TNCC Study Guide Exam Questions and Answers/ Graded A+/ Updated 2024-2025., Exams of Nursing

Download TNCC Study Guide Exam Questions and Answers/ Graded A+/ Updated 2024-2025. and more Exams Nursing in PDF only on Docsity! TNCC Written Exam TNCC Study Guide Exam Questions and Answers/ Graded A+/ Updated 2024- 2025. What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - Answer: Base deficit used in conjunction with serum lactate 1 TNCC Written Exam Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - Answer: Vasoconstriction What results from tissue hypo perfusion and oxygen deficit? - Answer: Metabolic acidosis What type of shock results in generalized vasodilation? - Answer: Neurogenic shock Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - Answer: Phrenic nerve; paralyzed diaphragm and inability to breath Extremity elevation AT the level of the heart is beneficial for what type of injury? - Answer: Compartment Syndrome What is a high risk of frostbite? - Answer: Thrombus formation What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - Answer: Tissue plasminogen activator or non- steroidal anti-inflammatory medication (NSAIDS) 2 TNCC Written Exam Signs and symptoms similar to early signs of increased ICP but do not worsen. - Answer: Post concussive Syndrome/ Mild Traumatic Brain Injury Cerebral Perfusion Pressure = ______-______ - Answer: MAP - ICP What is the range for CO2 to maximize perfusion? - Answer: 35-45 Does hypoventilation cause dilation or constriction? Increase or decrease ICP? - Answer: Dilation and increase in ICP due to high CO2 Hyperventilation cause dilation or constriction? - Answer: Constriction d/t low CO2 Pupils with pressure on cranial nerve - Answer: Fixed and dilated Pupils with opiates vs stimulants - Answer: small; large Pupils with anticholinergics such as atropine, ipratropium, and scopolamine - Answer: large 5 TNCC Written Exam Sluggish reaction of pupils is an early sign of what? - Answer: Increasing ICP Glasgow Coma Score with Mild, Moderate, and Severe TBI - Answer: Mild = 13-15 Moderate = 9-12 Severe = 3-8 Goal value for ICP - Answer: <15 Goal value for Cerebral Perfusion Pressure (CPP) - Answer: >60 Le Fort Fracture - Answer: Fracture of the maxilla What decrease ICP by decreasing cellular edema? - Answer: Osmotic diuretics (such as 3% saline and mannitol) Becks Triad is a sign of what? And includes what three symptoms? - Answer: Cardiac Tamponade; 1. Hypotension 2. JVD 6 TNCC Written Exam 3. Muffled heart sounds What is pulsus paradoxus? And what is it a sign of? - Answer: Drop in blood pressure with inspiration, sign of cardiac tamponade Tachycarida, weak pulses, hypotension, cool periphery, delayed cap refill, anxiety and agitation are signs of what type of shock? Seen with what? - Answer: Obstructive Shock; Cardiac Tamponade Persistent blood loss following chest tube insertion is a sign of what? - Answer: Hemothorax Ipsilateral diminished breath sounds and chest movement is a sign of what? - Answer: Hemothorax Tearing chest/back pain, unequal blood pressure and pulses are a sign of what? Caused by a high mechanism of injury. - Answer: Thoracic Aortic Disruption Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what? - Answer: Myocardial contusion from Blunt Cardiac Injury 7 TNCC Written Exam Wet, waxy, red to pale skin that does not blanch, multiple sisters. What degree burn? - Answer: Second degree; deep partial thickness Waxy white to leathery gray to charred skin that is dry and firm with absent hair, no blanching. What degree burn? - Answer: Third degree; full thickness Burn extends into the fascia and/or muscle. What degree burn? - Answer: Fourth degree; full thickness Zones of burn injury (3) - Answer: Zone of coagulation Zone of stasis Zone of hyperemia What syndrome occurs most often in burns greater than 20% BSA and lasts for approximately 6-12 hours? - Answer: Capillary Leak Syndrome Fluid replacement goals/calculation - Answer: 2mL/kg LR x TBSA% (give 1/2 over first 8 hours (minus transport time) and 1/2 over next 16 hours) Urine Output goals for fluid replacement therapy - Answer: 0.5 mL/kg (30-50mL/hr) 10 TNCC Written Exam Disaster Definition - Answer: A sudden calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic losses that exceed the community's or society's ability to cope using its own resources. Mitigation - Answer: A foundation to limit the potential impact of a disaster Triage colors and meanings: - Answer: Green - minor, walking wounded Yellow - delayed Red - immediate Black - expectant, deceased When should the decision to transfer be made? - Answer: When the patient's needs outweigh the capabilities of your facility Tertiary care facility, teaching hospital, comprehensive care from resuscitation or rehabilitation, research, injury prevention. - Answer: Level 1 Trauma Center 11 TNCC Written Exam Trauma rescucitation and definitive trauma care. Specialty and rehabilitation care may not be as comprehensive, may not conduct research. - Answer: Level 2 Trauma Center Provides ATLS assessment, intervention, resuscitation and emergency surgery. Generally does not accept transfers. - Answer: Level 3 Trauma Center Provides ATLS assessment, intervention, and resuscitation. May be in a remote area, has 24 hour physician and NP coverage. - Answer: Level 4 Trauma Center Greatest risk to the patient during interfaculty transfer/transport? - Answer: Loss of airway and respiratory compromise What survey is a complete exam within 24 hours of arrival and identified injuries missed during primary assessment, reviews radiology studies, orders more studies, and assesses for hidden injuries? - Answer: Tertiary Survey Stages of shock - Answer: 1. Compensatory Shock 2. Decompensatory Shock (progressive, hypotensive) 3. Irreversible Shock 12 TNCC Written Exam Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - Answer: Distributive Shock Options for hemorrhage - Answer: Pressure at site, tourniquet, hemostatic dressings, Massive Transfusion Protocol, Tranexamic Acid (clotting promoter) Treatment for cariogenic shock - Answer: inotropic support, anti-dysrhythmic medications, treat myocardial infarction or other underlying cause Treatment for obstructive shock - Answer: pericardiocentesis, cardiac window, needle decompression, position pregnant patient on L side Treatment for distributive shock - Answer: Support ventilations, vasopressors, pain management, apply warming methods Treatment for hypovolemic shock - Answer: Tourniquet, 1:1:1 blood products, massive transfusion protocol, TXA, surgical repair Subdural hematoma is caused by tearing of the ______ veins and symptoms usually present within ____ hours of the accident. - Answer: Bridging; 72 15 TNCC Written Exam Epidural hematoma is caused by an arterial or venous bleed? Sx are transient LOC followed by a lucid period. - Answer: Arterial Hyperventilation causes cerebral blood vessels to do what? - Answer: Constrict 16