FREE TNCC Nursing Skills Questions and Answers

Question 1

What is the cause of hypocapnia in a patient with a severe traumatic brain injury?

Accepted Answer

cerebral vasoconstriction

Vasoconstriction will result from hypocapnia or low carbon dioxide levels, particularly in the cerebral vasculature.

Answer

Hypocapnia, or low carbon dioxide levels in the blood, causes cerebral vasoconstriction, meaning the blood vessels in the brain narrow. This reduction in cerebral blood flow can decrease intracranial pressure, which might be a temporary therapeutic goal in severe traumatic brain injury, but prolonged or severe vasoconstriction can lead to cerebral ischemia.

Question 2

The patient who sustained a knife wound to the neck is hemodynamically stable and has an unbroken airway. He laments having trouble speaking and swallowing. For which of the following conditions is further evaluation recommended next?

Accepted Answer

spinal cord injury

Concurrent injuries to the spinal cord, airway, or vascular neck tissues may be present in penetrating neck trauma. The second frequent concomitant injury, with an unharmed airway and hemodynamic stability, is to the spinal cord.

Answer

Penetrating neck trauma, even with a stable airway and hemodynamics, carries a high risk of associated injuries due to the density of vital structures. Difficulty speaking (dysphonia) and swallowing (dysphagia) after such an injury strongly suggest potential damage to laryngeal structures, pharynx, or nerves, which can be indicative of a spinal cord injury or direct nerve damage requiring further evaluation.

Question 3

What could be an indication of cooperation in a 13-month-old involved in a motor vehicle accident?

Accepted Answer

shifts in mental state

Older, aware babies or toddlers may not obey orders and are typically wary of strangers.

Answer

For a 13-month-old, direct cooperation like following commands is not expected, especially in a traumatic situation. Instead, a nurse assesses their mental state and responsiveness. A 'shift in mental state' (e.g., becoming more alert, less irritable, or showing appropriate interaction for their age) would be a positive sign of cooperation or improvement, whereas a lack of cooperation might manifest as wariness or crying, which is normal for this age group in a stressful situation.

Question 4

What is the primary cause of death for trauma patients that can be prevented?

Accepted Answer

uncontrollably bleeding

Since uncontrolled bleeding is the primary factor in avoidable deaths following injuries, identifying and addressing it during the first evaluation procedure is crucial.

Answer

Uncontrolled hemorrhage is widely recognized as the leading cause of preventable death in trauma patients. Rapid identification and effective management of significant bleeding are paramount during the initial assessment and resuscitation phases to improve patient outcomes and prevent mortality.

Question 5

Is there a safe pharmaceutical substitute for opioids in the treatment of rib fracture pain in patients who are anticoagulated?

Accepted Answer

blocks of intercostal nerves

For patients who are anticoagulated, continuous intercostal nerve blocks can offer safe and efficient pain management since they employ long-acting anesthetics.

Answer

For anticoagulated patients with rib fractures, intercostal nerve blocks offer a safe and effective pain management alternative to systemic opioids. These blocks provide targeted pain relief by directly anesthetizing the affected nerves with long-acting anesthetics, minimizing systemic side effects and reducing the risk of bleeding complications associated with other invasive procedures.

TNCC - Trauma Nurse Core Curriculum Practice Test

TNCC - Trauma Nurse Core Curriculum Practice Test

FREE TNCC Nursing Skills Questions and Answers