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TNCC 9th Edition Practice Exam: Trauma Care Q&A, Exams of Nursing

A review of trauma care concepts and protocols for the TNCC 9th edition, featuring questions and answers on hemorrhage control, airway management, respiratory support, circulation, head injury and hypothermia management. It covers assessment techniques like AVPU and LACE, urinary catheterization contraindications, and ventilator alarm troubleshooting. Also addresses rapid sequence intubation (RSI), cerebral perfusion pressure (CPP), intracranial pressure (ICP), and management of corneal injuries, orbital fractures, neck injuries, and thoracic skeletal fractures. Key signs like Beck's triad, Kehr's sign, Cullen's sign, and Grey Turner's sign are highlighted, along with musculoskeletal injury and electrical burn classifications. This serves as a quick reference for healthcare professionals in trauma care, offering a structured overview of critical procedures and assessments.

Typology: Exams

2024/2025

Available from 05/19/2025

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TNCC 9th Edition Practice Exam
Questions and Answers 2025
MARCHxmneumonicx-xCORRECTxANSWER-
MassivexHemorrhage:xControlxwithxcombatxgauze,xceloxxgauze,xorxchitoxgauze;xreplacementxofxbloo
dxlossxwithxwholexbloodxorx1:1:1xratioxofxplasma,xRBC,xandxplateletsxtoxachievexSBPxofx80-90mmHg.
Airway:xEstablishxandxmaintainxpatentxairway
Respiration:xDecompressxsuspectedxtensionxpneumothorax,xsealxopenxchestxwounds,xandxsupport
xventilationxandxoxygenationxasxrequired.
Circulation:xProvidexvascularxaccessx(IV/IO)xandxadministerxfluidsxasxrequiredxtoxtreatxshock
Headxinjury/Hypothermia:xPreventxorxtreatxhypotensionxandxhypoxiaxtoxpreventxworseningxofxTBIxan
dxpreventxorxtreatxhypothermia.
AVPUx-xCORRECTxANSWER-
AssessingxAlertnessxA:xAlertxandxoriented
V:xRespondsxtoxverbalxstimuli
P:xRespondsxonlyxtoxpainfulxstimulixU:xUn
responsive
LACEx-xCORRECTxANSWER-
SoftxTissuexInjuriesxL:xLacerations
A:xAbrasions,xAvulsionsxC:xC
ontusions
E:xEdema,xEcchymosis
UrinaryxCatheterxContraindicationsx-xCORRECTxANSWER-ifxurethralxtranssectionxisxsuspected:
-bloodxatxthexurethralxmeatus
-perinealxecchymosis
-scrotalxecchymosis
-high-ridingxorxnonpalpablexprostate
BreathingxInterventionxReassessmentx-xCORRECTxANSWER-1.xAttachxCO2xdetector
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TNCC 9th Edition Practice Exam

Questions and Answers 202 5

MARCHxmneumonicx-xCORRECTxANSWER- MassivexHemorrhage:xControlxwithxcombatxgauze,xceloxxgauze,xorxchitoxgauze;xreplacementxofxbloo dxlossxwithxwholexbloodxorx1:1:1xratioxofxplasma,xRBC,xandxplateletsxtoxachievexSBPxofx 80 - 90mmHg. Airway:xEstablishxandxmaintainxpatentxairway Respiration:xDecompressxsuspectedxtensionxpneumothorax,xsealxopenxchestxwounds,xandxsupport xventilationxandxoxygenationxasxrequired. Circulation:xProvidexvascularxaccessx(IV/IO)xandxadministerxfluidsxasxrequiredxtoxtreatxshock Headxinjury/Hypothermia:xPreventxorxtreatxhypotensionxandxhypoxiaxtoxpreventxworseningxofxTBIxan dxpreventxorxtreatxhypothermia. AVPUx-xCORRECTxANSWER- AssessingxAlertnessxA:xAlertxandxoriented V:xRespondsxtoxverbalxstimuli P:xRespondsxonlyxtoxpainfulxstimulixU:xUn responsive LACEx-xCORRECTxANSWER- SoftxTissuexInjuriesxL:xLacerations A:xAbrasions,xAvulsionsxC:xC ontusions E:xEdema,xEcchymosis UrinaryxCatheterxContraindicationsx-xCORRECTxANSWER-ifxurethralxtranssectionxisxsuspected:

  • bloodxatxthexurethralxmeatus
  • perinealxecchymosis
  • scrotalxecchymosis
  • high-ridingxorxnonpalpablexprostate BreathingxInterventionxReassessmentx-xCORRECTxANSWER-1.xAttachxCO2xdetector
  1. Listenxoverxepigastrum
  2. Bilateralxbreathxsoundsxatxmidaxillaryxandxmidclavicularxlines
  3. Colorxchangexafterx 6 xbreaths
  4. Monitorxskinxcolor;xgetxxr TroubleshootingxVentilatorxAlarmsx-xCORRECTxANSWER- D:xDisplacedxTubexO:xObstructedxorxKinkedxTube P:xPneumothorax

Thexaveragexbloodxpressurexinxaxsinglexcardiacxcycle,xroughlyxcalculatedxasxthexSBPx+x 2 xxxthexDBP/ Avoidxhypoxemiaxinxthexpatientxwithxheadxtraumax-xCORRECTxANSWER- Axsinglexepisodexofxhypoxemiax(PaO2x<60mmHg)xcanxbexdetrimentalxtoxthexpatient'sxoutcome.xMain tainxpulsexoxxatx95%xorxgreaterxandxobtainxABGxmeasurementxasapxforxpatientxwithxseverexTBI. MaintainxETCO2xbetweenx 35 - 45 xmmHg

ManagexICPxinxthexpatientxwithxheadxtraumax-xCORRECTxANSWER- AnxICPxsustainedxatxgreaterxthanx 22 xmmHgxandxunresponsivextoxtreatmentxisxassociatedxwithxpoorx outcomes IncreasedxICPxAssessmentxFindingsx-xCORRECTxANSWER- Early:xHeadache;xn/v;xamnesia;xbehaviorxchangesx(restlessness,ximpairedxjudgement;xdrowsiness) ;xalteredxlevelxofxconsciousnessx(hyperarousabilityxandxhypoarousability) Late:xDilated,xnonreactivexpupils;xunresponsivextoxverbalxorxpainfulxstimuli;xabnormalxmotorxpostur ingx(flexion,xextension,xflaccidity);xCushingxresponse:xWideningxpulsexpressure,xreflexxbradycardia ,xandxdecreasedxrespiratoryxeffort. CornealxInjuryx-xCORRECTxANSWER- AssessmentxFindings:xPhotophobia,xpain,xeyexredness,xlidxswelling,xFBxsensation Treatment:xTopicalxanesthesia,xtopicalxophthalmicxNSAID,xnoxeyexpatch,xremovexFB,xmayxneedxtopi calxabxxforxlaceration. Followxup:xwithxophthalmologistxinx 24 - 48 xhours;xophthalmologyxconsultationxforxdeepxandxlargexFB OrbitalxFracturex-xCORRECTxANSWER- AssessmentxFindings:xPeriorbitalxecchymosis,xfacialxswelling,xdoublexvision,xenophthalmosx(poste riorxdisplacementxofxeyeballxwithinxorbit,xptosis. Treatment:xNasalx decongestant,xicexpacksxtoxthexorbitx forx 48 xhours,x oralxabxx Followxup:xMayxr equirexsurgery,xophthalmology.xAvoidxblowingxnose,xsneezing,xandxValsalvaxmaneuver Retrobulbarxhematomax-xCORRECTxANSWER- AssessmentxFindings:xSeverexpain,xdecreasedxvisionxorxlossxofxvision,xreducedxeyexmovement,xdou blexvision,xIOP

40mmHg Treatment:xAdministerxmedicationsxtoxdecreasexIOP,xemergencyxdecompressionxviaxlateralxcantho tomy Followxup:xEmergentxconsultationxwithxophthalmology GlobexRupturex-xCORRECTxANSWER-AssessmentxFindings:xIrregularxorxteardrop- xshapedxpupils,xperiorbitalxecchymosis,xdecreasedxvisualxacuityxandxEOM,xseverexsubconjunctivalx

Followxup:xOphthalmologyxconsultationxandxclosexfollowxup. NeckxInjuriesx-xCORRECTxANSWER- 3 xzones. Mortalityxisxthexhighestxwithxinjuriesxtoxzonex 1 xandxpatientsxwhoxhavexdysphonia,xdysphagia,xsubcut aneousxemphysema,xorxhematomasxtoxthexneckxregionxindicatingxvascularxtrauma,xairwayxinjuries,x orxesophagealxinjuriesxthatxmayxnotxbexdiagnosedxonximagingxstudies. Penetratingxthoracicxwoundxbelowxthexfourthxintercostalxspacex-xCORRECTxANSWER- xPenetrationxintoxthexabdominalxcavityxisxsuspectedxuntilxprovenxotherwise ThoracicxSkeletalxFracturesxandxAssociatedxInjuriesx-xCORRECTxANSWER- Sternal:xBluntxcardiacxinjury;xpneumothorax Firstxandxsecondxrib:xGreatxvesselxinjuries,xbrachialxplexusxinjuries,xheadxandxspinalxcordxinjuries Multiplexribsxandxflailxchest:xpulmonaryxcontusion;xpneumothorax;xhemothoraxxLowerxrib sx 7 - 12:xLiverxforxrightxsided;xspleenxforxleftxsided Beck'sxTriadx-xCORRECTxANSWER-Threexsignsxofxacutexcardiacxtamponade:

  1. Lowxarterialxbloodxpressure
  2. Distant,xmuffledxheartxsounds
  3. Distendedxneckxveins Pneumothoraxxwithxpositivexpressurexventilationx-xCORRECTxANSWER- Ventilatedxpatientsxwithxevenxaxsmallxpneumothoraxxarexatxhighxriskxforxexpansionxofxthexpneumoth oraxxorxdevelopmentxofxaxtensionxpneumothorax HemothoraxxManagement:xLarge-BorexChestxTubex-xCORRECTxANSWER- Bloodxisxthickxandxhasxthexabilityxtoxclotxoffxsmallerxdiameterxtubes.xThexlargestxborexchestxtubexforxt hexsizexofxthexpatientxshouldxbexconsideredxtoxavoidxunnecessaryxtubexobstruction PulmonaryxContusionx-xCORRECTxANSWER- Pulmonaryxcontusionsxmayxproducexonlyxvaguexsymptomsxandxbeginxtoxprogressxatx 4 - 6 xhoursxfollowingxthextrauma;xtheyxcanxtakexasxlongxasx 24 - 48 xhoursxtoxfullyxdevelop.xCarexofxaxpulmonaryxcontusionxisxgenerallyxsupportivexinxnature--

maximizingxoxygenationxandxpainxmanagement.xJudiciousxusexofxfluidsxshouldxbexconsideredxtoxprev entxincreasexinxintraparenchymalxhemorrhage,xatelectasis,xorxconsolidationxbyxinfusingxfluidsxintoxth exinjuredxregionxofxthexlung. Pulsusxparadoxusx-xCORRECTxANSWER- decreasexinxsystolicxBPxofxmorexthanx10mmHgxwithxnormalxinspiration.xItxisxcausedxbyxaxfallxinxcardi acxoutputxasxaxresultxofxincreasedxnegativexintrathoracicxpressurexduringxinhalation.xAsxpressurexwi thinxthexthoraxxfalls,xbloodxpoolsxinxthexlargexveinsxofxthexlungsxandxthorax,xandxstrokexvolumexisxdec reased. **NeverxclampxthexCT,xotherwisexaxtensionxpneumothoraxxmayxdevelop

nyxcortexxisxnotxcompletelyxinterruptedxComminuted:xbonexisxspli nteredxintoxfragmentsxGreenstick:xbonexbendsxorxisxbuckled Impacted:xbonexisxwedgedxintoxdistalxandxproximalxfracturexsitesxDisplace d:xbonexfracturexsitesxarexnotxaligned CompartmentxSyndomex-xCORRECTxANSWER-PainxPressure Pulses

ParesthesiaxPar alysisxPallorxPoi kilothermia Hyperkalemiax 12 - 36 xhoursxafterxinjuryxevent ElectricalxBurnsx-xCORRECTxANSWER-Doxnotxlabelxasx'exit'xorx'entrance',xbutxasx'contactxpoint' DisseminatedxIntravascularxCoagulopathyx-xCORRECTxANSWER- Decreasedxplateletxcount,xdecreasedxfibrinogen,xelevatedxfibrinxdegradationxproduct,xelevatedxd- dimer,xprolongedxprothrombinxtime,xprolongedxpartialxthromboplastinxtime