Comprehensive TCRN Practice Questions guide with 100% correct answers
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Module
TCRN Practice
Institution
TCRN Practice
1. A transcranial doppler is obtained for a patient with a traumatic subarachnoid hemorrhage. The doppler is positive for vasospasm. The trauma nurse would expect which of the following medications to be prescribed? - correct answerA vasospasm is a known complication of subarachnoid hemorrhages. Ca...
Comprehensive TCRN Practice Questions
guide with 100% correct answers
1. A transcranial doppler is obtained for a patient with a traumatic subarachnoid hemorrhage. The doppler
is positive for vasospasm. The trauma nurse would expect which of the following medications to be
prescribed? - correct answer✔✔A vasospasm is a known complication of subarachnoid hemorrhages.
Calcium channel blockers are used to prevent or reverse vasospasms and are frequently used in the
treatment of a subarachnoid hemorrhage. Metoprolol, Hydralazine and Lisinopril are not calcium
channel blockers and would not be effective to prevent and treat vasospasms caused by a subarachnoid
hemorrhage
2. Which chamber of the heart is most likely to be affected in blunt cardiac injuries? - correct
answer✔✔Given the anatomical position of the heart in the chest, the right ventricle is most exposed
to the anterior portion of the chest wall and is most likely to be injured in a blunt cardiac injury.
Patients with blunt cardiac injuries frequently experience signs of right ventricular failure. Additional
findings that are associated with blunt cardiac injuries include hypotension, atrial fibrillation,
unexplained sinus tachycardia, multiple PVCs, ST segment changes and right bundle branch blocks.
The left atrium, right atrium and left ventricle are less likely to be injured in a blunt cardiac injury.
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3. A widened mediastinum is noted on the chest x-ray of a traumatically injured hypotensive patient. The
trauma nurse would anticipate gathering which of the following pieces of equipment as the highest
priority in this scenario? - correct answer✔✔A widened mediastinum on chest x-ray, accompanied by
hypotension, is strongly indicative of an aortic injury. One of the most life-threatening complications
of an aortic injury is blood loss, which can be treated by giving blood products via a rapid transfuser.
Although patient assessment may be enhanced by inserting an arterial line, this is less of a priority than
giving fluids rapidly. A chest tube is placed in the pleural space rather than the mediastinum and is
therefore not indicated in this scenario. Similarly, there is nothing in this scenario that indicates a
pericardiocentesis is indicated so this is not a higher priority than preparing a rapid transfuser.
4. A properly applied pelvic binder sits across the: - correct answer✔✔A properly applied pelvic binder
is applied across the greater trochanters of the femur. This allows for optimal compression of the pelvis
to control bleeding. Applying it across the midshaft of the femur is too low and would provide no
therapeutic benefit. Applying it across the pelvic ring or the iliac crests is too high and could actually
separate the pelvis further, increasing bleeding and internal damage.
5. Treatment for an extraperitoneal bladder rupture will most likely include: - correct answer✔✔Bladder
lacerations that are located below the pelvic peritoneum are diagnosed as an extraperitoneal bladder
rupture. If a laceration is found along with pelvic peritoneum, it would then be classified as an
intraperitoneal bladder rupture. Management of an extraperitoneal bladder rupture involves urinary
catheterization (urethral or suprapubic) to facilitate urinary drainage from the bladder. Intraperitoneal
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bladder ruptures require surgical intervention for definitive closure. An isolated extraperitoneal bladder
rupture does not require emergent surgical repair or interventional radiology.
6. Hyperextension of the neck is known to cause: - correct answer✔✔Hyperextension of the neck (the
head snapping backwards commonly seen in "whiplash" injuries) causes compression and damage to
the posterior portion of the spinal cord. In anterior cord syndrome, the mechanism of injury is the
opposite of posterior cord syndrome (a hyperflexion injury where the neck hyperextends forward - chin
to chest) causing injury to the anterior portion of the spinal cord. A cauda equina syndrome causes
injury to the sacral nerve roots within the spinal canal and is caused by falling directly on the sacrum.
Brown-Sequard Syndrome caused by penetrating trauma to the lateral aspect of the spinal cord will
cause a left to right phenomenon instead of a top down phenomenon.
7. A patient has a Zone II penetrating neck injury with penetration through the platysma. The trauma
nurse knows that this patient is at increased risk of injury to: - correct answer✔✔The platysma is a
muscle in the neck that gives support and protection to the vital structures underneath it. Any time
there is penetration through the platysma, there is an increased risk of damage to the underlying
structures in the neck. The neck is divided into three zones. Zone I extends from the sternal notch and
clavicle up to the cricothyroid cartilage. Zone II extends from the cricothyroid cartilage upward to the
angle of the mandible. Zone III extends from the angle of the mandible to the base of the skull.
Structures found in Zone I include the subclavian artery, vertebral artery, lung apices, trachea, thyroid
and esophagus. Zone II includes the internal jugular vein, esophagus, larynx, vagus nerve, carotid
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artery and vertebral artery. Zone III includes the salivary and parotid glands, cranial nerves IX-XII,
vertebral artery, distal carotid artery, and distal jugular vein.
8. A pregnant patient's fundal height is palpated 6 cm above the umbilicus. What is the estimated
gestational age of the fetus? - correct answer✔✔Fundal height is defined as the distance from the
pubic bone to the top of the uterus in centimeters. In general, the fundus reaches the umbilicus by 20
weeks. Every centimeter past that point is measured as 1 week. If every one centimeter above the
umbilicus equals one week, then the patient is approximately 26 weeks gestation.
9. Appropriate care for an amputated body part includes: - correct answer✔✔When caring for an
amputated body part, the trauma nurse should clean the part removing any dirt and debris, wrapping
the part in a slightly saline moistened gauze, and then placing it in a sealed plastic bag. At this time,
the part should be placed in a second bag containing a mixture of ice and water. It is imperative that
the part does not freeze or does not come into contact with water (which is hypotonic to body tissue).
Also ensure that the amputated part is properly labeled with the patient information.
10. Decontamination with water is discouraged in patients exposed to powdered: - correct
answer✔✔Dry chemicals that should not be irrigated with water include dry lime, elemental metals
(including sodium, potassium, magnesium lithium and phosphorus) and phenol. When exposed to
water these substances will cause a harmful exothermic or "heat producing" reaction burning the
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