TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
A adult patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. They complain of difficulty swallowing and speaking. In the
primary survey, further assessment is indicated next for which of the following
conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ansa. Damage to the cervical spine
A patient arrives at the emergency department by private vehicle after sustaining an
injury to the right lower extremity while using a saw. There is a large gaping wound to
the right thigh area with significant bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure
A patient fell two weeks ago, striking their head. Today, the patient presented with a
persistent headache and nausea and was diagnosed with a small subdural hematoma.
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports the patient has been anxious, restless, shaky, and vomited twice during
the night. The patient states they couldn't sleep because a young child kept coming into
the room. What is the most likely cause for these signs and symptoms?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus - ansb. alcohol withdrawal
A patient involved in a MVC has sustained a fracture to the second rib of the anterior left
chest. Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - ansb. Brachial plexus injury
A patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management for this patient?
a. maintain adequate respiratory status.
b. administer balanced resuscitation fluid
c. perform serial assessments of neurologic function
d. maintain core temperature - ansa. maintain adequate respiratory status

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
called in sick for a couple of days and is now back working on the team. Which of the
following behaviors would indicate this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
d. They are thinking about transferring out of the emergency department. - ansa. They
are talking about taking the emergency nursing certification examination.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
d. quaternary - ansb. secondary
In a patient with severe traumatic brain injury, hypocapnia causes which condition?
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction
The general impression step in the initial assessment provides the opportunity to do
which of the following?
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.
The nurse is obtaining a history for a patient who presents following sexual assault. This
history is completed using which of the following techniques?
a. Bring the family in to the interview room.
b. Use direct quotes to record information.
c. Obtain information specific only to the assault.
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record
information.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of
94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124
beats/minute. The emergency nurse interprets the patient's hemodynamic findings as
an indication of which of the following?

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c. administer tissue plasminogen activator
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator
Understanding the kinematic concepts associated with the mechanism of injury and
energy transfer can initially assist the trauma care provider in which of the following?
a. Anticipating the types of injuries that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries
that may be present
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests, downward and laterally.
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply gentle
pressure over the iliac crests, downward and medially.
What is the best measure of the adequacy of cellular perfusion and can help to predict
the outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hematocrit level
c. Base deficit
d. Oxygen saturation - ansc. Base deficit
What is the best position for maintaining an open airway in the obese patient?
a. Prone
b. Supine
c. Reverse Trendelenburg
d. Right lateral recumbent - ansc. Reverse Trendelenburg
What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
a. Airway compromise

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled external hemorrhage - ansd. Uncontrolled external hemorrhage
Which of the following accurately describes ventilation principles associated with use of
a bag-mask device for an adult?
a. Compress the bag-mask device at a rate of one breath every 6 seconds.
b. Delivers 100% oxygen.
c. Squeeze the bag-mask device completely for each breath.
d. Maintain the oxygen saturation levels between 92% and 94%. - ansa. Compress the
bag-mask device at a rate of one breath every 6 seconds.
Which of the following is considered a cornerstone of a high-performance trauma team?
a. Individual goals
b. Use of TeamSTEPPS
c. Identification of a single decision maker
d. Effective communication - ansd. Effective communication
While performing an assessment on a 13-month-old involved in a motor vehicle
collision, the nurse identifies which of the following findings from the patient as a sign of
possible altered mental status?
a. Sunken fontanel
b. Crying, but consolable
c. Spontaneous movement of arms and legs
d. Cooperation with the assessment - ansd. Cooperation with the assessment
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)

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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
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.

Loading page 6...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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
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

Loading page 7...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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.
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.

Loading page 8...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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
1: Does not open eyes
2: Opens eyes in response to pain

Loading page 9...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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:

Loading page 10...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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

Loading page 11...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
5. Reevaluation Adjuncts
6. Reevaluation and Post Resuscitation Care
7. Definitive Care or Transport
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)

Loading page 12...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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.
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.

Loading page 13...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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) 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

Loading page 14...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
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
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.

Loading page 15...

TNCC 9TH EDITION – QUESTIONS AND ANSWERS GRADED A+ (SOLVED
2023/2024)
**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
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

Loading page 16...

2023-2024 TNCC 9th Edition with Answers (498 Solved Questions)

Study Now!

Document Details

Related Documents

2023-2024 TNCC Final Practice Exam 4 with Answers (49 Solved Questions)

2023-2024 TNCC Final Practice Exam 4 with Answers (1343 Solved Questions)

TNCC 10th Edition Practice Exam 3 Version A and B with Answers (740 Solved Questions)

TNCC Trauma Nursing Core Course 11th Edition ENA Test with Answers (220 Solved Questions)

2024 TNCC Nursing Process with Answers (17 Solved Questions)

2023-2024 TNCC Final Exam with Answers (48 Solved Questions)

2023-2024 TNCC Final Exam 4 with Answers (1343 Solved Questions)

2024-2025 TNCC: Trauma Nursing Process with Answers (71 Solved Questions)

Company

Explore

Study Tools