TNCC final exam: open book: TNCC final exam open book
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
Answer: c
- to measure oxygenation and ventilation
- to quantify the base deficit for the adequacy of cellular perfusion
- *to gauge end-organ perfusion and tissue hypoxia **
- to determine the underlying cause of shock
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The patient is demonstrating signs and symptoms of which stage of shock?
Answer: A
- compensated **
- Progressive
- irreversible
- decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home that day. she denies any loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and nausea. Which is a most likely cause of her symptoms?
Answer: D
- epidural hematoma
- diffuse axonal injury
- post-concussive syndrome 1 / 3
- subdural hematoma ***
EMS brings a patient who fell riding his bicycle. Using the American College of Surgeons screening guidelines, which assessment finding would prompt the nurse to prepare the patient for radiologic spine clearance?
Answer: D
- Alert with no neurologic deficits
- Multiple abrasions to the extremities
- Multiple requests of water
- Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C
- The driver of the vehicle collides with the steering wheel
- the vehicle collides with a tree
- the aorta is torn at its attachment with the ligamentum arteriosum
- the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following a high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary survey, which of the following is the priority interventions?
Answer: A
- initiate transfer to a trauma center **
- provide report to the operating room nurse
- Obtained imaging studies
- Place a gastric tube
- / 3
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C
- spleen
- lung
- bowel ***
- brain
Patients with a crush injury should be monitored for which of the following conditions?
Answer: C
- Hypernatremia
- Hypercalcemia
- Dysrhthmias **
- polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B
- Weakness in the lower extremities
- Priapism ***
- voluntary anal sphincter tone
- intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs?
Answer: D
- Bradycardia and ipsilateral absences of motor function
- Tachycardia and respiratory depression
- Tachycardia and absent motor function below the level of injury
- Bradycardia and absent motor function below the level of the injury ***
- / 3