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TCRN NEW EXAM REVIEW 2022 TRY MOST CHALLENGING QUESTIONS ON COMING EXAM IN THIS DOCUMENT (GRADED A SOLUTION WITH ALL CORRECT ANSWERS)$15.99
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tcrn new exam review 2022 try most challenging questions on coming exam in this document graded a solution with all correct answers
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TCRN NEW EXAM REVIEW 2022 TRY MOST CHALLENGING QUESTIONS ON
COMING EXAM IN THIS DOCUMENT (GRADED A SOLUTION WITH ALL CORRECT
ANSWERS)
Fluid resuscitation is undertaken for the patient in late, decompensatory hypovolemic shock.
Which of the following findings indicates that this treatment is having its intended effect? An
elevation in the:
A. Pulse pressure
B. Urinary output
C. Respiratory rate
D. Serum lactate levels - CORRECT ANSWER B
A decrease in urinary output is associated with decompensatory hypovolemic shock, therefore
an increase in this parameter is an indication of successful treatment. Pulse pressure,
respiratory rate and serum lactate levels all increase with decompensatory shock, therefore an
elevation in these levels is not associated with successful treatment.
A patient receives 2 units of whole blood during the resuscitation phase of trauma. When
documenting intake for the resuscitation, the trauma nurse will record what volume of fluid to
account for those two units of while blood?
A. 400 mL
B. 500 mL
C. 800 mL
D. 1000 mL - CORRECT ANSWER D
Which of the following factors is considered the most accurate indicator of successful
resuscitation in the patient with hypovolemic shock?
A. Base deficit
B. Mental status
C. Urinary output
D. Blood pressure - CORRECT ANSWER A
Tissue hypoxia causes the base deficit to decrease. Since tissue hypoxia is associated with
inadequate fluid resuscitation, normalization of the base deficits associated with successful
treatment. Alteration of mental status and an elevation in blood pressure are associated with
successful treatment of hypovolemic shock but these parameters may be altered by many
other factors including the use of beta-blocker medication, vasoconstriction associated with
shock and use of alcohol or other illicit substances. Therefore, these indicators are less accurate
than the base deficit. Similarly, an increase in urinary output is associated with successful
resuscitation but may be altered by pre-existing renal failure, diabetes insipidus and other
confounding factors. Therefore arterial base deficit is the most accurate indicator of adequate
fluid resuscitation in the patient with hypovolemic shock.
The trauma nurse knows that an elevation of which of the following laboratory values is
associated with disseminated intravascular coagulation?
, A. D-Dimer
B. Hematocrit
C. Platelet count
D. Fibrinogen levels - CORRECT ANSWER A
Disseminated intravascular coagulation (DIC) results in abnormal increase in clotting. Fibrin
degradation products are released from the breakdown of formed clots therefore increasing
the D-dimer. The bleeding associated with DIC would cause the hematocrit to decrease rather
than elevate. Consumption of clotting factors caused by abnormal clotting would cause the
platelet count and fibrinogen level to drop rather than elevate.
The trauma nurse knows that a patient who successfully deals with the crisis of a traumatic
event shortly after the injury is more likely to:
A. Handle future crisis effectively
B. Avoid complications such as sepsis during the recovery phase
C. Become alienated from family members who are not dealing with the crisis.
D. Decompensate emotionally and fail to progress during the rehabilitation phase of recovery. -
CORRECT ANSWER A
One of the advantages of effective crisis management is the development of new skills which
allows the individual to handle future crisis more effectively. The onset of sepsis is independent
of the ability of the patient to handle crisis early. A patient who is able to handle the crisis of a
traumatic injury is more likely to assist the family to deal with the crisis rather than alienate
them. Patients who deal with the crisis immediately after the injury do not have a higher rate of
decompensation during the rehabilitation phase of recovery.
The trauma nurse knows that the most common onset of symptoms of post-traumatic stress
disorder occurs at what time frame following the traumatic event?
A. 4 weeks
B. 3 months
C. 1 year
D. 3 years - CORRECT ANSWER B
Although the onset of post-traumatic stress disorder can occur at any time interval following a
traumatic event, the most likely time of onset is approximately 3 months after the event. It
generally does not appear as early as 4 weeks after the event and frequently occurs before one
or three years.
A patient is admitted to the trauma unit after being extricated from underneath a concrete slab
following an explosion. As part of the patient's treatment plan, the trauma nurse administers
intravenous insulin and dextrose. Which of the following findings indicates that this treatment
is having its intended effect? The patient's:
A. Urine returns to an amber color
B. Level of consciousness improves
C. White blood cell count increases
D. Serum potassium levels decrease. - CORRECT ANSWER D
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