TNCC 9th Edition FINAL TEST Open Book Questions and Answers 2024

1. 1. An adult patient who sustained a severe head trauma has been intubat- ed 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 (4.0 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.: A. Decrease the rate of manual ventilation 2. 2. 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: 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. 3. 3. 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: B. Medical history including current medications 4. 4. You are caring for a patient who was thrown from a bike and was not wearing a helmet. While performing the head-totoe 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.: C. Notify the physician 5. 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: 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. 6. In a motor vehicle collision, which injury pathway is most likely to in- crease the patient's morbidity and mortality? A. Rotational B. Ejection C. Lateral D. Rollover: B. Ejection 7. 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: 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.