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TNCC 20th Edition Test Bank: Trauma Nursing Core Course, Exams of Nursing

American InterContinental University (AIU)Nursing

A test bank for the TNCC 20th edition, emphasizing critical thinking in trauma patient management. It features questions and answers on patient assessment, airway management, shock treatment, and pain management in trauma scenarios. Designed to prepare nurses for trauma situations, it tests knowledge and decision-making skills in emergency care. Covering initial assessment, interventions, and ongoing management, it's a valuable resource for nursing students and professionals. This test bank enhances expertise in trauma care and improves patient outcomes, offering a review of trauma nursing principles and practices. Questions promote critical thinking and problem-solving, enabling informed decisions under pressure, emphasizing continuous reassessment and treatment adaptation.

Typology: Exams

2024/2025

Available from 05/16/2025

caroline-njeri 🇺🇸

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TNCC Trauma Nursing Core Course 20th

Edition ENA Test Bank |Graded A+ pass

1. Which of the following requires you to develop a plan of action, initiate the

plan, reassess the plan as care for the patient moves forward, and adjust the

plan as the patient's condition or circumstances change?

A. Principles of PHTLS

B. The Golden Period

C. The XABCDE assessment

D. Critical thinking process - ansQuestion 1: D

To help achieve the PHTLS goals, you will apply your critical thinking skills in the

field. Critical thinking in medicine is a process in which the healthcare practitioner

assesses the situation, the patient, and the resources available and uses the

information to decide on and provide the best care for the patient.

1. You and your partner are responding to a call for a 2-year-old patient with a

burn injury to the hand. He has a visible burn to the left hand, ending at the

level above the wrist, red color, and wet in appearance. What type of burn do

you suspect the patient has sustained?

A. Superficial (first degree)

B. Partial thickness (second degree)

C. Full thickness (third degree)

D. Subdermal (fourth degree) - ansQuestion 1: B

Scald burns are the most common burns seen in the pediatric population ages 1 to

5 years. Scalds are partial thickness burns. The dermal layer is damaged, and

blisters are present or popped. It is also the most painful type of burn.

1. You are called to the scene of a possible mass casualty motor vehicle collision

on the highway. Once you arrive on scene, what is your first priority?

A. Immediately begin triaging patients.

B. Treat the patient with the most visible blood loss.

C. Determine the need for additional resources.

D. Assess the scene and ensure it is safe. - ansQuestion 1: D

Ensure safety for responders, bystanders, and patient(s). The first consideration

when approaching any scene is the safety of all emergency responders. When

EMS personnel become victims, they not only can no longer assist others, but also

add to the number of patients.

1. You are called to the scene of an explosion and fire at a chemical plant where

you find multiple casualties.Triage has begun. Your first patient is a 40-year-old

man who was near the source of the explosion. He is unconscious and has

Partial preview of the text

Download TNCC 20th Edition Test Bank: Trauma Nursing Core Course and more Exams Nursing in PDF only on Docsity!

Edition ENA Test Bank |Graded A+ pass

Which of the following requires you to develop a plan of action, initiate the plan, reassess the plan as care for the patient moves forward, and adjust the plan as the patient's condition or circumstances change? A. Principles of PHTLS B. The Golden Period C. The XABCDE assessment D. Critical thinking process - ansQuestion 1: D To help achieve the PHTLS goals, you will apply your critical thinking skills in the field. Critical thinking in medicine is a process in which the healthcare practitioner assesses the situation, the patient, and the resources available and uses the information to decide on and provide the best care for the patient.
You and your partner are responding to a call for a 2-year-old patient with a burn injury to the hand. He has a visible burn to the left hand, ending at the level above the wrist, red color, and wet in appearance. What type of burn do you suspect the patient has sustained? A. Superficial (first degree) B. Partial thickness (second degree) C. Full thickness (third degree) D. Subdermal (fourth degree) - ansQuestion 1: B Scald burns are the most common burns seen in the pediatric population ages 1 to 5 years. Scalds are partial thickness burns. The dermal layer is damaged, and blisters are present or popped. It is also the most painful type of burn.
You are called to the scene of a possible mass casualty motor vehicle collision on the highway. Once you arrive on scene, what is your first priority? A. Immediately begin triaging patients. B. Treat the patient with the most visible blood loss. C. Determine the need for additional resources. D. Assess the scene and ensure it is safe. - ansQuestion 1: D Ensure safety for responders, bystanders, and patient(s). The first consideration when approaching any scene is the safety of all emergency responders. When EMS personnel become victims, they not only can no longer assist others, but also add to the number of patients.
You are called to the scene of an explosion and fire at a chemical plant where you find multiple casualties.Triage has begun. Your first patient is a 40-year-old man who was near the source of the explosion. He is unconscious and has

Edition ENA Test Bank |Graded A+ pass

extensive injuries. You note gurgling respirations. Why should you use the trauma jaw thrust maneuver first when dealing with a trauma patient? A. It's an easy technique that always works to open the airway.

Edition ENA Test Bank |Graded A+ pass

reports she fell out of her wheelchair earlier in the week but didn't appear to be hurt; however, she's become increasingly disoriented over the last day or so. Vital signs show: BP 110/90; heartrate 118 and irregularly regular; ventilation rate 20 and slightly labored; SpO2 93% on room

Edition ENA Test Bank |Graded A+ pass

air. She is taking warfarin for a clotting issue. Which of the following should you suspect? A. Cerebral contusion B. Epidural hematoma C. Subarachnoid hemorrhage D. Subdural hematoma - ansQuestion 1: D The patient's age, use of a blood thinner, and the fact she fell recently point to a subdural hematoma.

Your partner is compressing the bleeding site of a male patient who was stabbed multiple times in the left chest. The bleeding seems to be controlled, yet the patient becomes combative. He is pale and is breathing rapidly, yet states that he "can't breathe" and feels that he is about to die. Your next step in patient management is to: A. start assisted ventilation. B. give high-flow oxygen. C. decompress the left chest. D. give a 250-mL fluid bolus. - ansQuestion 1: C After X come A and B. You can quickly auscultate the lungs (pneumothorax is almost certain with multiple stabs in the chest) and decompress the chest. Decompressing a tension pneumothorax is the quickest way to treat shock.
Your patient is experiencing severe pain after sustaining a femur fracture in a motorcycle crash. You have a 20 minute transport to the nearest trauma center. There are no other injuries noted on your primary and secondary assessments. Which of the following medications would be the best pain management choice? A. NSAIDs B. Acetaminophen C. Fentanyl D. Morphine - ansQuestion 1: C Fentanyl is often a first-line agent due to speed of onset, short duration of action, and minimal effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV route provides effects instantly whereasthe IN and IM route have an onset of <10 minutes. The duration of fentanyl is short at 30 minutes to an hour. This will provide enough time to ease pain during transport and let the traumacenter decide pain management upon arrival.
A trauma patient from the highway incident is holding her right arm, and you note a significant amount of blood steadily flowing from a long gash. This is an example of what type of hemorrhage? A. Capillary bleeding

Edition ENA Test Bank |Graded A+ pass

During primary survey, you find the following: . LOC: alert and oriented; speaking in full sentences . GCS: 15 . Airway: good air entry to bases . Breathing: bilateral . Circulation: skin warm, flushed, dry . Pulse rate: 112 bpm, strong andregular . BP: 90/42 mm Hg . Pain: Patient complains of severe pain at clavicle site and pain on inspiration at site of possible fractured ribs. No other injuries detected. What is your next step? A. Apply a cervical collar and in-line immobilization device. B. Treat for hypovolemic shock. C. Apply an arm sling for the clavicle injury. D. Administer pain medication. - ansQuestion 2: A Although the patient's GCS is normal, she does have a distracting injury, and the state of her helmet indicates possible spinal compression/flexion, so you should immobilize the patient.
The patient becomes apneic. You suspect he has a cervical injury. Which type of airway should you use? A. Supraglottic airway B. Blind nasotracheal intubation C. Oropharyngeal airway D. Surgical airway - ansQuestion 2: A The supraglottic airway's greatest advantage is that it can be inserted independent of the patient's position, which may be especially important in trauma patients with high suspicion of cervical injury.
The patient's care giver is a babysitter who reports the child was crawling on the counter and placed his hand in a pot of water that was boiling on the stove. She is applying ice to the burn and the child is shivering. What is your next step? A. Administer analgesia for pain. B. Cover the patient with a blanket to stop the shivering. C. Start IV for fluid resuscitation. D. Stop the burning process and remove the ice pack. - ansQuestion 2: D A common error that results in damage to the zone of stasis is the application of ice by a bystander or prehospital care practitioner. When ice is applied to a burn, the patient will experience some reduction in pain; however, the pain relief will be at the expense of additional tissue destruction.

Edition ENA Test Bank |Graded A+ pass

The patient's respiration improves markedly, but he remains confused. He has an absent radial pulse, and his carotid pulse is fast and thready. Your partner asks if he can let the compression go to put in an IV. How should you respond?

Edition ENA Test Bank |Graded A+ pass

You have determined that you are going to need to perform orotracheal intubation on a 50-year-old male motor vehicle crash (MVC) critically injured trauma patient due to prolonged transport time. What do you need to do first?

Edition ENA Test Bank |Graded A+ pass

A. Preoxygenate to maximize oxygen saturation. B. Place the patient in a "sniffing"position. C. Clear the mouth of any obstructions. D. Prepare the patient for immediate transport. - ansQuestion 2: A Before insertion of any invasive airway, the patient is preoxygenated with a high concentration of oxygen using a simple airway adjunct or manual airway procedure.

After exposing the patient, no other burn injuries were found, but blisters have started to form on the hand and the child is crying from pain. How should you manage the blisters? A. Lance the blisters to drain the fluidand relieve the pressure. B. Cover the injury with a dry, loose, sterile dressing, being sure to leave the blisters intact. C. Use a topical antibiotic ointment and firmly wrap the burn injury. D. Establish an IV for fluid resuscitation. - ansQuestion 3: B In the prehospital setting, blisters are generally best left alone during the relatively short transport time. Blisters that have already ruptured should be covered with a clean, dry dressing.
What does the GCS score indicate? A. Mild TBI B. Moderate TBI C. Severe TBI D. No TBI - ansQuestion 3: B A total GCS score of 13 to 15 likely indicates a mild TBI whereas a score of 9 to 12 is indicative of moderate TBI. A GCS score of 3 to 8 suggests severe TBI.
What is the best way to control the bleeding? A. Direct pressure B. Elevation of the arm above the heart C. Tourniquet D. Occlusive dressing - ansQuestion 3: A With venous bleeds, direct pressure isusually sufficient to stop the flow.
When securing a patient to a backboard, which body part should you secure first? A. Head B. Torso C. Legs D. Pelvis - ansQuestion 3: B

Edition ENA Test Bank |Graded A+ pass

A. Preferences B. Phases C. Principles D. Transport - ansQuestion 3: C The science of medicine provides the principles of medical care. Simply stated, principles define the duties required of the prehospital care practitioner in optimizing patient survival and outcome.

While en route to the hospital, you manage to put an 18-gauge IV in the right arm. Your patient is still confused, and you still have no radial pulse. Your next move is to: A. give 1-L fluid bolus. B. give one 250-mL fluid bolus, and then stop. C. give fluid until you get a radial pulse. D. administer TXA. - ansQuestion 3: C Now is the time to titrate IV fluids to restore tissue perfusion. Giving 1 liter blindly could overshoot your target pressure and reinforce internal bleeding. TXA is not a priority, although it can run parallel to fluids.
Why might it be more difficult to deal with an airway obstruction in a child? A. Children have longer tracheas. B. Children have larger heads and tongues so there is a greater potential for airway obstruction. C. Children have smaller heads, so there is less room to clear the obstruction. D. A child's epiglottis is smaller and stiffer than an adult's. - ansQuestion 3: B Children have larger heads and tongues as compared to an adult so there is a greater potential for airway obstruction in a pediatric patient. You must pay special attention to the proper positioning of a pediatric patient to maintain a patent airway.
You are oxygenating a pediatric patient using a properly fitted oxygen mask and the "squeeze-release-release" timing technique. As you watch for the rise and fall of the chest, you check end-tidal CO2 (ETCO2) monitoring aiming to maintain what level? A. Between 40 and 45 mm Hg B. Between 30 and 35 mm Hg C. Between 35 and 40 mm Hg D. The level is irrelevant because capnography is inaccurate in pediatric patients. - ansQuestion 3: C

Edition ENA Test Bank |Graded A+ pass

The proper level to maintain is between 35 and 40 mm Hg.

You are transporting a 37-year-old male patient with a suspected intraabdominal bleed. His blood pressure is 70/50 mm Hg (MAP 57), and his skin is pale and diaphoretic. How will you manage fluid resuscitation for this patient? A. Aggressively administer IV fluids to compensate for internal blood loss. B. Do not administer IV fluids to patients with intra-abdominal bleeding.

Edition ENA Test Bank |Graded A+ pass

blood pressure, so it cannot beused to determine if a patient is hypotensive. Pulse oximetry, not capnography, measures arterial blood saturation. Capnography is not useful in needle decompression.

Edition ENA Test Bank |Graded A+ pass

What type of padding should you provide for this patient? A. Use compressible padding under the shoulders and torso to prevent hyperflexion. B. Use firm padding between the back of the head and the backboard to prevent hyperextension. C. Do not use any padding. It can cause extension or flexion in the neck. D. No padding needed, but to avoid decreased venous return you should tip the backboard to a left lateral position. - ansQuestion 4: B Because the patient is an adult, you should use firm padding between the back of the head and the backboard to prevent hyperextension. You would pad a child's shoulder and torso to prevent hyperflexion, and you would tip the backboard for a pregnant patient to prevent decreased venous return.
When you examine the patient's pupils, you notice the right one is dilated significantly and her motor response on the left is delayed. What does this suggest? A. Coup-countercoup injury B. Hyphema C. Hypoxia D. Uncal herniation - ansQuestion 4: D When the medial portion of the temporal lobe (uncus) is pushed toward the tentorium and puts pressure on the brain stem, herniation compresses CN III, the motor tract, and the reticular activating system on the same side, resulting in a dilated or blown pupil on the same side, motor weakness on the opposite side, and respiratory dysfunction, progressing to coma.
Which of the following is a goal of the Golden Period? A. Provide written documentation from field care to receiving hospital. B. Expedite the field care and transport of the patient. C. Use a team approach for optimal patient care. D. Use the XABCDE approach to patient assessment. - ansQuestion 4: B One of your most importantresponsibilities as a prehospital carepractitioner is to spend as little time onthe scene as possible and expedite yourfield care and transport of the patient.Studies show that the time from injuryto arrival at the appropriate site fordefinitive care is critical to survival.
Why might you consider early mechanical ventilation via bag-mask device in a geriatric patient? A. Shorter tracheas in geriatric patients create the need for ventilation assistance. B. Laxity of the rib cage makes hyperventilation more likely.

Edition ENA Test Bank |Graded A+ pass

Early mechanical ventilation via bag mask device or advanced airway measures should be considered in geriatric trauma patients because of their greatly limited physiologic reserve.

Which of the following signs would be most concerning at this point? A. A drop in systolic blood pressure to 88 mm Hg B. SpO₂ of 93% C. A field GCS motor score of 4 D. Hemiplegia on the left side - ansQuestion 5: A A systolic blood pressure of less than 90 mm Hg indicates secondary brain injury. Her SpO2 is > 90%, and a motor score of 4 is not as concerning.
While attempting to lay the patient supine for spinal motion restriction she becomes increasingly distressed and complains of shortness of breath and difficulty breathing. The fractured clavicle appears to move distally and increases the difficulty of breathing as the patient lies back. What should you do? A. Tip the backboard to a left lateral position. B. Raise the back of the stretcher. C. Let her sit up in a position of comfort. D. Administer morphine. - ansQuestion 5: B Because laying the patient supine increases the risk of airway/ventilation problems, raising the back of the stretchers slightly fundamentally maintains spinal alignment while reducing the ventilation issues.
You now perform a secondary survey. You notice a sternotomy scar. Your patient tells you he is on oral clopidogrel since he had a coronary artery bypass graft 2 years ago. Is this information useful? A. No, he should stop talking and breathe. B. Yes, he should see a cardiologist once in the local hospital. C. Yes, he will need platelets and a heart surgeon ASAP. D. Yes, you should raise his blood pressure up to 130 mm Hg systolic. - ansQuestion 5: C Because he is on clopidogrel, his platelets are out of order for at least 5 days, so he will require urgent platelet transfusion.
According to the Monro-Kellie doctrine, what happens to the brain when it is still in a compensated state after a TBI? A. CSF, ICP, heart rate, and blood pressure are still within normal range. B. CSF increases, ICP decreases, heart rate increases, and blood pressure decreases. C. CSF and blood volume decrease, while heart rate and blood pressure are still

Edition ENA Test Bank |Graded A+ pass

within normál range. D. CSF decreases, ICP increases, heart rate decreases, and blood pressure increases.

ansQuestion 6: C

TNCC 20th Edition Test Bank: Trauma Nursing Core Course, Exams of Nursing

Related documents

Partial preview of the text

Download TNCC 20th Edition Test Bank: Trauma Nursing Core Course and more Exams Nursing in PDF only on Docsity!

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass

Edition ENA Test Bank |Graded A+ pass