TNCC Written Exam 2024 Complete 100 Actual

pg. 1 TNCC Written Exam 2024 Complete 100 Actual Exam Questions with Correct Detailed Answers (Verified Answers) Rated A+

What is the DOPE mnemonic? - Correct Answer - D - Displaced tube

O - Obstruction: Check secretions or pt biting tube

P - Pneumothorax: Condition may occur from original trauma or

barotrauma from ventilator

E - Equipment failure: pt may have become detached from equipment or

there's a kink in the tubing

Explain Hypovolemic Shock. - Correct Answer - Most common to affect a trauma pt cause by hypovolemia.. Hypovolemia, a decrease in amount of circulating blood volume, may result from significant loss of whole blood because of hemorrhage or from loss of semipermeable integrity of cellular membrane leading to leakage of plasma and protein from intravascular space to the interstitial space (as in a burn).

Some causes:

• Blood loss
• Burns, etc.

Define tension pneumothorax. - Correct Answer - Life-threatening injury. Air enters pleural space on inspiration, but air cannot escape on expiration.Rising intrathoracic pressure collapses lung on side of injury causing a mediastinal shift that compresses the heart, great vessels, trachea and uninjured lung. Venous return impeded, cardiac output falls, hypotension results. 1 / 4

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Immediate decompression should be performed. Treatment should not be delayed.

What are the S/S of a tension pneumothorax? - Correct Answer - - Severe respiratory distress

• Markedly diminished or absent breath sounds on affected side
• hypotension
• Distended neck, head and upper extremity veins-may not be clinically

appreciated if significant blood loss present

• Tracheal deviation - shift toward uninjured side (LATE sign)
• Cyanosis (LATE sign)

Define Hemothorax. - Correct Answer - Accumulation of blood in the pleural space.

What are the S/S of Hemothorax? - Correct Answer - - Dyspnea, tachypnea

• Chest pain
• Signs of shock
• Decreased breath sounds on injured side
• Dullness to percussion on the injured side

What is a pulmonary contusion? - Correct Answer - They occur as a result of direct impact, deceleration or high-velocity bullet wounds. It develops when blood leaks into lung parenchyma, causing edema + hemorrhage.This usually develops overtime and not immediately.

What are the S/S of pulmonary contusion? - Correct Answer - - Dyspnea 2 / 4

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• Ineffective cough
• Hemoptysis
• Hypoxia
• Chest pain
• Chest wall contusion or abrasions

What happens to a ruptured diaphragm? - Correct Answer - Potentially life- threatening, results from forces that penetrate the body. Left hemidiaphragm is more susceptible to injury because the right side is protected by the liver.

• Herniation of abdominal contents
• Respiratory compromise b/c impaired lung capacity + displacement of

normal tissue.

• Mediastinal structures may shift to opposite side of injury

What are S/S of a ruptured diaphragm? - Correct Answer - (Anything below the nipple line and should be evaluated for potential diaphragmatic injury).

• Dyspnea or orthopnea
• Dysphagia
• Abdominal pain
• Sharp epigastric or chest pain radiating to left shoulder (Kehr's sign)
• Bowel sounds heard in lower middle chest
• Decreased breath sounds on injured side

What are S/S with tracheobronchial injury? - Correct Answer - Blunt trauma. "Clothesline-type" injuries.

• Dyspnea, tachypnea 3 / 4

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• Hoarseness
• Hemoptysis
• Subcutaneous emphysema in neck, face, or suprasternal area
• Decreased or absent breath sounds
• S/S of airway obstruction

What are S/S with blunt cardiac injury? - Correct Answer - "Cardiac contusion" or "concussion." Common with MVC or falls from heights.

• ECG (sinus tach, PVC's, AV blocks)
• Chest pain
• Chest wall ecchymosis

Explain Cardiogenic Shock. - Correct Answer - Syndrome that results from ineffective perfusion caused by inadequate contractility of cardiac muscle.

Some causes: MI, Blunt cardiac injury, Mitral valve insufficiency,

dysrhythmias, Cardiac Failure

Explain Obstructive Shock. - Correct Answer - Results from inadequate circulating blood volume because of an obstruction or compression of great veins, aorta, pulmonary arteries, or heart itself.

Some causes:

• Cardiac tamponade (may compress the heart during diastole to such and

extent that atria cannot adequately fill, leading to decreased stroke volume).

• Tension pneumothorax may lead to inadequate stroke volume by

displacing inferior vena cava and obstructing venous return to right atrium.

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