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TCRN REVIEW QUESTIONS AND ANSWERS
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TCRN REVIEW QUESTIONS AND ANSWERS
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TCRN REVIEW QUESTIONS AND ANSWERSWhich of the following techniques is used for initial control of hemorrhage to an
extremity?
A. Apply direct pressure to the open wound
B. Apply pressure to the affected pulse point
C. Elevate the extremity above the heart
D. Apply a tourniquet 4 inches above the open wound - answer- A
Injury prevention programs should NOT include which of the following?
A. Non-measurable outcomes
B. Partnerships with communities
C. Monitoring and supporting
D. Intervention strategies - answer- A
Fluid coming from the nose or the ear after a traumatic injury to the head should raise
concern for:
A. LeFort I fracture
B. Occipital fracture
C. Perforated tympanic membrane
D. Basilar skull fracture - answer- D
A patient is coming to the ED following a high-speed MVC. EMS is reporting a GCS of
3; vital signs: HR 65, BP 85/50, RR assisted at 12, O2 sats 94%. Which parameter
increases the risk for long-term disability?
A. Blood pressure 85/50
B. GCS 3
C. HR 65
D. O2 94% even with assistance - answer- A
When greeting the family of a 23 year old male being resuscitated in the trauma bay,
which approach is not an effective way of delivering the patient's condition?
A. Inform at first possible opportunity once patient arrives to ED either by phone or in
person
B. Provide good news first
C. Outline the nature of injuries, what has been done so far, and predict patient course
D. Immediately allow the family into the room during resuscitation - answer- D
When obtaining a history for an injured patient, understanding energy transfer through
biomechanical information helps the nurse to:
A. Anticipate the types of injury that may be present
B. Decide if law enforcement should be notified
C. Determine needed laboratory tests
D. Predict the need for a surgical procedure - answer- A
The major preventable cause of death in the trauma patient is:
,A. Airway compromise
B. Ineffective ventilation
C. Secondary head injury
D. Uncontrolled hemorrhage - answer- D
What is the best position to maintain an open airway in the bariatric patient?
A. Prone
B. Supine
C. Reverse Trendelenburg
D. Right lateral recumbent - answer- C
Your patient has a subdural hematoma sustained while falling down a flight of stairs
after drinking. He is going to the OR in the morning, however, overnight he became
anxious and stated he could not sleep. He vomited once. What is your priority concern
for this patient?
A. Alcohol withdrawal
B. Acute stroke
C. Increased intracranial pressure - answer- C
A patient from the ED has been transferred to your unit. They were resuscitated in the
trauma bay and sustained an open femur fracture that is now immobilized. When the
patient bends her knee on her uninjured leg she has intense left shoulder pain. What is
this called and what does it indicate?
A. Cullen's sign; abdominal bleeding
B. Kehr's sign; undiagnosed PE
C. Kehr's sign; spleen injury
D. Cullen's sign; undiagnosed spine injury - answer- C
A patient involved in an MVC suffered a splenic laceration requiring a splenectomy.
Which vaccine would you expect to administer prior to the surgery?
A. Recombivax HB
B. Tetanus toxoid
C. Attenuvax
D. Pneumovax 23 - answer- D
A patient from the ED has been transferred to the ICU. The patient is hypovolemic and
needs fluid. Which replacement fluid would be indicated without causing significant fluid
shifts across the cellular membranes or vessels?
A. D5 1/2 NS
B. D5W
C. NS
D. 3%NS - answer- C
A patient with a history of a shoulder and elbow dislocation is most likely to experience
which complication?
A. Median nerve damage
, B. Brachial plexus injury
C. Radial nerve damage
D. Humeral head fracture - answer- B
Your patient has just returned from the OR following a complex right tibia-fibula fracture
repair with ORIF and one-compartment fasciotomy. Patient has a well known low
tolerance for pain and is on PCA narcotics for pain control. Upon assessment patient
continues to complain of increased pain, and decreased ability to dorsiflex his right foot.
The nurse believes:
A. Normal post-operative pain and presentation-- call trauma for increased pain meds
B. Deep vein thrombosis
C. Fat embolism syndrome
D. Compartment syndrome - answer- D
A patient on your unit is unable to cooperate verbally with your assessment (either
intubated or has baseline dementia). Which of the following assessments help
determine the risk for compartment syndrome in a patient that cannot verbalize
pain/sensation?
A. Pulselessness
B. Paresthesia
C. Paralysis
D. Pressure - answer- D
A patient is admitted to your unit with previous SCI. The patient begins to have signs
and symptoms of autonomic dysreflexia. Which of the following would indicate a
possible cause for this condition? Select all that apply:
A. Hypertension
B. Kinked catheter tubing
C. New onset wheezing
D. Diarrhea - answer- B and E
A patient with a spinal cord injury at level C3-4 is on your unit. What is the priority
assessment- to start?
A. Determine the level at which patient has intact sensation
B. Assess the level at which the patient has retained mobility
C. Check blood pressure and pulse for signs of neurogenic shock
D. Monitor respiratory effort and oxygen saturation levels - answer- D
The nurse understands that when the spinal cord is injured, ischemia results and edema
occurs. How should the nurse explain to the patient the reason that the extent of the
injury cannot be determined for several days to a week?
A. Tissue repair does not being for 72 hours
B. The edema extends to the level of the injury for two cord segments above and below
the affected level
C. Neurons need time to regenerate so stating the injury early is not predictive of how
the patient progresses
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