TNCC Written Exam: Answers & Explanations for Postconcussive Syndrome, Mild TBI, & Shock, Exams of Nursing

Download TNCC Written Exam: Answers & Explanations for Postconcussive Syndrome, Mild TBI, & Shock and more Exams Nursing in PDF only on Docsity! TNCC Written Exam. Real Exam Questions & Correct Verified Answers. A+ Graded. Affect concentration, memory, sleep, mode, and libido. Causes headaches, dizziness and nausea. – ANS Postconcussive Syndrome/ Mild Traumatic Brain Injury An rise in diastolic blood pressures is a sign of increasing what? – ANS Peripheral resistance Anxiety, confusion, restlessness, narrowing pulse pressure, tachycardia, bounding pulse, and decreasing urinary output are signs of what? – ANS Compensated Shock Becks Triad is a sign of what? And includes what three symptoms? – ANS Cardiac Tamponade; 1. Hypotension 2. JVD 3. Muffled heart sounds Benefits of the trauma nursing process – ANS Systematic approach to the evaluation of each trauma patient. Identifies life-threatening conditions, determines priorities of care. Burn extends into the fascia and/or muscle. What degree burn? – ANS Fourth degree; full thickness Cerebral Perfusion Pressure = ______-______ - ANSMAP - ICP Contaminated wound, granulation tissue, delayed closure with suture. This is _______ Intention. – ANS Tertiary Decreased level of consciousness, hypotension, and narrowed pulse pressure, tachycardia with weak pulse, tachypnea, and cool, clammy, cyanotic skin are signs of what? – ANS Decompensated/Progressive shock Decreased/absent breath sounds ipsilateral, JVD, hypotension, and tracheal deviation to the contralateral side (late sign) is seen with what? Can lead to what? – ANS Tension Pneumothorax; PEA Diaphragmatic Tears are seen with what types of injuries? – ANS Penetrating injuries between T4-T12, and rapid deceleration causing severe blunt trauma to the torso. Disaster Definition - ANSA 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. Does hypoventilation cause dilation or constriction? Increase or decrease ICP? – ANS Dilation and increase in ICP due to high CO2 Dysrhythmia, ischemic changes, and persistent unexplained tachycardia are signs of what? – ANS Myocardial contusion from Blunt Cardiac Injury Efficient production of ATP, which maintains cellular metabolic function, is seen with what type of metabolism? - ANSAerobic metabolism Epidural hematoma is caused by an arterial or venous bleed? Sx are transient LOC followed by a lucid period. - ANSArterial Extremity elevation AT the level of the heart is beneficial for what type of injury? - ANSCompartment Syndrome Fluid replacement goals/calculation - ANS2mL/kg LR x TBSA% (give 1/2 over first 8 hours (minus transport time) and 1/2 over next 16 hours) Glasgow Coma Score with Mild, Moderate, and Severe TBI - ANSMild = 13-15 Moderate = 9-12 Severe = 3-8 Goal value for Cerebral Perfusion Pressure (CPP) - ANS>60 Goal value for ICP - ANS<15 Greatest risk to the patient during interfaculty transfer/transport? - ANSLoss of airway and respiratory compromise Hear bowel sounds in chest and Kehr's sign seen with what? - ANSTraumatic Diaphragmatic Tear Hemoptysis, ineffective cough, crackles in affected lung, hypoxia/hypercapnia, and alveolar opacities are signs of what? - ANSPulmonary Contusion Hyperventilation cause dilation or constriction? - ANSConstriction d/t low CO2 Hyperventilation causes cerebral blood vessels to do what? - ANSConstrict Incision with blood clot, edges approximated with suture closer, and results in a fine scar. This is __________ Intention. - ANSPrimary Inefficient production of ATP, byproduct is lactic acid, leads to metabolic acidosis, cellular dysfunction leads to cell death with what type of metabolism? - ANSAnaerobic metabolism The cellular process in which glucose is metabolized into energy without oxygen. Energy is produced in an inefficient manner with many waste products. - ANSAnaerobic metabolism The cellular process in which oxygen is used to metabolize glucose. Energy is produced in an efficient manner with minimal waste products. - ANSAerobic metabolism Trauma rescucitation and definitive trauma care. Specialty and rehabilitation care may not be as comprehensive, may not conduct research. - ANSLevel 2 Trauma Center Treatment for cariogenic shock - ANSinotropic support, anti-dysrhythmic medications, treat myocardial infarction or other underlying cause Treatment for distributive shock - ANSSupport ventilations, vasopressors, pain management, apply warming methods Treatment for hypovolemic shock - ANSTourniquet, 1:1:1 blood products, massive transfusion protocol, TXA, surgical repair Treatment for obstructive shock - ANSpericardiocentesis, cardiac window, needle decompression, position pregnant patient on L side Triage colors and meanings: - ANSGreen - minor, walking wounded Yellow - delayed Red - immediate Black - expectant, deceased Urine Output goals for fluid replacement therapy - ANS0.5 mL/kg (30-50mL/hr) Vasodilation, anaphylaxis, sepsis, and spinal cord injuries cause which type of shock? - ANSDistributive Shock Waxy white to leathery gray to charred skin that is dry and firm with absent hair, no blanching. What degree burn? - ANSThird degree; full thickness Wet, waxy, red to pale skin that does not blanch, multiple sisters. What degree burn? - ANSSecond degree; deep partial thickness What decrease ICP by decreasing cellular edema? - ANSOsmotic diuretics (such as 3% saline and mannitol) What is a high risk of frostbite? - ANSThrombus formation What is caused by the tear of the bridging veins or middle meningeal artery? - ANSSubdural and Epidural Hematoma What is included in the Trauma Triad of Death? - ANSCoagulopathy Acidosis Hypothermia What is pulsus paradoxus? And what is it a sign of? - ANSDrop in blood pressure with inspiration, sign of cardiac tamponade What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - ANSBase deficit used in conjunction with serum lactate What is the range for CO2 to maximize perfusion? - ANS35-45 What phase of a blast results from any explosion-related illness or injury including hyperglycemia, hypertension, angina, asthma, COPD, or sepsis? - ANSQuaternary Phase What phase of a blast results from impact of the over and under pressurization wave with body surfaces. Injuries include blast lung, tympanic membrane rupture, abdominal hemorrhage, globe rupture, and mild traumatic brain injury? - ANSPrimary Phase What phase of a blast results from individuals being thrown by the blast and impacting walls, ground, or any hard object? - ANSTertiary Phase What position will benefit the airway and work of breathing for the bariatric patient? - ANSReverse Trendelenburg What results from tissue hypo perfusion and oxygen deficit? - ANSMetabolic acidosis 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? - ANSTertiary Survey What syndrome occurs most often in burns greater than 20% BSA and lasts for approximately 6-12 hours? - ANSCapillary Leak Syndrome What two medications can be administered to maintain perfusion after a frostbite injury along with rewarming? - ANSTissue plasminogen activator or non steroidal anti- inflammatory medication (NSAIDS) What type of shock is caused by cardiac tamponade or tension pneumothorax? Ventricular failure is seen. - ANSObstructive Shock What type of shock results in generalized vasodilation? - ANSNeurogenic shock When should the decision to transfer be made? - ANSWhen the patient's needs outweigh the capabilities of your facility Which phase of a blast results from flying debris, projectiles, and bomb fragments causing lacerations or penetrating injuries? - ANSSecondary Phase Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - ANSVasoconstriction Zones of burn injury (3) - ANSZone of coagulation Zone of stasis Zone of hyperemia