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TNCC 9TH EDITION FINAL EXAM TEST - 100 QUESTIONS & CORRECT AND VERIFIED ANSWERS. GRADED A+, Quizzes of Nursing

Lancaster UniversityNursing

"1. A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these findings? A. Rhabdomyolysis B. Fat embolism C. Disseminated intravascular coagulopathy D. Multiple organ dysfunctions syndrome - Correct answer C. Disseminated intravascular coagulopathy" "2. 1. A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? A. Oculomotor nerve palsy B. Globe rupture C. Retrobulbar hematoma D. Retinal detachment - Correct answer B. Globe rupture

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TNCC 9TH EDITION FINAL EXAM TEST - 100 QUESTIONS &
CORRECT AND VERIFIED ANSWERS. GRADED A+, EXAMS OF
NURSING
"1. A trauma patient is being held in the emergency department because there are no available inpatient
beds. The patient sustained a femur fracture and required multiple blood products. The patient now has
blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these
findings?
A. Rhabdomyolysis
B. Fat embolism
C. Disseminated intravascular coagulopathy
D. Multiple organ dysfunctions syndrome - Correct answer C. Disseminated intravascular coagulopathy"
"2. 1. A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
A. Oculomotor nerve palsy
B. Globe rupture
C. Retrobulbar hematoma
D. Retinal detachment - Correct answer B. Globe rupture
Rationale: Head and Torso Trauma\Head Trauma
The globe of the eye consists of multiple layers. The sclera is the white outer layer, while the cornea
covers the iris and pupil. When a full thickness injury occurs to the cornea, sclera, or both, the globe will
rupture, causing the shape of the pupil to become irregular or teardrop-shaped"
"3. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the
following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam. - Correct answer C. Notify the physician"
"4. What is the most important consideration during the initial assessment when caring for an older
adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician - Correct answer B. Medical history including current
medications"
"5. When should the definitive calculation for intravenous fluid resuscitation rate be performed for a
patient with burns?
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TNCC 9TH EDITION FINAL EXAM TEST - 100 QUESTIONS &

CORRECT AND VERIFIED ANSWERS. GRADED A+, EXAMS OF

NURSING

"1. A trauma patient is being held in the emergency department because there are no available inpatient beds. The patient sustained a femur fracture and required multiple blood products. The patient now has blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these findings? A. Rhabdomyolysis B. Fat embolism C. Disseminated intravascular coagulopathy D. Multiple organ dysfunctions syndrome - Correct answer C. Disseminated intravascular coagulopathy" "2. 1. A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected? A. Oculomotor nerve palsy B. Globe rupture C. Retrobulbar hematoma D. Retinal detachment - Correct answer B. Globe rupture Rationale: Head and Torso Trauma\Head Trauma The globe of the eye consists of multiple layers. The sclera is the white outer layer, while the cornea covers the iris and pupil. When a full thickness injury occurs to the cornea, sclera, or both, the globe will rupture, causing the shape of the pupil to become irregular or teardrop-shaped" "3. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the following is the most appropriate next step? A. Clean the ear with a cotton-tipped applicator. B. Pack the ear with gauze. C. Notify the physician D. Document and continue the exam. - Correct answer C. Notify the physician" "4. What is the most important consideration during the initial assessment when caring for an older adult who has sustained serious injuries? A. They are likely to be fearful in the emergency department B. Medical history including current medications C. Availability of support systems after discharge D. Accessibility to a primary care physician - Correct answer B. Medical history including current medications" "5. When should the definitive calculation for intravenous fluid resuscitation rate be performed for a patient with burns?

A. As soon as the patient arrives B. After removal of clothing C. Only at a burn center D. During the circulation assessment - Correct answer B. After removal of clothing Rationale: Musculoskeletal and Wounds\Burns Some fluid will be given initially, but an accurate fluid total is based on percentage of total body surface area which requires a good skin assessment and is calculated after clothing is removed." “6. An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4. kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the cerebral blood flow? A. Decrease the rate of manual ventilation B. Initiate another fluid bolus. C. Recheck endotracheal tube placement. D. Increase the amount of oxygen delivered. - Correct answer A. Decrease the rate of manual ventilation" "7. A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally relieved by pain medications. Which of the following is the priority nursing intervention? A. Elevating the leg above the level of the heart B. Repositioning the leg and applying ice C. Elevating the leg to the level of the heart D. Preparing the patient for ultrasound of the leg - Correct answer C. Elevating the leg to the level of the heart Rationale: Musculoskeletal and Wounds\Musculoskeletal This patient is exhibiting signs of possible compartment syndrome which is a dangerous complication of fractured extremities. The pain is often out of proportion to the injury and might not respond to pain medications. Elevate the limb to the level of the heart to decrease dependent edema but not above the heart, which can cause increased venous congestion and pressure within the compartment." "8. Which of the following situations could cause functional grief? A. Inability to live at home B. Amputation of a limb C. Loss of one's self-image D. Destruction of the patient's car - Correct answer B. Amputation of a limb Rationale: Preparation and Ongoing Care\Psychosocial Aspects Functional grief relates to the loss of body function or body parts such as amputation of a limb, paralysis, or loss of sight." "9. An intubated trauma patient has just been transported back from CT scan. Upon arrival to their room in the emergency department, resistance is noted with bag-mask ventilations and auscultation reveals unequal breath sounds. What is the most appropriate initial intervention for this patient? A. Place the patient back on the ventilator.

assessment findings include widening pulse pressure, reflex bradycardia, and irregular, decreased respiratory effort." "15. A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right lower chest and complaints of shortness of breath. What is the priority intervention? A. Surgical intervention B. Chest tube insertion C. Needle decompression D. Airway and ventilation support - Correct answer D. Airway and ventilation support" "16. A severely injured patient has been intubated and is being mechanically ventilated. The patient has received a balanced resuscitation including multiple blood products. Under which circumstance will it be harder for the hemoglobin to release oxygen to the tissues? A. Decreased pH B. Elevated carbon dioxide level C. Decreased body temperature D. Increased metabolic demand Rationale: Primary Assessment\Airway and Ventilation If the blood is not sufficiently warmed when transfused, it can produce hypothermia. In the oxyhemoglobin dissociation curve, a shift to the left increases the affinity of hemoglobin for oxygen making it harder to release for use by the tissues. Factors that can cause this shift include an elevated pH, decreased carbon dioxide, decreased temperature, and low metabolic demand. - Correct answer C. Decreased body temperature" "17. 1. An older adult presents to the emergency department with complaints of dizziness, headache, and nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant therapy. What is most likely the cause of their symptoms? A. Intracerebral hemorrhage B. Epidural hematoma C. Diffuse axonal injury D. Post-concussive syndrome - Correct answer D. Post-concussive syndrome Rationale: Special Populations\Older Adult Post-concussive syndrome can occur days to weeks after injury or trauma. The other three conditions present as a more rapid decline, especially in patients who are on anticoagulants." "18. Your patient was the unrestrained driver involved in a moderate speed motor vehicle collision. Assessment reveals tenderness in the upper right quadrant, crepitus in the lower right ribs, and ecchymosis around the umbilicus. The nurse is concerned about injury to which organ? A. Transverse colon B. Pancreas C. Liver D. Spleen - Correct answer C. Liver

Rationale: Head and Torso Trauma\Abdominal and Pelvic Trauma Liver injuries are associated with right, lower rib fractures. They also can present with tenderness, guarding, or rigidity in the right upper quadrant, along with ecchymosis of the right upper quadrant or around the umbilicus, known as Cullen's sign" "19. An adult arrives at the emergency department with superficial burns to the extremities following a house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the most likely cause of these symptoms? A. Capillary leak syndrome B. Rhabdomyolysis C. Carbon monoxide poisoning D. Hypothermia - Correct answer C. Carbon monoxide poisoning" "20. A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the water seal chamber during inspiration and expiration. What is the best action for the nurse to take? A. Clamp the chest tube B. Return to the emergency department C. Assist ventilations with bag-mask device D. Continue to the intensive care unit - Correct answer D. Continue to the intensive care unit" "21. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib fractures on the right side, a small pneumothorax on the right, and a Grade III liver injury. The patient was intubated and placed on a ventilator with PEEP. Chest tube was deferred at this time. Upon reassessment, which finding is most concerning? A. Severely diminished breath sounds on the right B. Guarding in the right upper quadrant C. Ecchymosis in the right upper quadrant D. Crepitus to the right chest - Correct answer A. Severely diminished breath sounds on the right" "22. 1. Which one of the following characteristics is found in high performing teams? A. Interdisciplinary collaboration B. Provide on-the-job training C. Work individually D. Minimal feedback to decrease confusion - Correct answer A. Interdisciplinary collaboration" "23. A teenaged patient presents to the emergency department with left arm pain after a ground level fall. The patient identifies as transgender and shares they are homeless. The ED staff are concerned the patient is experiencing human trafficking. What is most consistent with human trafficking? A. The individual appears well nourished. B. Those who are being trafficked rarely seek medical care. C. It is infrequently associated with substance abuse. D. Those experiencing human trafficking rarely self-disclose. - Correct answer D. Those experiencing human trafficking rarely self-disclose."