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TNCC 9th Edition Study Guide: Questions and Answers on Trauma Care, Exams of Nursing

The University of ManchesterNursing

This study guide provides a comprehensive set of questions and answers covering key concepts in trauma care, based on the tncc 9th edition. It explores topics such as biomechanics, initial assessment, airway management, shock, and specific injuries like spinal cord trauma and burns. The guide is designed to help students and healthcare professionals prepare for the tncc exam and enhance their understanding of trauma care principles.

Typology: Exams

2024/2025

Available from 01/18/2025

Laura-Davison
Laura-Davison 🇬🇧

139 documents

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TNCC 9th Edition Study guide -
Questions and answers
Why is it important to understand biomechanics as it relates to types of energy forces and
mechanism of injury (MOI)? - Correct answer To understand and anticipate potential injuries."
"What are common MOIs that result in trauma? - Correct answer Blunt and Penetrating"
"What is the most common mechanism of blunt trauma seen at your facility? Penetrating trauma? -
Correct answer Blunt- Falls
Penetrating- GSW"
"Why is it important to use a systematic approach to the initial assessment of a trauma patient? -
Correct answer To maximize outcomes and reduce the risk of undiscovered injuries."
"What is included in the preparation for a trauma patient? - Correct answer - Activate the Trauma
Team and assign roles
- Prepare the room/equipment
- Don PPE
- Consider safety threats
- Decontamination"
"What information is obtained during the general impression? - Correct answer - Uncontrolled
hemorrhage
- Unresponsiveness/Apnea
- Need to reprioritize C-ABC"
"What does the A-J mnemonic stand for? - Correct answer A** Alertness (A1) and Airway (A2)
B** Breathing and Ventilation
C** Circulation and Control of Hemorrhage
D** Disability (Neurologic Status
E** Exposure (E1) and Environmental Control (E2)
F- Full Set of Vital Signs (F1) and Family Presence (F2)
G- Get Adjuncts (G1) and Give Comfort (G2) [L-P]
H- History (H1) and Head-to-Toe (H2)
I- Inspect Posterior Surfaces
J- Just keep reevaluating (VIPP)"
"Why is alertness included with the airway assessment? - Correct answer To evaluate the Pts ability
to protect their airway
AVPU
- Alert and Orientated
- Verbal (responds to)
- Pain (responds to)
- Unresponsive"
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Download TNCC 9th Edition Study Guide: Questions and Answers on Trauma Care and more Exams Nursing in PDF only on Docsity!

TNCC 9th Edition Study guide -

Questions and answers

Why is it important to understand biomechanics as it relates to types of energy forces and mechanism of injury (MOI)? - Correct answer To understand and anticipate potential injuries." "What are common MOIs that result in trauma? - Correct answer Blunt and Penetrating" "What is the most common mechanism of blunt trauma seen at your facility? Penetrating trauma? - Correct answer Blunt- Falls Penetrating- GSW" "Why is it important to use a systematic approach to the initial assessment of a trauma patient? - Correct answer To maximize outcomes and reduce the risk of undiscovered injuries." "What is included in the preparation for a trauma patient? - Correct answer - Activate the Trauma Team and assign roles

  • Prepare the room/equipment
  • Don PPE
  • Consider safety threats
  • Decontamination" "What information is obtained during the general impression? - Correct answer - Uncontrolled hemorrhage
  • Unresponsiveness/Apnea
  • Need to reprioritize C-ABC" "What does the A-J mnemonic stand for? - Correct answer A** Alertness (A1) and Airway (A2) B** Breathing and Ventilation C** Circulation and Control of Hemorrhage D** Disability (Neurologic Status E** Exposure (E1) and Environmental Control (E2) F- Full Set of Vital Signs (F1) and Family Presence (F2) G- Get Adjuncts (G1) and Give Comfort (G2) [L-P] H- History (H1) and Head-to-Toe (H2) I- Inspect Posterior Surfaces J- Just keep reevaluating (VIPP)" "Why is alertness included with the airway assessment? - Correct answer To evaluate the Pts ability to protect their airway AVPU
  • Alert and Orientated
  • Verbal (responds to)
  • Pain (responds to)
  • Unresponsive"

"When an intervention is taken during the primary survey, what must the nurse do after the intervention? - Correct answer Reassess effectiveness and move on to the next component" "What are the components of the secondary survey? - Correct answer H- History and Head to Toe I- Inspect Posterior J- Just Keep reevaluating (VIPP)" "What laboratory tests are commonly utilized for trauma patients? - Correct answer VBG/ABG Lactic CMP/CBC Type Screen Clotting Factors UA" "What should the nurse reevaluate while the patient is in their care? - Correct answer VIPP V- Vital I- Injuries/Interventions P- Primary Survey P- Pain" "What are the differences between ventilation, diffusion, and perfusion? - Correct answer Ventilation- movement of air Diffusion- movement of gases from high concentration to lower concentration, alveolar-capillary membrane exchange" "What are possible causes of airway obstruction in the trauma patient? What interventions address these causes of airway obstruction? - Correct answer Tongue Blood, vomit, secretions Altered LOC Trauma Obesity Interventions- suctions, jaw thrust, insert airway" "What is the difference between an airway adjunct and a definitive airway? - Correct answer Adjunct airway- upper airway management

  • nasopharyngeal
  • oropharyngeal (unresponsive/no gag reflex)
  • extraglottic (Supra or Retro "king tube") Definitive airway- placed within the trachea below the vocal cords" "What is the difference between normoxia and hyperoxia? Why does it matter? - Correct answer Normoxia- Pa02 60-120 mmHg Hyperoxia- Pa02 >120 mmHg Can cause tissue damage, cell death, oxygen toxicity. Poor outcomes." "What is the most common type of shock in trauma patients? What are possible interventions to manage uncontrolled external hemorrhage? - Correct answer Hypovolemic

"What MOI is associated with major injuries to the thorax? - Correct answer MVA" "What injuries are associated with fractures to the thorax? - Correct answer Blunt cardiac injury Great vessel injury Hemothorax Pneumothorax Liver/Spleen (7-12 rib fx)" "What is the significance of a flail chest and what intervention should be anticipated? - Correct answer Unstable chest wall that moves paradoxically

  • analgesics
  • intubation
  • surgery" "What are the signs of Beck's triad? What are the limitations when assessing for these signswhen the patient is hypovolemic? - Correct answer JVD ↓ BP Muffled heart sounds Hypovolemia may prevent JVD" "What is the most important intervention for a patient in acute respiratory distress with tachycardia, hypotension, jugular vein distention, and unilateral absence of breath sounds? - Correct answer Bilateral chest tubes" "What are the differences between a simple (closed) pneumothorax and a complex or communicating (open) pneumothorax? What causes progression to a tension pneumothorax? - Correct answer Air entering from the outside of the body Air entering the cavity and unable to escape increasing the pressure" "What interventions should the nurse anticipate for a patient with a massive hemothorax? - Correct answer Chest tube MTP Surgical intervention" "What are the indications for a resuscitative thoracotomy? - Correct answer Penetrating chest trauma Limit hemorrhage of heart and great vessels" "What injuries are common with blunt abdominal trauma? - Correct answer Liver Spleen Bowel" "What are some examples of hollow abdominal organs? Solid abdominal organs? - Correct answer Hollow- bowel, stomach, gallbladder Solid- Liver, spleen"

"List concurrent injuries that may occur with abdominal and/or pelvic injuries. - Correct answer Rib Fx Renal injuries Pelvic Fx Lumbar Fx Bladder" "Describe why trauma to the abdomen and/or pelvis can result in significant hemorrhage. - Correct answer Major vessels in abdominal and pelvic cavities" "What equipment or intervention may be used to stabilize a suspected or known pelvic fracture? - Correct answer Pelvic binder" "What assessment finding is a contraindication to inserting an indwelling urinary catheter? - Correct answer Blood at the meatus" "How can a FAST exam be used to help direct appropriate interventions? - Correct answer Utilizes US to detect fluid in ABD/Pelvic cavities" "When is REBOA used? - Correct answer Control internal hemorrhage at a noncompressible location" "What interventions can be anticipated for suspected compartment syndrome? - Correct answer IV fluids Remove cast, splint, dsg Elevate limb Monitor compartment pressure Fasciotomy ICE CONTRAINDICATED" "What are the indications for use of a tourniquet? - Correct answer Bleeding uncontrolled by elevation or pressure Amputation" "What are the steps to applying a tourniquet? - Correct answer 1) Apply and wrap the tourniquet 2 inches above the injury

  1. Tighten the tourniquet until the bleeding stops
  2. Write down the time the tourniquet was applied" "What is the policy at your facility for the care of amputated body parts such as a digit or limb? - Correct answer " "When is spinal motion restriction (SMR) indicated? What is the proper technique for the measurement and application of a cervical collar? - Correct answer For any suspected spinal injury" "What is the difference between a primary and secondary injury in spinal cord trauma? - Correct answer Primary- mechanism of injury Secondary- biochemical and cellular reactions inflammation, ischemia, edema, necrosis"

Pain control" "What is the difference between cultural competence and cultural humility? - Correct answer Competence is knowledge and stereotyping Humility is lifelong learning and flexibility" "Why is it important to use a person's correct pronoun? - Correct answer Demonstrates respect, inclusiveness and promotes feeling of safety" "What are some physiologic considerations for the trauma patient who is undergoing gender reassignment procedures? - Correct answer Airway- potential alterations Respiratory- Breast/chest surgery, binders Cardiac- ↑ Risk MI and stroke Urinary- Strictures, fistulas Labs- Alterations d/t HRT" "What is the pediatric assessment triangle? - Correct answer Pediatric triage tool -Appearance -Work of breathing -Circulation to skin" "How is the pediatric assessment triangle used to help form a general impression of physiologic stability when a pediatric patient arrives at the emergency department? - Correct answer Determine "sick, sicker, sickest"" "What are some anatomic or physiologic differences in the pediatric patient that can affect the components of the primary survey? - Correct answer Smaller airway Increased RR Larger tongue Horizontal rib cage Thin chest wall transmits sounds to the other side" "What are some cognitive and developmental considerations that increase risk for injuries in pediatric patients? - Correct answer " "What are some differences in pediatric compensatory mechanisms compared to adults? - Correct answer Sustain major hemorrhage without drop in BP" "What special considerations are needed for pediatric fluid volume and medication administration and pediatric pain assessment? - Correct answer Fluid volume has high level h20, more easily dehydrated. Warm fluids d/t easily losing body heat Medication wt. based Pain can have environmental/emotional factors" "What are possible signs of child maltreatment? - Correct answer Prolonged time between injury and treatment Fx of long bones

Injuries in protected areas" "What is the TEN-4 mnemonic? - Correct answer T- Torso E- Ears N- Neck 4- >4 years old" "What injuries are more common and should be anticipated in the obese patient? - Correct answer Spinal Upper torso Upper/lower limb fx" "What airway and ventilation differences should be considered when caring for the obese patient? - Correct answer Narrowed airway Increased airway resistance Dyspnea at rest Increased RR Decreased tidal volumes Difficulty bag-mask" "What differences in equipment or its use might be necessary? - Correct answer Larger equipment Reverse Trendelenburg US placed IV 2 people to hold bag-mask" "What considerations may be appropriate to keep the patient and staff safe with obese trauma pt? - Correct answer Use assistive transfer devices Increase the number of staff for the transfer" "What are some ways to provide sensitive care for obese patients? - Correct answer Appropriate size equipment/clothing Sensitive to wording used when speaking to pt" "What are some anatomic or physiologic differences in the older adult that can affect the components of the primary survey and should be considered when caring for these patients? - Correct answer Decreased gag reflex Dentures Changes in spinal curvature Neurological changes Decreased muscle mass Increase comorbidities" "What are the most common MOIs in older adults? Why? - Correct answer Falls d/t decreased muscle tone, changes in visual acuity, medications" "What comorbidities or other factors should be considered when providing care for the older trauma patient? - Correct answer Cardiac disease Stroke

"What are some examples of stress disorders? - Correct answer Acute stress disorder PTSD Cisis" "What are some interventions you can use to prevent escalation of negative behaviors in patients or visitors? - Correct answer Minimize chaos One point of contact Clear communication Spiritual support Comfort measures (food, drink, quiet room)" "What are the four phases of disaster management?What is a key component of each phase of disaster management? - Correct answer Mitigation- minimize impact on lives Preparedness- improve safety and resilience Response- patient surge Recovery- repair and restoration of services" "What are some injuries that can affect the patient's ability to oxygenate and ventilate in the post resuscitation period? - Correct answer TBI Thoracic injuries- pnumo/hemothorax, rib fx Analgesics/sedation" "What type of shock can occur in the post resuscitative period due to infection? - Correct answer Sepsis" "What is abdominal compartment syndrome, and what body systems can it affect? - Correct answer Massive interstitial edema d/t hematoma/aggressive volume resuscitation, causing increased intra- abdominal pressure/hypertension (IAH). Affects abdominal, cardiovascular and respiratory systems" "What is the difference between missed injuries and delayed injuries? - Correct answer Missed injuries- presents on arrival Delayed injuries- develop over time as a result of initial injury" "