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Trauma Nursing Core Course Provider Manual
(TNCC) 9th edition Final Test Exam Latest 2025
Whatvarevthevgreatestvrisksvforvtransport?v-vCORRECTvANSWER- Lossvofvairwayvpatency,vdisplacedvobstructivevtubesvlinesvorvcatheters,vdislodgevsplintingvdevices,vn eedvtovreplacevorvreinforcevdressings,vdeteriorationvinvpatientvstatusvchangevinvvitalvsignsvorvlevelvof vconsciousness,vinjuryvtovthevpatientvand/orvteamvmembers Accordingvtovnewtonsvlawvwhichvofvthesevtwovforcevisvgreater:vsizevorvforce?v-vCORRECTvANSWER- Neither.vForveachvforcevtherevisvanvequalvandvoppositevreaction. Whatvisvthevrelationshipvbetweenvmassvandvvelocityvtovkineticvenergy?v-vCORRECTvANSWER- Kineticvenergyvisvequalvtov1/2vthevmassvmultipliedvthevsquarevofvitsvvelocityvthereforevwhenvmassvisv doubledvsovisvthevnetvenergy,vhowever,vwhenvvelocityvisvdoubledvenergyvisvquadrupled. Whatvisvtension?v-vCORRECTvANSWER-stretchingvforcevbyvpullingvatvoppositevends Whatvisvcompression?v-vCORRECTvANSWER-Crushingvbyvsqueezingvtogether Whatvisvbending?v-vCORRECTvANSWER- Loadingvaboutvanvaxis.vBendingvcausesvcompressionvonvthevsidevthevpersonvisvbendingvtowardvintentionvto vthevoppositevside Whatvisvshearing?v-vCORRECTvANSWER- Damagevbyvtearingvorvbendingvbyvexertingvfaucetvdifferentvpartsvinvoppositevdirectionsvatvthevsamevt ime. Whatvisvtorsion?v-vCORRECTvANSWER-Torsionvforcesvtwistvendsvinvoppositevdirections. Whatvisvcombinedvloading?v-vCORRECTvANSWER- Anyvcombinationvofvtensionvcompressionvtorsionvbendingvand/orvshear. Whatvarevthevfourvtypesvofvtraumavrelatedvinjuries?v-vCORRECTvANSWER-
Blunt,vpenetrating,vthermal,vorvblast. Whatvarevcontributingvfactorsvtovinjuriesvrelatedvtovbluntvtraumas?v-vCORRECTvANSWER- Thevpointvofvimpactvonvthevpatient'svbody,vthevtypevofvsurfacevthatvisvhit,vthevtissuesvabilityvtovresis tv(bonevversusvsoftvtissue,vair-filledvversusvsolidvorgans),vandvthevtrajectoryvofvforce. Whatvarevthevsevenvpatternsvofvpathwayvinjuriesvrelatedvtovmotorvvehiclevaccidents?v- vCORRECTvANSWER-Upvandvover,vdownvandvunder,vlateral,vrotational,vrear,vrollvover,vandvejection.
Ventilation:vthevactivevmechanicalvmovementvofvairvintovandvoutvofvthevlungs;vdiffusion:vthevpassivev movementvofvgasesvfromvanvareavofvhighervconcentrationvtovanvareavofvlowervconcentration;vandvper fusion:vthevmovementvofvbloodvtovandvfromvthevlungsvasvavdeliveryvmediumvofvoxygenvtovtheventirevb ody. Whenvwouldvyouvusevavnasopharyngealvairwayvversusvanvoralvpharyngealvairway?v- vCORRECTvANSWER- Nasopharyngealvairwaysvisvcontraindicatedvinvpatientsvwithvfacialvtraumavorvavsuspectedvbasilarvsk ullvfracture.vOralvpharyngealvairwaysvisvusedvinvunresponsivevpatientsvunablevtovmaintainvtheirvairw ay,vwithoutvavgagvreflexvasvavtemporaryvmeasurevtovfacilitatevventilationvwithvavbagvmaskvdevicevorvs pontaneousvventilationvuntilvthevpatientvcanvbevintubated.
DescribevthevmeasurementvofvanvNPAv-vCORRECTvANSWER- Measurevfromvthevtipvofvthevpatient'svnosevtovthevtipvofvthevpatientsvearlobe. MeasurementvofvanvOPAv-vCORRECTvANSWER- Placevthevproximalvendvorvflangevofvthevairwayvadjunctvatvthevcornervofvthevmouthvtovthevtipvofvthevmandibul arvangle. Truevorvfalse:vNPAsvandvOPAsvarevdefinitivevairways.v-vCORRECTvANSWER- False.vWhenvplacingvonevofvthese?vOnevshouldvconsidervthevpotentialvneedvforvavdefinitivevairway. NamevthevthreevwaysvtovconfirmvETTvplacementv-vCORRECTvANSWER- PlacementvofvavCO2vmonitoringvdevice,vAssessingvforvequalvchestvrisevandvfall,vandvlisteningvatvthev epigastriumvandvfourvlungvfieldsvforvequalvbreathvsounds. Whenvcapnographyvmeasurementvreadsvgreatervthanv45MMHG,vthevnursevshouldvconsidervincre asingvorvdecreasingvthevventilationvrate?v-vCORRECTvANSWER- vIncreasingvthevventilationvrate.vDoingvsovwouldvallowvthevpatientvtovblowvoffvretainedvCO2. Whenvcapnographyvmeasurementvreadsvlessvthanv35MMHG,vthevnursevshouldvconsidervincreasingvorvdecr easingvthevventilationvrate?v-vCORRECTvANSWER- Decreasingvthevventilationvrate.vByvdoingvso,vthevnursevallowsvthevpatientvtovretainvCO2. Whatvarevthevthreevstagesvofvshockv-vCORRECTvANSWER- Compensated,vdecompensatedvorvprogressive,vandvirreversible. Whatvarevthevsignsvofvcompensatedvshock?v-vCORRECTvANSWER- Anxiety,vconfusion,vrestlessness,vincreasedvrespiratoryvrate,vnarrowingvpulsevpressurevwerevdiasto licvincreasesvyetvsystolicvremainsvunchanged,vtachycardiavwithvboundingvpulses,vandvdecreasedvur inaryvoutput Whatvarevthevsignsvandvsymptomsvofvdecompensatedvshock?v-vCORRECTvANSWER- vDecreasedvlevelvofvconsciousness,vhypertension,vnarrowvpulsevpressure,vtachycardiavwithvweakvp
Whatvisvthevtraumavtriadvofvdeath?v-vCORRECTvANSWER-hypothermia,vacidosis,vcoagulopathy Describevthevcharacteristicsvofvobstructivevshockv-vCORRECTvANSWER- Obstructivevshockvisvitvmechanicalvproblemvthatvresultsvfromvhypoperfusionvofvthevtissuevduevtovanv obstructionvinveithervthevvasculaturevorvthevheartvresultingvinvdecreasedvcardiacvoutput.vSomevcaus esvincludevavtensionvpneumothorax,vcardiacvtamponade,vorvvenousvairvembolismvonvthevrightvsidev ofvthevheartvduringvsystolevinvthevpulmonaryvartery.Signsvincludevanxiety,vmuffledvheartvsounds,vJV D,vhypertension,vchestvpain,vdifficultyvbreathing,vorvpulsesvparadoxes. Describevthevcharacteristicsvofvcardiogenicvshockv-vCORRECTvANSWER- Cardiogenicvshockvresultsvfromvpumpvfailurevinvthevpresencevofvadequatevintravascularvvolume.vLa ckvofvcardiacvoutputvandvanvorganvperfusionvoccursvsecondaryvtovavdecreasevinvmyocardialvcontrac tilityvandvorvvalvularvinsufficiency.vThisvcanvhappenvwithvbluntvcardiacvtraumavorvanvMI.vSymptomsvc anvincludevlowvbloodvpressurevincreasevheartvratevandvrespiratoryvratevchestvpainvshortnessvofvbrea thvdysrhythmiasvincreasevtroponinvandvpalevcoolvmoistvskin Describevthevcharacteristicsvofvdistributivevshock.v-vCORRECTvANSWER- DistributivevshockvoccursvasvavresultvofvMelvdistributionvofvanvadequatevcirculatingvbloodvvolumevwit hvthevlossvofvvascularvtonevorvincreasedvpermeability.vThisvcanvoccurvwithvspinalvcordvinjuries,vsepsi s,vorvanaphylaxis.vSymptomsvincludevlowvbloodvpressurevheartvratevrespiratoryvratevpreloadvandvaft erload,vspinalvtenderness,vdifficultyvbreathing,vwarmvpinkvandvdryvskinvwithvavcoolvcorevtemperature . Describevthevcharacteristicsvofvhypovolemicvshockv-vCORRECTvANSWER- Hypovolemiavisvcausedvbyvavdecreasevinvthevamountvofvcirculatingvvolumevusuallyvcausedvbyvmassi vevbleeding,vbutvalsovcanvbevfromvvomitingvandvdiarrhea.vCharacteristicsvincludevlowvbloodvpressur evandvpreload,vincreasevheartvratevrespiratoryvratevandvafterload,vwithvcontractilityvunchanged.vSign svincludevobviousvbleeding,vweakvperipheralvpulses,vpalevcoolvandvmoistvskin,vdistendedvabdomen, vpelvicvfracture,vorvbruisevswollenvandvdeformedvextremitiesvespeciallyvlongvbones. Whatvisvthevrecommendedvfluidvbolusvforvavtrauma?v-vCORRECTvANSWER- 500 vML'svofvwarmedvisotonicvcrystalloid.vOngoingvfluidvbolusesvofv 500 vML'svshouldvbevgivenvjudicio
uslyvwithvconstantvreassessmentsvaftervadministration. Whatvisvthevminimumvpermissivevhypertensionvandvavtraumavpatient?v-vCORRECTvANSWER- Avsystolicvofvgreatervthanvorvequalvtov 90 vMMHG Whatvisvthevminimumvpermissivevoxygenationvlevelvofvavtraumavpatient?v-vCORRECTvANSWER- Greatervthanvorvequalvtov94%
mevalthoughvrarevisvwhenvthevpatientvisvunablevtovusevsensevvibrationvinvproprioception Describevonevfatvembolismvsyndromevisvmostvlikelyvtovoccurvinvitsvcharacteristicsv- vCORRECTvANSWER- Withvlongformvfractures.vTachycardia,vThrombocytopenia,vandvpetechiaevrash. WhatvisvthevMunro-Kellievdoctrine?v-vCORRECTvANSWER- Withinvthevskullv80%vhisvbrain,v10%visvblood,vandv10%visvCSF.vAnyvincreasevofvanyvofvthevprodu ctsvresultsvinvincreasedvintracranialvpressure. WhatvarevthevtreatmentvgoalsvforvavTBI?v-vCORRECTvANSWER- O2vsaturationv>vorvequalvtov95%,vsystolicvbloodvpressurev>vorvequalvtov 100 vMMHG,vICPv<v 15 vMMHG,v CPP
vorvequalvtov 60 vMMHG,vnormalvglycemia,vhemoglobinv>vorvequalvtov 7 vg/DL,vsodium 135 - 145,vosmoticvdiuretics,vanti- emetics,vsedatives,vanticonvulsants,vheadvofvbedvatv30°,vandvneckvatvmidline
