knife. amputaiton is brought in with pt. it is
wrapped in sterile gauze with saline and sealed in a plastic bag. the next step
amputation care is - ANSplace the bag on ice
D restrained driver is involved in a severe head on MVC and presnts with a seatbelt
mark along the neck and upper chest area. bilateral decreased breath sounds,
hemoptysis and diffuse sub q emphysemato the neck and upper chest area -
ANStracheobronchial injury
D which of the following diagnostic intervention is most appropriate for the unstable pt
with a suspectedinternal hemorrhage - ANSfocused assessment with sonography for
trauma
D which physiological change in airway of an odler adult pt places the pt at risk for
difficult intubation - ANScervical arthritis
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 - ANSA) report your suspicion of
the maltreatment in accordance with local regulations
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on
the bicycle cross bars which performing an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the nurse questions?
A) Fast exam
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Cthe term worried well when refering to disaster preparedness planning refers to: -
ANSindividuals hwo think they have been affected by the event but are asymptomatic
Cthe trauma nurse would prepare for a definitive airwya for which of the following
condition. - ANSGCS of 8 or ls
D An unrestrained driver is brought into the emergency department following a frontal
impact MVC. she is pale, anxious, and c/o SOB. what is the potential injury -
ANSLumbar fx
D elevated comaprtment pressure can be the result of - ANShemorrhage from within the
muscle
D pt with amputation of an index finger with a knife. amputaiton is brought in with pt. it is
wrapped in sterile gauze with saline and sealed in a plastic bag. the next step
amputation care is - ANSplace the bag on ice
D restrained driver is involved in a severe head on MVC and presnts with a seatbelt
mark along the neck and upper chest area. bilateral decreased breath sounds,
hemoptysis and diffuse sub q emphysemato the neck and upper chest area -
ANStracheobronchial injury
D which of the following diagnostic intervention is most appropriate for the unstable pt
with a suspectedinternal hemorrhage - ANSfocused assessment with sonography for
trauma
D which physiological change in airway of an odler adult pt places the pt at risk for
difficult intubation - ANScervical arthritis
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 - ANSA) report your suspicion of
the maltreatment in accordance with local regulations
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on
the bicycle cross bars which performing an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the nurse questions?
A) Fast exam
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
B) CT scan
C) straight cath for urine sample
D) ice and elevation of the scrotum - ANSC) straight cath for urine sample
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 - ANSB) globe rupture
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. - ANSB) apply a
splint and ELEVATE ABOVE THE LEVEL OF THE HEART
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all
of these negative fast exam except which of the following?
A. Diagnostic peritoneal lavage
B. Serial FAST exams
C. Abdominal and pelvic CT scans
D. Serial abdominal assessments - ANSA) diagnostic peritoneal lavage
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma.
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
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B) CT scan
C) straight cath for urine sample
D) ice and elevation of the scrotum - ANSC) straight cath for urine sample
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 - ANSB) globe rupture
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. - ANSB) apply a
splint and ELEVATE ABOVE THE LEVEL OF THE HEART
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all
of these negative fast exam except which of the following?
A. Diagnostic peritoneal lavage
B. Serial FAST exams
C. Abdominal and pelvic CT scans
D. Serial abdominal assessments - ANSA) diagnostic peritoneal lavage
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma.
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
Loading page 10...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
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 patients family - ANSC) expedite transfer to the closest trauma center
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 - ANSA) initiate transfer to a trauma center
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 tapes it
on 3 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 interventions?
A) needle decompression
B) tube thoracostomy
C) dressing removal
D) surgical repair - ANSC) dressing removal
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 - ANSB) fat embolism
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab
values is expected with a musculoskeletal complication associated with this
presentation?
A) elevated creatine kinase
B) decreased potassium level
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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 patients family - ANSC) expedite transfer to the closest trauma center
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 - ANSA) initiate transfer to a trauma center
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 tapes it
on 3 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 interventions?
A) needle decompression
B) tube thoracostomy
C) dressing removal
D) surgical repair - ANSC) dressing removal
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 - ANSB) fat embolism
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab
values is expected with a musculoskeletal complication associated with this
presentation?
A) elevated creatine kinase
B) decreased potassium level
Loading page 11...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
C) decreased WBC
D) elevated GFR - ANSA) elevated creatine kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - ANSA) initiate
two large bore intravenous lines for Ringers lactate solution administration
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 - ANSD)
Bradycardia and absent motor function below the level of the injury
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
D) Preparing the patient for ultrasound - ANSC) Elevating the extremity to the level of
the heart
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 - ANSD) huddle
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival
were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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C) decreased WBC
D) elevated GFR - ANSA) elevated creatine kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient based on
the disaster triage principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - ANSA) initiate
two large bore intravenous lines for Ringers lactate solution administration
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 - ANSD)
Bradycardia and absent motor function below the level of the injury
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
D) Preparing the patient for ultrasound - ANSC) Elevating the extremity to the level of
the heart
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 - ANSD) huddle
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival
were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and
Loading page 12...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient
is demonstrating signs and symptoms of which stage of shock?
A) compensated
B) Progressive
C) irreversible
D) decompensated - ANSA) compensated
An elderly patient with a history of anticoagulant use presents after a fall at home that
day. she denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma - ANSD) subdural hematoma
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 - ANSD) confirm ET tube placement
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 - ANSA) Ventilate with a BVM
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
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dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient
is demonstrating signs and symptoms of which stage of shock?
A) compensated
B) Progressive
C) irreversible
D) decompensated - ANSA) compensated
An elderly patient with a history of anticoagulant use presents after a fall at home that
day. she denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?
A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma - ANSD) subdural hematoma
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 - ANSD) confirm ET tube placement
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 - ANSA) Ventilate with a BVM
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
Loading page 13...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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D) preparing for drug assisted intubation - ANSA) padding the upper back while
stabilizing the cervical spine
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 - ANSD) insert an
oropharyngeal airway if there is no gag reflex
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 - ANSA)
after a physical examination if the patient has no radiologic abnormalities on a
computed tomography scan
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 - ANSD) Smell of alcohol on breath
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 - ANSA) mitigation
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D) preparing for drug assisted intubation - ANSA) padding the upper back while
stabilizing the cervical spine
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 - ANSD) insert an
oropharyngeal airway if there is no gag reflex
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 - ANSA)
after a physical examination if the patient has no radiologic abnormalities on a
computed tomography scan
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 - ANSD) Smell of alcohol on breath
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 - ANSA) mitigation
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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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 - ANSD) calcium
Patients with a crush injury should be monitored for which of the following conditions?
A) Hypernatremia
B) Hypercalcemia
C) Dysrhythmias
D) polyuria - ANSC) Dysrhythmias
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 - ANSB) subdural hematoma
The most reassuring finding for a male patient with hop pain after a fall is which of the
following?
A) a normal prostate exam
B) absence of abdominal distension
C) a normal fast exam
D) pelvic stability - ANSD) pelvic stability
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL - ANSA) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
4560 / 2 (half of fluids given in first 8 hours) = 2280 mL
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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 - ANSD) calcium
Patients with a crush injury should be monitored for which of the following conditions?
A) Hypernatremia
B) Hypercalcemia
C) Dysrhythmias
D) polyuria - ANSC) Dysrhythmias
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 - ANSB) subdural hematoma
The most reassuring finding for a male patient with hop pain after a fall is which of the
following?
A) a normal prostate exam
B) absence of abdominal distension
C) a normal fast exam
D) pelvic stability - ANSD) pelvic stability
The nurse is caring for a 120 kg male is brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total BSA burned, how
much IV fluids would be administered in the first 8 hours?
A) 2280 mL
B) 3840 mL
C) 4560 mL
D) 7680 mL - ANSA) 2280 mL
(upper arm 4+4 / lower arm 3+3 / hand 2.5+2.5) = 19% TBSA.
120 kg x (2 mL) x (19% TBSA) = 4560 mL
4560 / 2 (half of fluids given in first 8 hours) = 2280 mL
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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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 - ANSC) ET tube
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 - ANSA) pulse oximetry and capnogaphy
What factor contributes most the kinetic energy of a body in motion?
A) acceleration
B) mass
C) velocity
D) inertia - ANSC) velocity
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 - ANSB) Priapism
Which is the effect of hypothermia on the oxyhemoglobin dissociation curve?
A) Hemoglobin does not readily release oxygen for use by the tissues
B) The amount of oxygen available to the tissues increases
C) Tissue oxygenation (PaO2) increases
D) Hemoglobin molecule saturation (SaO2) decreases - ANSA) Hemoglobin does not
readily release oxygen for use by the tissues
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) pleuritic chest pain
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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 - ANSC) ET tube
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 - ANSA) pulse oximetry and capnogaphy
What factor contributes most the kinetic energy of a body in motion?
A) acceleration
B) mass
C) velocity
D) inertia - ANSC) velocity
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 - ANSB) Priapism
Which is the effect of hypothermia on the oxyhemoglobin dissociation curve?
A) Hemoglobin does not readily release oxygen for use by the tissues
B) The amount of oxygen available to the tissues increases
C) Tissue oxygenation (PaO2) increases
D) Hemoglobin molecule saturation (SaO2) decreases - ANSA) Hemoglobin does not
readily release oxygen for use by the tissues
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) pleuritic chest pain
Loading page 16...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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D) hypotension that worsens with inspiration - ANSD) hypotension that worsens with
inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side.
Hypotension due to compression of the heart and great vessels is consistent with
obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
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
D) falls - ANSB) medical history
Which of the following injuries is LEAST likely to be promptly identified?
A) spleen
B) lung
C) bowel
D) brain - ANSC) bowel
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis - ANSA) Acidosis
hypothermia, metabolic acidosis, coagulopathy
Which of the following is a late sign of increased intracranial pressure?
A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort
D) Amnesia and anxiety - ANSC) Decreased respiratory effort
Which of the following is an expected finding in a patient with a thoracostomy connected
to a chest drainage system?
A) output of 200 mL/hr
B) tubing clamp closed for transport
C) dependent loops in the tubing to promote drainage
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D) hypotension that worsens with inspiration - ANSD) hypotension that worsens with
inspiration.
Assessment findings associated with tension pneumothorax include anxiety, severe
restlessness, severe respiratory distress, and absent breath sounds on the injured side.
Hypotension due to compression of the heart and great vessels is consistent with
obstructive shock. Hypotension worsens with inspiration due to increased intrathoracic
pressure. Late signs include distended neck veins, tracheal deviation, and cyanosis.
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
D) falls - ANSB) medical history
Which of the following injuries is LEAST likely to be promptly identified?
A) spleen
B) lung
C) bowel
D) brain - ANSC) bowel
Which of the following is a component of the trauma triad of death?
A) Acidosis
B) hyperthermia
C) hemorrhage
D) sepsis - ANSA) Acidosis
hypothermia, metabolic acidosis, coagulopathy
Which of the following is a late sign of increased intracranial pressure?
A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort
D) Amnesia and anxiety - ANSC) Decreased respiratory effort
Which of the following is an expected finding in a patient with a thoracostomy connected
to a chest drainage system?
A) output of 200 mL/hr
B) tubing clamp closed for transport
C) dependent loops in the tubing to promote drainage
Loading page 17...
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D) fluctuations in the water serial chamber - ANSD) fluctuations in the water serial
chamber
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 - ANSC) pericardiocentesis
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 - ANSA) worsening pneumothorax
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 -
ANSC) it can worsen cord damage from an unstable spinal injury
Which of the following mnemonics can help the nurse prioritize care for a trauma patient
with massive uncontrolled hemorrhage?
A) ABC
B) MARCH
C) AVPU
D) VIPP - ANSB) MARCH
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 - ANSC) the aorta is torn at
its attachment with the ligamentum arteriosum
Which of the following patients warrants referral to a burn center?
A) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
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D) fluctuations in the water serial chamber - ANSD) fluctuations in the water serial
chamber
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 - ANSC) pericardiocentesis
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 - ANSA) worsening pneumothorax
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 -
ANSC) it can worsen cord damage from an unstable spinal injury
Which of the following mnemonics can help the nurse prioritize care for a trauma patient
with massive uncontrolled hemorrhage?
A) ABC
B) MARCH
C) AVPU
D) VIPP - ANSB) MARCH
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 - ANSC) the aorta is torn at
its attachment with the ligamentum arteriosum
Which of the following patients warrants referral to a burn center?
A) a 21- year old female with a partial thickness burn to the right forearm
B) a 40-year old hypertensive male with a superficial burn to the back
Loading page 18...
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C) a 52-year old diabetic male with partial thickness burn to the left lower leg
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. -
ANSC) a 52-year old diabetic male with partial thickness burn to the left lower leg
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 - ANSA) CIWA-Ar of 36
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSB) narrowed
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 - ANSc) to gauge end-organ perfusion
and tissue hypoxia
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 - ANSA) placental abruption
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
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C) a 52-year old diabetic male with partial thickness burn to the left lower leg
D) a 35-year old hyperlipidemic female with superficial burns to the anterior thorax. -
ANSC) a 52-year old diabetic male with partial thickness burn to the left lower leg
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 - ANSA) CIWA-Ar of 36
Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
D) weak - ANSB) narrowed
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 - ANSc) to gauge end-organ perfusion
and tissue hypoxia
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 - ANSA) placental abruption
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
Loading page 19...
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D) 125 mL/hr - ANSB) 500 mL/hr
A (AVPU) - ANSAlert. Will be able to maintain airway once clear.
A (Primary Survey) - ANSAirway and alertness with simultaneous cervical spinal
stabilization.
Airway Assessment - ANSInspect: tongue obstruction, loose/missing teeth, foreign
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
Airway Interventions: - ANSSuction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
Alertness Assessment - ANSA-Alert
V-Verbal
P-Painful
U-Unresponsive
B (Primary Survey) - ANSBreathing and Ventilation
Breathing and Ventilation Assessment - ANSInspect: spontaneous breathing,
symmetrical rise and fall, depth/pattern/rate of respirations, accessory muscle use,
diaphragmatic breathing, skin color (normal, pale, flushed, cyanotic),
contusions/abrasions/deformities (signs of underlying injury), open pneumothoraces
(sucking chest wound), JVD, tracheal position, signs of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
midclavicular line and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
pulsations at suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open
pneumothorax, tension pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - ANSBreathing absent: jaw-thrust maneuver,
oral airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
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D) 125 mL/hr - ANSB) 500 mL/hr
A (AVPU) - ANSAlert. Will be able to maintain airway once clear.
A (Primary Survey) - ANSAirway and alertness with simultaneous cervical spinal
stabilization.
Airway Assessment - ANSInspect: tongue obstruction, loose/missing teeth, foreign
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury
Auscultate: listen for obstructive airway sounds (ie. snoring, gurgling, stridor)
Palpate: palpate for possible occlusive maxillofacial bony deformity, subcutaneous
emphysema
Airway Interventions: - ANSSuction
Remove foreign body if noted
Jaw thrust maneuver (maintain cspine)
Nasopharyngeal airway (can be conscious) Oropharyngeal airway (no gag)
Consider definitive airway
Alertness Assessment - ANSA-Alert
V-Verbal
P-Painful
U-Unresponsive
B (Primary Survey) - ANSBreathing and Ventilation
Breathing and Ventilation Assessment - ANSInspect: spontaneous breathing,
symmetrical rise and fall, depth/pattern/rate of respirations, accessory muscle use,
diaphragmatic breathing, skin color (normal, pale, flushed, cyanotic),
contusions/abrasions/deformities (signs of underlying injury), open pneumothoraces
(sucking chest wound), JVD, tracheal position, signs of inhalation injury
Auscultate: presence, absence and equality of breath sounds at 2nd intercostal space
midclavicular line and bases at the fifth intercostal space anterior axillary line
Palpate: bony structures, possible rib fractures, SQ emphysema, soft tissue injury, JV
pulsations at suprasternal notch or supraclavicular area
Life-threatening pulmonary injuries requiring immediate intervention: open
pneumothorax, tension pneumothorax, flail chest, hemothorax.
Breathing and Ventilation Intervention - ANSBreathing absent: jaw-thrust maneuver,
oral airway adjunct, assist ventilation with bag-mask device, prepare for definitive airway
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Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or
higher. If ineffective: assist with bag-mask and determine need for definitive airway
C (Primary Survey) - ANSCirculation and Control of Hemorrhage
Cardiogenic Shock - ANSResults from pump failure in the presence of adequate
intravascular volume. There is a lack of cardiac output and end-organ perfusion
secondary to a decrease in myocardial contractility and/or valvular insufficiency.
Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart
failure is a chronic cause.
Blunt cardiac injury may present similar to MI.
Excess of volume administration or increased after load can result in pulmonary edema
and increased myocardial ischemia.
Inotropic support to improve contractility.
Circulation and Control of Hemorrhage Assessment - ANSInspect: Uncontrolled
external bleeding, skin color
Auscultate: Muffled heart sounds - may indicate pericardial tamponade
Palpate: carotid and/or femoral pulses for rate, rhythm, strength
Circulation and Control of Hemorrhage Interventions - ANSControl and treat external
bleeding: apply direct pressure, elevate bleeding extremity, apply pressure over arterial
sites, consider use of a tourniquet.
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis
and may cause hypothermia. Component therapy, including administering RBC, plasma
and platelets is a balanced approach so that O2 delivery is optimized, acidosis
corrected and coagulopathy prevented.
Classifications of Shock - ANSHypovolemic - decrease in the amount of circulating
blood volume
Obstructive - obstruction in either the vasculature or heart
Cardiogenic - pump failure in the presence of adequate intravascular volume
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Breathing present: NRB. Determine if ventilation effective: etCO2 35-45, SpO2 94% or
higher. If ineffective: assist with bag-mask and determine need for definitive airway
C (Primary Survey) - ANSCirculation and Control of Hemorrhage
Cardiogenic Shock - ANSResults from pump failure in the presence of adequate
intravascular volume. There is a lack of cardiac output and end-organ perfusion
secondary to a decrease in myocardial contractility and/or valvular insufficiency.
Acute causes - myocardial infarction, dysrhythmias or toxicologic pathologies. Heart
failure is a chronic cause.
Blunt cardiac injury may present similar to MI.
Excess of volume administration or increased after load can result in pulmonary edema
and increased myocardial ischemia.
Inotropic support to improve contractility.
Circulation and Control of Hemorrhage Assessment - ANSInspect: Uncontrolled
external bleeding, skin color
Auscultate: Muffled heart sounds - may indicate pericardial tamponade
Palpate: carotid and/or femoral pulses for rate, rhythm, strength
Circulation and Control of Hemorrhage Interventions - ANSControl and treat external
bleeding: apply direct pressure, elevate bleeding extremity, apply pressure over arterial
sites, consider use of a tourniquet.
2 large bore IVs, if unable consider IO, obtain labs and crossmatch.
Initiate IVF of warmed isotonic crystalloid solution. Consider blood products after 2L.
**Large volumes of fluid lead to dilution coagulopathy which worsens metabolic acidosis
and may cause hypothermia. Component therapy, including administering RBC, plasma
and platelets is a balanced approach so that O2 delivery is optimized, acidosis
corrected and coagulopathy prevented.
Classifications of Shock - ANSHypovolemic - decrease in the amount of circulating
blood volume
Obstructive - obstruction in either the vasculature or heart
Cardiogenic - pump failure in the presence of adequate intravascular volume
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Distributive - maldistribution of an adequate circulating blood volume (septic,
anaphylactic, neurogenic)
Corneal Abrasion - ANSDamage to the corneal epithelium. Easy to evaluate with
fluorescein.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling,
irritation
Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain,
ophthalmic NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
(Do NOT patch - increases infection)
Corneal Foreign Body - ANSRoutinely metal, plastic or wood.
Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics,
oral analgesia
Corneal Laceration - ANSInvolves one or more layers of the cornea. Visualized with a
slit lamp.
Findings: similar to abrasion, pain out of proportion to findings, decreased vision
Treatment: treat small lacerations similar to an abrasion, larger lacerations need
ophthalmology referral and possible surgery
Cycloplegic agent - ANSCycloplegia is paralysis of the ciliary muscle of the eye,
resulting in a loss of accommodation. Because of the paralysis of the ciliary muscle, the
curvature of the lens can no longer be adjusted to focus on nearby objects.
D (Primary Survey) - ANSDisability (Neurologic Status)
Disability Assessment - ANSAssess GCS on arrival and repeat per policy.
Assess pupils for equality, shape and reactivity (PERRL)
Disability interventions - ANSEvaluate for need for CT. Assume AMS to be the result of
CNS injury until proven otherwise.
Consider ABGs - AMS may be indicator of decreased cerebral perfusion,
hypoventilation or acid-base imbalance.
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Distributive - maldistribution of an adequate circulating blood volume (septic,
anaphylactic, neurogenic)
Corneal Abrasion - ANSDamage to the corneal epithelium. Easy to evaluate with
fluorescein.
Findings: photophobia, tearing, pain, injected conjunctiva (redness), lid swelling,
irritation
Treatment: Ophthalmic ABX, Cycloplegic agent to decrease spasms and pain,
ophthalmic NSAIDS to decrease swelling, oral analgesics, Ophthalmic f/u in 24 hours.
(Do NOT patch - increases infection)
Corneal Foreign Body - ANSRoutinely metal, plastic or wood.
Findings: photophobia, pain, injected conjunctiva (redness), lid swelling
Treatment: topical anesthetic, removal of foreign body, ophthalmic ABX, cycloplegics,
oral analgesia
Corneal Laceration - ANSInvolves one or more layers of the cornea. Visualized with a
slit lamp.
Findings: similar to abrasion, pain out of proportion to findings, decreased vision
Treatment: treat small lacerations similar to an abrasion, larger lacerations need
ophthalmology referral and possible surgery
Cycloplegic agent - ANSCycloplegia is paralysis of the ciliary muscle of the eye,
resulting in a loss of accommodation. Because of the paralysis of the ciliary muscle, the
curvature of the lens can no longer be adjusted to focus on nearby objects.
D (Primary Survey) - ANSDisability (Neurologic Status)
Disability Assessment - ANSAssess GCS on arrival and repeat per policy.
Assess pupils for equality, shape and reactivity (PERRL)
Disability interventions - ANSEvaluate for need for CT. Assume AMS to be the result of
CNS injury until proven otherwise.
Consider ABGs - AMS may be indicator of decreased cerebral perfusion,
hypoventilation or acid-base imbalance.
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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Consider bedside glucose.
Distributive Shock - ANSOccurs as a result of maldistribution of an adequate circulating
volume with a loss of vascular tone or increased permeability.
Diffuse vasodilation lowers the systemic pressure, creating a relative hypovolemia or
reduction of the mean systemic volume and venous return to the heart or drop in
preload, resulting in distributive shock.
Anaphylactic: release of inflammatory mediators, such as histamine, which contracts
bronchial smooth muscle and increases vascular permeability and vasodilation.
Septic Shock: systemic release of bacterial endotoxins, resulting in an increased
vascular permeability and vasodilation
Neurogenic shock: loss of sympathetic nervous system control of vascular tone, which
produces venous and arterial vasodilation. With the loss of sympathetic nervous system
input in spinal cord injury, unopposed vagal activity may result in decreased cardiac
output through bradycardia.
TREATMENT: increase systemic resistance, controlled volume replacement.
Vasoconstriction and in some cases (neurogenic) Atropine to counteract bradycardia.
E (Primary Survey) - ANSExposure and Environmental Control
Exposure and Environmental Control - ANSCarefully and completely undress the
patient. Inspect for uncontrolled bleeding and note any obvious injuries.
Prevent heat loss. Hypothermia combined with hypotension and acidosis is a potentially
lethal combination in the injured patient. Consider: warm blankets, keep ambient
temperature warm, warm IVF, forced air warmers, radiant warming lights.
F (Primary Survey) - ANSFull Set of VS & Family Presence
G (Primary Survey) - ANSGet Resuscitation Adjuncts:
(LMNOP)
L: Labs
M: Monitor cardiac rate and rhythm
N: Naso or orogastric tube consideration
O: Oxygenation - SpO2 and/or etCO2 monitor
P: Pain assessment and management
GCS - ANSGCS
EYES
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Consider bedside glucose.
Distributive Shock - ANSOccurs as a result of maldistribution of an adequate circulating
volume with a loss of vascular tone or increased permeability.
Diffuse vasodilation lowers the systemic pressure, creating a relative hypovolemia or
reduction of the mean systemic volume and venous return to the heart or drop in
preload, resulting in distributive shock.
Anaphylactic: release of inflammatory mediators, such as histamine, which contracts
bronchial smooth muscle and increases vascular permeability and vasodilation.
Septic Shock: systemic release of bacterial endotoxins, resulting in an increased
vascular permeability and vasodilation
Neurogenic shock: loss of sympathetic nervous system control of vascular tone, which
produces venous and arterial vasodilation. With the loss of sympathetic nervous system
input in spinal cord injury, unopposed vagal activity may result in decreased cardiac
output through bradycardia.
TREATMENT: increase systemic resistance, controlled volume replacement.
Vasoconstriction and in some cases (neurogenic) Atropine to counteract bradycardia.
E (Primary Survey) - ANSExposure and Environmental Control
Exposure and Environmental Control - ANSCarefully and completely undress the
patient. Inspect for uncontrolled bleeding and note any obvious injuries.
Prevent heat loss. Hypothermia combined with hypotension and acidosis is a potentially
lethal combination in the injured patient. Consider: warm blankets, keep ambient
temperature warm, warm IVF, forced air warmers, radiant warming lights.
F (Primary Survey) - ANSFull Set of VS & Family Presence
G (Primary Survey) - ANSGet Resuscitation Adjuncts:
(LMNOP)
L: Labs
M: Monitor cardiac rate and rhythm
N: Naso or orogastric tube consideration
O: Oxygenation - SpO2 and/or etCO2 monitor
P: Pain assessment and management
GCS - ANSGCS
EYES
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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1: Does not open eyes
2: Opens eyes in response to pain
3: Opens eyes in response to voice
4: Opens eyes spontaneously
VERBAL
1. Makes no sounds
2. Makes sounds
3. Words
4. Confused, disoriented
5. Oriented, converses normally
MOTOR
1. Makes no movements
2. Extension to painful stimuli (decerebrate)
3. Abnormal flexion to painful stimuli (decorticate)
4. Withdrawal to painful stimuli
5. Localizes painful stimuli
6. Obeys commands
H (Secondary Survey) - ANSHistory
Prehospital Report (MIST)
M: MOI
I: Injuries sustained
S: Signs and symptoms in the field
T: Treatment in field
Patient History (SAMPLE):
S: Symptoms
A: Allergies and tetanus status
M: Medications
P: Past medical history
L: Last oral intake
E: Events and Environmental factors related to injury.
H: Head and Face
Head to Toe Assessment (secondary survey) - ANSSOFT TISSUE:
Inspect: lacerations, puncture wounds, abrasions, contusions, edema, ecchymosis,
impaled objects.
Palpate: areas of tenderness, step-offs, crepitus
BONY DEFORMITIES:
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1: Does not open eyes
2: Opens eyes in response to pain
3: Opens eyes in response to voice
4: Opens eyes spontaneously
VERBAL
1. Makes no sounds
2. Makes sounds
3. Words
4. Confused, disoriented
5. Oriented, converses normally
MOTOR
1. Makes no movements
2. Extension to painful stimuli (decerebrate)
3. Abnormal flexion to painful stimuli (decorticate)
4. Withdrawal to painful stimuli
5. Localizes painful stimuli
6. Obeys commands
H (Secondary Survey) - ANSHistory
Prehospital Report (MIST)
M: MOI
I: Injuries sustained
S: Signs and symptoms in the field
T: Treatment in field
Patient History (SAMPLE):
S: Symptoms
A: Allergies and tetanus status
M: Medications
P: Past medical history
L: Last oral intake
E: Events and Environmental factors related to injury.
H: Head and Face
Head to Toe Assessment (secondary survey) - ANSSOFT TISSUE:
Inspect: lacerations, puncture wounds, abrasions, contusions, edema, ecchymosis,
impaled objects.
Palpate: areas of tenderness, step-offs, crepitus
BONY DEFORMITIES:
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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Inspect: asymmetry of facial expressions, exposed tissue or bone for brain matter
Palpate: depressions, angulations, tenderness
Hepatic Injuries - ANSIn blunt trauma the liver may lacerate from increased abdominal
pressure.
Hematoma - bleeding contained within the capsule
Laceration - the capsule is disrupted
Findings: Cullen sign (ecchymosis around the umbilicus or RUQ), tenderness, guarding
or rigidity RUQ, 9-12 rib FXs, elevated LFT
Graded I-VI, I = minor trauma
Nonoperative management is standard of care in hemodynamically stable patient.
Observed with serial abdominal exams.
Findings of contrast extravasation may be embolized by IR.
For surgical patients - fluid resuscitation is essential. Risks of surgery include disruption
of the natural tamponade process due to the evacuation of large amounts of blood
resulting in hypovolemia.
Hypovolemic Shock - ANSCaused by a decrease in the amount of circulating blood
volume.
In trauma typically results from hemorrhage, but can result in a precipitous loss of
volume, ie vomiting or diarrhea.
Burn trauma can result in hypovolemic shock from damage to the cell membranes
leading to plasma and protein leakage. of body water, results in inadequate perfusion.
Hyperventilation can cause increased intrathoracic pressure resulting in compression of
the heart and decreased cardiac output.
Initial Assessment - ANS1. Preparation and Triage
2. Primary Survey
3. Reevaluation
4. Secondary Survey
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
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Inspect: asymmetry of facial expressions, exposed tissue or bone for brain matter
Palpate: depressions, angulations, tenderness
Hepatic Injuries - ANSIn blunt trauma the liver may lacerate from increased abdominal
pressure.
Hematoma - bleeding contained within the capsule
Laceration - the capsule is disrupted
Findings: Cullen sign (ecchymosis around the umbilicus or RUQ), tenderness, guarding
or rigidity RUQ, 9-12 rib FXs, elevated LFT
Graded I-VI, I = minor trauma
Nonoperative management is standard of care in hemodynamically stable patient.
Observed with serial abdominal exams.
Findings of contrast extravasation may be embolized by IR.
For surgical patients - fluid resuscitation is essential. Risks of surgery include disruption
of the natural tamponade process due to the evacuation of large amounts of blood
resulting in hypovolemia.
Hypovolemic Shock - ANSCaused by a decrease in the amount of circulating blood
volume.
In trauma typically results from hemorrhage, but can result in a precipitous loss of
volume, ie vomiting or diarrhea.
Burn trauma can result in hypovolemic shock from damage to the cell membranes
leading to plasma and protein leakage. of body water, results in inadequate perfusion.
Hyperventilation can cause increased intrathoracic pressure resulting in compression of
the heart and decreased cardiac output.
Initial Assessment - ANS1. Preparation and Triage
2. Primary Survey
3. Reevaluation
4. Secondary Survey
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
Loading page 25...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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Intraocular Foreign Body - ANS*TRUE EMERGENCY AND EARLY INTERVENTION IS
ESSENTIAL.
Findings: compromised visual acuity, misshapen pupils, pain
Treatment: elevate HOB, ophthalmology, immobilize foreign body, patch UNAFFECTED
eye to limit concomitant eye movement, globe closure ASAP, systemic and ophthalmic
ABX, analgesics.
Postop infection, retinal detachment and vision loss are common complications.
lid injury - ANS
Liver - ANSLargest solid organ of the body. RUQ, 6th to 10th ribs. Encased by Glisson
capsule with blood vessels, lymphatics and nerves. Filters 1.7L of blood per minute.
The liver filters out toxins, takes the nutrients and returns the blood to the heart via the
hepatic veins.
Hepatocyte cells are capable of regeneration allowing the liver to repair its own tissue.
Functions: Store and metabolize lipids, transport nutrients, produce glucose and
bilirubin, convert ammonia to urea, secrete electrolytes, lipids, lecithin, cholesterol and
bile. Metabolizes vitamin K and produces thrombin and fibrinogen (all necessary for
clotting).
Obstructive Shock - ANSResults from hypo perfusion of the tissue due to an obstruction
in either the vasculature or heart.
Tension pneumothorax - increased thoracic pressure leads to displacement of the vena
cava, obstruction to atrial filling, decreased preload and decreased cardiac output.
Cardiac tamponade - impedes diastolic expansion and filling leads to decreased
preload, strokes volume and cardiac output and ultimately end organ perfusion.
P (AVPU) - ANSPainful. Responds only to painful stimuli.
(Airway adjunct may be needed while determining need for intubation)
Reevaluation - ANSPortable radiograph - AP chest, pelvis. Can quickly identify
potentially life-threatening injuries such as pneumothorax or pelvic fracture with
uncontrolled internal hemorrhage. Can also confirm placement of ET tubes, chest tubes
and gastric tubes.
Consider need for transfer.
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Intraocular Foreign Body - ANS*TRUE EMERGENCY AND EARLY INTERVENTION IS
ESSENTIAL.
Findings: compromised visual acuity, misshapen pupils, pain
Treatment: elevate HOB, ophthalmology, immobilize foreign body, patch UNAFFECTED
eye to limit concomitant eye movement, globe closure ASAP, systemic and ophthalmic
ABX, analgesics.
Postop infection, retinal detachment and vision loss are common complications.
lid injury - ANS
Liver - ANSLargest solid organ of the body. RUQ, 6th to 10th ribs. Encased by Glisson
capsule with blood vessels, lymphatics and nerves. Filters 1.7L of blood per minute.
The liver filters out toxins, takes the nutrients and returns the blood to the heart via the
hepatic veins.
Hepatocyte cells are capable of regeneration allowing the liver to repair its own tissue.
Functions: Store and metabolize lipids, transport nutrients, produce glucose and
bilirubin, convert ammonia to urea, secrete electrolytes, lipids, lecithin, cholesterol and
bile. Metabolizes vitamin K and produces thrombin and fibrinogen (all necessary for
clotting).
Obstructive Shock - ANSResults from hypo perfusion of the tissue due to an obstruction
in either the vasculature or heart.
Tension pneumothorax - increased thoracic pressure leads to displacement of the vena
cava, obstruction to atrial filling, decreased preload and decreased cardiac output.
Cardiac tamponade - impedes diastolic expansion and filling leads to decreased
preload, strokes volume and cardiac output and ultimately end organ perfusion.
P (AVPU) - ANSPainful. Responds only to painful stimuli.
(Airway adjunct may be needed while determining need for intubation)
Reevaluation - ANSPortable radiograph - AP chest, pelvis. Can quickly identify
potentially life-threatening injuries such as pneumothorax or pelvic fracture with
uncontrolled internal hemorrhage. Can also confirm placement of ET tubes, chest tubes
and gastric tubes.
Consider need for transfer.
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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shock - ANSInadequate tissue perfusion.
Spleen - ANSEncapsulated organ LUQ level of 9th-11th ribs and curves around a
portion of the stomach. Minimal elasticity and flexibility - most frequent injured organ in
blunt trauma.
Secondary lymph organ that filters and cleanses the blood. Removes old RBCs and
holds a reserve of blood. It recycles iron. It removes antibody-coated bacteria. Supplies
lymphocytes to stimulate an immune response to blood borne microorganisms. Stores
200-300ml of blood and leads to hemodynamic instability quickly if damaged.
Splenic Injuries - ANSIn blunt trauma the spleen may lacerate from increased
abdominal pressure.
Graded I-V, I = minor trauma
Assessment findings: signs of trauma LUQ, abdominal distention, asymmetry, abnormal
contour, tenderness, guarding, rigidity, pain left shoulder when supine.
CT: Hemoperitoneum. Hypodensity - represents parenchymal disruption,
intraparenchymal hematoma or subcapsular hematoma. Contrast blush or extravasation
- hyperdense area that represent traumatic disruption. Active extravasation implies
ongoing bleeding.
Nonoperative management is preferred if hemodynamically stable, stable H/H x 12-24
hours, minimal transfusion requirements (<2units), grade I or II without blush, age <55,
alert able to assist in assessment of abdomen.
Surgical options: total splenectomy for severe injury, for less severe - direct pressure
packing, embolization, splenorrhaphy (suturing spleen), partial removal.
Asplenic patients have difficulty destroying encapsulated bacteria - Streptococcus
pneumonia, Neisseria meningitides and Haemophilus influenza. At risk for
pneumococcal sepsis. Need annual flu shot and q5yr meningococcal and
pneumococcal vaccines.
U (AVPU) - ANSUnresponsive. Does not respond to any stimuli.
V (AVPU) - ANSVerbal. Needs verbal stimuli to respond.
(Airway adjunct may be needed to prevent tongue obstruction)
- ANSPrehospital shock index pg. 85
____________ ___________ Injury: shearing or tearing. Diagnosed with MRI.
Widespread microscopic hemorrhage. - ANSDiffuse Axonal Injury (Cannot recover from
this; shearing/tearing portion DOES NOT heal)
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shock - ANSInadequate tissue perfusion.
Spleen - ANSEncapsulated organ LUQ level of 9th-11th ribs and curves around a
portion of the stomach. Minimal elasticity and flexibility - most frequent injured organ in
blunt trauma.
Secondary lymph organ that filters and cleanses the blood. Removes old RBCs and
holds a reserve of blood. It recycles iron. It removes antibody-coated bacteria. Supplies
lymphocytes to stimulate an immune response to blood borne microorganisms. Stores
200-300ml of blood and leads to hemodynamic instability quickly if damaged.
Splenic Injuries - ANSIn blunt trauma the spleen may lacerate from increased
abdominal pressure.
Graded I-V, I = minor trauma
Assessment findings: signs of trauma LUQ, abdominal distention, asymmetry, abnormal
contour, tenderness, guarding, rigidity, pain left shoulder when supine.
CT: Hemoperitoneum. Hypodensity - represents parenchymal disruption,
intraparenchymal hematoma or subcapsular hematoma. Contrast blush or extravasation
- hyperdense area that represent traumatic disruption. Active extravasation implies
ongoing bleeding.
Nonoperative management is preferred if hemodynamically stable, stable H/H x 12-24
hours, minimal transfusion requirements (<2units), grade I or II without blush, age <55,
alert able to assist in assessment of abdomen.
Surgical options: total splenectomy for severe injury, for less severe - direct pressure
packing, embolization, splenorrhaphy (suturing spleen), partial removal.
Asplenic patients have difficulty destroying encapsulated bacteria - Streptococcus
pneumonia, Neisseria meningitides and Haemophilus influenza. At risk for
pneumococcal sepsis. Need annual flu shot and q5yr meningococcal and
pneumococcal vaccines.
U (AVPU) - ANSUnresponsive. Does not respond to any stimuli.
V (AVPU) - ANSVerbal. Needs verbal stimuli to respond.
(Airway adjunct may be needed to prevent tongue obstruction)
- ANSPrehospital shock index pg. 85
____________ ___________ Injury: shearing or tearing. Diagnosed with MRI.
Widespread microscopic hemorrhage. - ANSDiffuse Axonal Injury (Cannot recover from
this; shearing/tearing portion DOES NOT heal)
Loading page 27...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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____________ ___________ Injury: shearing or tearing. Diagnosed with MRI.
Widespread microscopic hemorrhage. - ANSDiffuse Axonal Injury (Cannot recover from
this; shearing/tearing portion DOES NOT heal)
______________ Shock: Spinal cord injury at any level. Transient loss of reflex below
the level of injury. Variable duration. S & S: flaccidity, loss of reflexes, bowel/bladder
dysfunction. - ANSSpinal
______________ Shock: Spinal cord injury at any level. Transient loss of reflex below
the level of injury. Variable duration. S & S: flaccidity, loss of reflexes, bowel/bladder
dysfunction. - ANSSpinal
__________________ Shock: Spinal cord injury at T6 or above. Temporary loss of
vasomotor tone and sympathetic innervation. Temporary duration usually <72 hours. S
& S: hypotension, bradycardia, loss of ability to sweat below level of injury. -
ANSNeurogenic
__________________ Shock: Spinal cord injury at T6 or above. Temporary loss of
vasomotor tone and sympathetic innervation. Temporary duration usually <72 hours. S
& S: hypotension, bradycardia, loss of ability to sweat below level of injury. -
ANSNeurogenic
___________________: Impairs thrombin production and platelet function
_____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSTrauma Triad of
Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
___________________: Impairs thrombin production and platelet function
_____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSTrauma Triad of
Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
???;.][''''''''''''''''''' - ANSthis card was created by a cat. enjoy.
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to
the degree of stretch in the arterial wall. When the receptors sense a decrease in
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____________ ___________ Injury: shearing or tearing. Diagnosed with MRI.
Widespread microscopic hemorrhage. - ANSDiffuse Axonal Injury (Cannot recover from
this; shearing/tearing portion DOES NOT heal)
______________ Shock: Spinal cord injury at any level. Transient loss of reflex below
the level of injury. Variable duration. S & S: flaccidity, loss of reflexes, bowel/bladder
dysfunction. - ANSSpinal
______________ Shock: Spinal cord injury at any level. Transient loss of reflex below
the level of injury. Variable duration. S & S: flaccidity, loss of reflexes, bowel/bladder
dysfunction. - ANSSpinal
__________________ Shock: Spinal cord injury at T6 or above. Temporary loss of
vasomotor tone and sympathetic innervation. Temporary duration usually <72 hours. S
& S: hypotension, bradycardia, loss of ability to sweat below level of injury. -
ANSNeurogenic
__________________ Shock: Spinal cord injury at T6 or above. Temporary loss of
vasomotor tone and sympathetic innervation. Temporary duration usually <72 hours. S
& S: hypotension, bradycardia, loss of ability to sweat below level of injury. -
ANSNeurogenic
___________________: Impairs thrombin production and platelet function
_____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSTrauma Triad of
Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
___________________: Impairs thrombin production and platelet function
_____________ ______________: Impairs thrombin production
_______________________: Results in depletion of clotting factors through
hemodilution and the impaired ability to produce clotting factors. - ANSTrauma Triad of
Death
1. Hypothermia
2. Metabolic Acidosis
3. Coagulopathy
???;.][''''''''''''''''''' - ANSthis card was created by a cat. enjoy.
.. activation: .... are found in the carotid sinus and along the aortic arch, are sensitive to
the degree of stretch in the arterial wall. When the receptors sense a decrease in
Loading page 28...
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
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stretch, they stimulate the sympathetic nervous system to release Epi, norepi, causing
stimulation of cardiac activity and constriction of blood vessels, which causes a rise in
heart rate and diastolic blood pressure - ANSBaroreceptors:
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
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stretch, they stimulate the sympathetic nervous system to release Epi, norepi, causing
stimulation of cardiac activity and constriction of blood vessels, which causes a rise in
heart rate and diastolic blood pressure - ANSBaroreceptors:
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... describes the concept of under treatment of pain. - ANSOligoanalgesia
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a principle that confuses on prevention rather than intervention. - ANSDamage
control resuscitation
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a test that requires fluid to be sent to the lab and is considered the gold standard
for identifying CSF - ANSBeta2-Transferrin
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is a triad of assessment findings; widening pulse pressure, bradycardia, and
diminished respiratory effort - ANSCushing ( it is an attempt to increase MAP against
elevated ICP, ultimately trying to cause a rise in CPP)
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
... is damaged brain tissue usually caused by blunt trauma - ANSCerebral contusion
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
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... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is defined as the pressure gradient across the brain tissue, or the difference between
the pressures of the cerebral artery and venous vessels. - ANSCPP; CPP = map - icp
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the initial post traumatic inflammatory response. ... ... activates this response and
... are sent to the injury sites, activating signaling pathways that mobilize inflammatory
cells. - ANSImmune response; tissue hypoxia;neutrophils
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... is the shifting of brain tissue with displacement into another compartment as the
result of bleeding or edema. - ANSHerniation
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain is persistent and usually lasts longer than 3 to 6 months. - ANSChronic
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from organs and may lead to referred pain. (Trauma) - ANSVisceral
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
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TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2024 CONTAINS 800 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
CORRECT ANSWERS (VERIFIED ANSWERS)TEST BANK |ALREADY GRADED A+|
LATEST
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
... pain originates from skin and musculoskeletal structures (burns) - ANSSomatic
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... refers to a condition that occurs when the patient suffers a second milks TBI before
recovery from the first - ANSSecond impact syndrome
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... results from a collection of blood forming between the dura Mater and the skull. This
is frequently associated with fractures of the temporal or parietal skull that lacerated the
.... - ANSEpidural hematoma ; middle meninges artery
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock is from hemorrhage and is the leading cause of preventable deaths in trauma
patients. Can also be caused by plasma loss in ... - ANSHypovolemic; burns
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
... shock occurs as a result of maldistribution of an adequate circulation blood volume
with the loss of vascular tone or increased permeability. 3 examples. - ANSDistributive;
anaphylactic, septic and neurogenic
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Subject
Trauma Nursing Core Course