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TNCC 9th Final Exam Test Latest 2025 Paper 1 Q&A
Whydisdadmeasuredofdserumdlactatedobtaineddindthedinitialdassessmentdofdthedtraumadpatient? Answer:dcd-dCORRECTdANSWER-a)dtodmeasuredoxygenationdanddventilation b) todquantifydthedbaseddeficitdfordthedadequacydofdcellulardperfusion c) todgaugedend-organdperfusiondanddtissuedhypoxiad* d) toddeterminedthedunderlyingdcausedofdshock Adtraumadpatientdisdrestlessdanddrepeatedlydaskingd"wheredamdI?"dvitaldsignsdupondarrivaldweredBPd 1 00/60dmmdHg,dHRd 96 dbeats/min,danddRRd 24 dbreaths/min.dHerdskindisdcooldandddry.dCurrentdvitaldsig nsdaredBPd104/84mmdHg,dHRd108,dRRd 28 dbreaths/min.dThedpatientdisddemonstratingdsignsdanddsym ptomsdofdwhichdstagedofdshock? Answer:dAd-dCORRECTdANSWER-A)dcompensatedd** B) Progressive C) irreversible D) decompensated Andelderlydpatientdwithdadhistorydofdanticoagulantdusedpresentsdafterdadfalldatdhomedthatdday.dshedde niesdanydlossdofdconsciousness.dShedhasdadhematomadtodherdforeheaddanddcomplainsdofdheadache ,ddizziness,danddnausea.dWhichdisdadmostdlikelydcausedofdherdsymptoms? Answer:dDd-dCORRECTdANSWER-A)depiduraldhematoma B) diffusedaxonaldinjury C) post-concussivedsyndrome D) subduraldhematomad*** EMSdbringsdadpatientdwhodfelldridingdhisdbicycle.dUsingdthedAmericandCollegedofdSurgeonsdscreenin gdguidelines,dwhichdassessmentdfindingdwoulddpromptdthednursedtodpreparedthedpatientdfordradiolog icdspinedclearance? Answer:dDd-dCORRECTdANSWER-A)dAlertdwithdnodneurologicddeficits B) Multipledabrasionsdtodthedextremities C) Multipledrequestsdofdwater D) Smelldofdalcoholdondbreathd*** Whichdofdthedfollowingdoccursdduringdthedthirddimpactdofdadmotordvehicledcrash? Answer:dCd-dCORRECTdANSWER-A)dTheddriverdofdthedvehicledcollidesdwithdthedsteeringdwheel B) thedvehicledcollidesdwithdadtree
C) thedaortadisdtorndatditsdattachmentdwithdthedligamentumdarteriosum D) thedairbagddeploysdanddstrikesdthedfrontdseatdpassengerd*** Adpassengerdisdbroughtdtodthedemergencyddepartmentdofdadruraldhospitaldfollowingdadhigh- speeddMVC.dWhendsignificantdabdominaldanddpelvicdinjuriesdarednoteddindthedprimarydsurvey, dwhichdofdthedfollowingdisdthedprioritydinterventions? Answer:dAd-dCORRECTdANSWER-A)dinitiatedtransferdtodadtraumadcenterd** B) providedreportdtodthedoperatingdroomdnurse C) Obtaineddimagingdstudies D) Placedadgastricdtube WhichdofdthedfollowingdinjuriesdisdLEASTdlikelydtodbedpromptlydidentified? Answer:dCd-dCORRECTdANSWER-A)dspleen B) lung C) boweld*** D) brain Patientsdwithdadcrushdinjurydshoulddbedmonitoreddfordwhichdofdthedfollowingdconditions? Answer:dCd-dCORRECTdANSWER-A)dHypernatremia B) Hypercalcemia C) Dysrhthmiasd** D) polyuria Whatdfindingdraisesdsuspiciondofdcompletedspinaldcorddinjury? Answer:dBd-dCORRECTdANSWER-A)dWeaknessdindthedlowerdextremities B) Priapismd*** C) voluntarydanaldsphincterdtone D) intactdreflexesddistaldtodthedinjury Adpatientdwithdadcompletedspinaldcorddinjurydindneurogenicdshockdwillddemonstratedhypotensiondan ddwhichdotherdclinicaldsigns? Answer:dDd-dCORRECTdANSWER-A)dBradycardiadanddipsilateraldabsencesdofdmotordfunction B) Tachycardiadanddrespiratoryddepression C) Tachycardiadanddabsentdmotordfunctiondbelowdthedleveldofdinjury D) Bradycardiadanddabsentdmotordfunctiondbelowdthedleveldofdthedinjuryd*** Ad 5 - yeardolddchilddpresentsdtodthedEDdwithdbruisesdtodthedupperdarmsdanddbuttocksdindvariousdstagesdofd
Answer:dAd-dCORRECTdANSWER- A)dreportdyourdsuspiciondofdthedmaltreatmentdindaccordancedwithdlocaldregulationsd*** B) applydicedtodthedbruisesdanddconsultdwounddcare C) engagedindtherapeuticdcommunicationdtoddeterminedthedMOI D) providedthedfamilydwithdinjurydpreventiondresourse Adpatientdwithdlowerdextremitydfracturedcomplainsdofdseveredpaindanddtightnessdindhisdcalf,dminimallydrelie veddbydpaindmedications.dWhichdofdthedfollowingdisdthedprioritydnursingdintervention? Answer:dCd-dCORRECTdANSWER-A)delevatingdthedextremitydabovedthedleveldofdthedheart B) repositioningdanddapplydice C) Elevatingdthedextremitydtodthedleveldofdthedheartd*** D) Preparingdthedpatientdfordultrasound Ad 36 - yeardolddfemaledhasdaddeformitydofdthedleftdwristdafterdadfall.dShedisdreluctantdtodmovedherdhandddue dtodpain.dWhichdofdthedfollowingdisdthedmostdappropriatedintervention? Answer:dBd-dCORRECTdANSWER-A)dapplydadslingdanddelevatedthedextremitydtodthedleveldofdthedheart. B) applydadsplintdanddELEVATEdABOVEdTHEdLEVELdOFdTHEdHEARTd*** C) Applydadslingdanddelevatedthedextremitydabovedthedleveldofdthedheart D) applydadsplintdanddelevatedthedextremitydtodthedleveldofdthedheart. Whichdofdthedfollowingdisdadlatedsigndofdincreaseddintracranialdpressure? Answer:dC CushingdResponse dWideningdpulsedpressure dReflexdbradycardia dDecreaseddRRd-dCORRECTdANSWER-A)dRestlessnessdorddrowsiness B) Nauseadanddvomiting C) Decreaseddrespiratorydeffort** D) amnesiadanddanxiety Whichdofdthedfollowingdmnemonicsdcandhelpdthednursedprioritizedcaredfordadtraumadpatientdwithdma ssiveduncontrolleddhemorrhage? Answer:dBd-dCORRECTdANSWER-A)dABC B) MARCH*** C) AVPU D) VIPP
Adpatientdisdthrowndagainstdadcardduringdadtornadodanddpresentsdwithdobviousdbilateraldfemoraldfrac tures.dThedpatientdisdpale,dalert,ddisoriented,danddhasddelayeddcapdrefill. Whichdofdthedfollowingdinterventionsdwoulddbedmostdappropriatedfordthisdpatientdbaseddondtheddisas terdtriagedprinciple? Answer:dAd-dCORRECTdANSWER- A)dinitiatedtwodlargedcaliberdintravenousdlinesdfordRingersdlactatedsolutiondadministrationd*** B) AdministerdDilaudiddfordpaindcontroldanddprovidedcomfortdcare C) Placedthedpatientdindandobservationdareadfordcaredwithindthednextdfewdhours D) Contactdthedcommanddcenterdfordthedpersonneldtodnotifydnextdofdkin. Adpatientdarrivesdwithdadlargedopendchestdwounddafterdbeingdassaultdeddwithdadmachete,dPrehospita ldprovidersdplaceddadnonporousddressingdoverdthedchestdwounddanddtapesditdond 3 dsides.dHedisdnowd showingdsignsdofdanxiety,drestlessness,dseveredrespiratoryddistress,dcyanosis,dandddecreasingdbloo ddpressure.dWhichdofdthedfollowingdisdthedMOSTdappropriatedinterventions? Answer:dCd-dCORRECTdANSWER-A)dneedleddecompression B) tubedthoracostomy C) dressingdremovald** D) surgicaldrepair Adpatientdisdfounddlyingdondthedfloordafterdfallingd 13 dhoursdago.dWhichdofdthedfollowingdlabdvaluesdisd expecteddwithdadmusculoskeletaldcomplicationdassociateddwithdthisdpresentation? Answer:dAd-dCORRECTdANSWER-A)delevateddcreatinedkinased*** B) decreaseddpotassiumdlevel C) decreaseddWBC D) elevateddGFR Ad 56 - year- dmaledpatientdinvolveddindadMVCdisdbroughtdtodthedEDdofdadruraldcriticaldaccessdfacility.dHedc/odneckd pain,dSOB,dandddiffusedabddpain.dHisdGCSdisd15.dHisdvitalsdaredasdfollows: BPd98/ HRd 125 dbeats/min RRd 26 dbreaths/min SpO2d94%dondhighdflowdO2dviadNRBdmask whichdofdthedfollowingdisdthedprioritydinterventiondfordthisdpatient? Answer:dCd-dCORRECTdANSWER-A)dExpeditedtransportdtodthedCTdscanner B) preparedthedpatientdfordspinaldradiographs C) expeditedtransferdtodthedclosestdtraumadcenterd*** D) notifydthedpatientsdfamily
Tearingdofdthedbridgingdveinsdisdmostdfrequentlydassociateddwithdwhichdbraindinjury? Answer:dBd-dCORRECTdANSWER-A)depiduraldhematoma B) subduraldhematomad*** C) diffusedaxonaldinjury D) intracerebraldhematoma Ifdadpatientdhasdreceiveddmultipledtransfusionsdofdbankeddblooddpreserveddwithdcitrate,dwhichdelect rolytedisdmostdlikelydtoddropdanddrequiredsupplementation? Answer:dDd-dCORRECTdANSWER-A)dpotassium B) magnesium C) sodium D) calciumd*** AdtraumadpatientdisdendroutedtodadruraldED.dRadiologydnotifiesdthedchargednursedthatdthedCTdscannerd willdbedoutdofdservicedfordseveraldofdhours.dThedteamdgathersdtodplandaccordingly.dWhichdofdthedfollo wingdtermsdbestddescribesdthisdtraumadteamsdcommunication? Answer:dDd-dCORRECTdANSWER-A)dBrief B) loop C) debrief D) huddled*** Thednursedisdcaringdfordad 120 dkgdmaledisdbroughtdindafterdadwarehousedfiredanddisdcalculatingdthedpa tient'sdfluiddresuscitationdneeds.dHedhasdpainfuldreddblisteringdtodthedentiredsurfacedofdbothdupperde xtremitiesdanddsuperficialdburnsdtodthedanteriordchest.dUsingdthedmodifieddLunddanddBrowderdchart dtodcalculatedthedtotaldBSAdburned,dhowdmuchdIVdfluidsdwoulddbedadministereddindthedfirstd 8 dhours? (upperdarmd4+4d/dlowerdarmd3+3d/dhandd2.5+2.5)d=d19%dTBSA. 120 dkgdxd(2dmL)dxd(19%dTBSA)d=d 4560 dmL 4560 d/d 2 d(halfdofdfluidsdgivendindfirstd 8 dhours)d=d 2280 dmL Answer:dAd-dCORRECTdANSWER-A)d 2280 dmLd*** B) 3840 dmL C) 4560 dmL D) 7680 dmL WhichdofdthedfollowingdassessmentdfindingsddifferentiatesdadtensiondPTXdfromdadsimpledPTX?
answer:dD Assessmentdfindingsdassociateddwithdtensiondpneumothoraxdincludedanxiety,dseveredrestlessness, dseveredrespiratoryddistress,danddabsentdbreathdsoundsdondthedinjureddside.dHypotensiondduedtodco mpressiondofdthedheartdanddgreatdvesselsdisdconsistentdwithdobstructivedshock.dHypotensiondworse nsdwithdinspirationdduedtodincreaseddintrathoracicdpressure.dLatedsignsdincludeddistendeddneckdvei ns,dtrachealddeviation,danddcyanosis.d-dCORRECTdANSWER-A)dincreaseddworkdofdbreathing B) unilaterallyddiminisheddbreathdsounds C) pleuriticdchestdpain D) hypotensiondthatdworsensdwithdinspirationd*** Whichdofdthedfollowingdconsiderationsdisdmostdimportantdwhendcaringdfordadgeriatricdtraumadpatient ? Answer:dBd-dCORRECTdANSWER-A)dheaddtodtodexam B) medicaldhistoryd** C) incontinence D) falls Andintubateddtraumadpatientdisdbeingdtransferreddtodadtertiarydcaredcenter.dAfterdmovingdthedpatientdt odthedstretcherdfordtransport,daddropdindpulsedoximetrydtod85%disdnoted.dWhichdofdthedfollowingdisdthe dprioritydinterventions? Answer:dDd-dCORRECTdANSWER-A)dcalldfordadportabledCXRdstat B) chestdtodmakedsuredthedventilatordisdpluggeddin C) suctiondthedETdtube D) confirmdETdtubedplacement Whatdfactordcontributesdmostdthedkineticdenergydofdadbodydindmotion? answer:dCd-dCORRECTdANSWER-A)dacceleration B) mass C) velocityd*** D) inertia Duringdthedprimarydsurveydofdandunconsciousdpatientdwithdmulti- systemdtrauma,dthednursednotesdsnoringdrespirations.dWhichdprioritydnursingdinterventionsdsh oulddbedperformeddnext? Answer:dDd-dCORRECTdANSWER-A)dopendthedairwaydwithdthedhead-tilt/chindliftdmaneuver B) auscultatedbilateraldbreathdsoundsdtodassessdventilatorydstatus C) assistdrespirationsdusingdadBVM D) insertdandoropharyngealdairwaydifdtheredisdnodgagdreflexd***
D) serialdabdominaldassessments
Whichdofdthedfollowingdisdandexpecteddfindingdindadpatientdwithdadthoracostomydconnecteddtodadches tddrainagedsystem? Answer:dDd-dCORRECTdANSWER-A)doutputdofd 200 dmL/hr B) tubingdclampdcloseddfordtransport C) dependentdloopsdindthedtubingdtodpromoteddrainage D) fluctuationsdindthedwaterdserialdchamberd*** Whichdofdthedfollowingdpatientsdwarrantsdreferraldtodadburndcenter? Answer:dCd-dCORRECTdANSWER-A)dad 21 - dyeardolddfemaledwithdadpartialdthicknessdburndtodthedrightdforearm B) ad 40 - yeardolddhypertensivedmaledwithdadsuperficialdburndtodthedback C) ad 52 - yeardoldddiabeticdmaledwithdpartialdthicknessdburndtodthedleftdlowerdlegd*** D) ad 35 - yeardolddhyperlipidemicdfemaledwithdsuperficialdburnsdtodthedanteriordthorax. AdpatientdhasdbeendindthedEDdfordseveraldhoursdwaitingdtodbedadmitted.dHedsustaineddmultipledribdfr acturesdanddadfemurdfracturedafterdadfall.dHedhasdbeendawake,dalert,danddc/odlegdpain.dHisdwifedrepo rteddsuddenlydbecomingdanxiousdanddconfused.dUpondreassessment,dthedpatientdisdrestless,dwithdr espiratoryddistressdanddpetechiaedtodhisdneck.dthedpatientdisdexhibitingdsignsdofdsymptomsdcommon lydassociateddwithdwhichdofdthedfollowingdconditions? Answer:dBd-dCORRECTdANSWER-A)dacutedlungdinjury B) fatdembolismd*** C) PTX D) pulmonarydcontusion Whichdisdthedeffectdofdhypothermiadondthedoxyhemoglobinddissociationdcurve? Answer:dAd-dCORRECTdANSWER- A)dHemoglobinddoesdnotdreadilydreleasedoxygendfordusedbydthedtissuesd*** B) Thedamountdofdoxygendavailabledtodthedtissuesdincreases C) Tissuedoxygenationd(PaO2)dincreases D) Hemoglobindmoleculedsaturationd(SaO2)ddecreases Ad 20 - yeardolddmaledpresentsdtodthedEDdc/odseveredlowerdabddpaindafterdlandingdharddondthedbicycledcrossd barsdwhichdperformingdandaerialdBMXdmaneuver.dSecondarydassessmentdrevealsdlowerdabddtender nessdanddscrotaldecchymosis.dWhichdofdthedfollowingdordersdwoulddthednursedquestions? Answer:dCd-dCORRECTdANSWER-A)dFastdexam B) CTdscan C) straightdcathdfordurinedsampled*** D) icedanddelevationdofdthedscrotum
B) Preparedfordcricothyroidotomy C) administerdreversaldmedications
D) contactdanesthesiadfordassistance Thedtraumadnursedknowsdthatdplacingdadbariatricdpatientsdindad"rampeddposition"dprovidesdbetterdvis ualizationdduringdthedinsertiondofdwhichddevice? Answer:dCd-dCORRECTdANSWER-A)dIntraosseousdline B) orogastricdtube C) ETdtubed*** D) urinarydcatheter YoudaredcaringdfordadpatientdwhodwasdinvolveddindadMVAdanddisd 32 dweeksdpregnant.dFindingsdofdyourd secondarydsurveydincludedabddpaindondpalpation,dfundaldhighdatdthedcostaldmargin,danddsomeddarkd bloodydshow.dVarying,daccelerationsdandddecelerationsdarednoteddondthedcardiotocography.dThesedf indingsdaredmostdconsistentdwithdwhichdofdthedfollowing? Answer:dAd-dCORRECTdANSWER-A)dplacentaldabruptiond*** B) pretermdlabor C) uterinedrupture D) fetalddemise
