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TCRN 2024 QUESTIONS WITH CORRECT ANSWERS
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TCRN 2024 QUESTIONS WITH CORRECT ANSWERS
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TCRN 2024 QUESTIONS WITHCORRECT ANSWERS
1)
The mmtrauma mmnurse mmis mmcaring mmfor mma mm6-year-old mmchild mmwho mmsustained
mma mmtackle mmwhile mmparticipating mmin mma mmyouth mmfootball mmgame. mmThe
mmpatient's mmmother mmstates, mm"He mmgot mmthe mmwind mmknocked mmout mmof mmhim."
mmVital mmsigns mmare:
HR mm120 mmbeats/min
BP mm85/50 mmmmHg
RR mm26 mmbreaths/min
SpO2 mm92% mm(room mmair)
Based mmon mmthe mminjury mmpattern, mmthe mmnurse mmsuspects mmwhich mminjury mmis
mmMOST mmlikely?
Possible mmanswer(s):
Cardiac mmcontusion
Tension mmpneumothorax
Pulmonary mmcontusion
Splenic mmrupture mm- mmAnswer mmPulmonary mmcontusion
The mmchest mmwall mmof mma mmchild mmallows mmfor mmpulmonary mmcontusions mmwithout
mmrib mmfractures. mmThe mmchild mmis mmnot mmactively mmhypotensive mmor mmshowing
mmsigns mmof mma mmtension mmpneumothorax. mmCardiac mmcontusion mmcan mmlead mmto
mmdecreased mmcardiac mmoutput, mmtachycardia, mmand mmventricular mmectopy.
mmSplenic mmrupture mmwill mmcause mmhypotension, mmwhich mmthis mmchild mmis mmnot
mmexperiencing.
2)
An mminfant mmwith mma mmhistory mmof mmTrisomy mm21 mmis mmbeing mmevaluated mmstatus
mmpost mmmotor mmvehicle mmcollision. mmThe mmnurse mmanticipates mmwhich mmof mmthe
mmfollowing mmmay mmbe mmrelated mmto mmtraumatic mminjury mmrather mmthan mma
mmhistory mmof mmTrisomy mm21?
Possible mmanswer(s):
atlantoaxial mminstability
limp mmextremities
tongue mmobstruction
bulging mmfontanels mm- mmAnswer mmBulging mmfontanels
,Limp mmextremities, mmtongue mmobstruction mmand mmatlantoaxial mminstability mmmay
mmall mmbe mmcommon mmin mmpatients mmwith mmDown mmsyndrome mm(Trisomy mm21).
mmBulging mmfontanels mmare mma mmsign mmof mmincreased mmintracranial mmpressure mmin
mmthe mminfant mmpatient, mmand mmshould mmbe mmconsidered mmto mmbe mmrelated mmto
mmtraumatic mminjury.
3)
An mmopportunity mmfor mmimprovement mmis mmidentified mmfollowing mma mmpatient
mmdelay mmtransferring mmto mmthe mmoperating mmroom mmand mma mmcorrective mmaction
mmplan mmis mmimplemented. mmWhich mmof mmthe mmfollowing mmprovides mmthe mmBEST
mmexample mmof mmloop mmclosure?
Possible mmanswers:
Communicating mmwith mmthe mmoperating mmroom mmstaff mmon mmhow mmto
mmappropriately mmschedule mmcases
Measuring mmthe mmtime mmto mmthe mmoperating mmroom mmfor mmthe mmnext mm10
mmpatients.
Documenting mman mmeducational mmletter mmsent mmto mmthe mminvolved mmsurgeon
Recording mmdiscussion mmof mmthe mmissue mmin mmpeer mmreview mmminutes mm-
mmAnswer mmMeasuring mmthe mmtime mmto mmthe mmoperating mmroom mmfor mmthe mmnext
mm10 mmpatients.
Comments: mm
Effective mmperformance mmimprovement mmdemonstrates mmthat mmcorrective mmaction
mmhas mmhad mmthe mmdesired mmeffect mmas mmdetermined mmby mmcontinuous
mmmonitoring mmand mmevaluation. mmDemonstrating mmthat mmthe mmtime mmto mmthe
mmoperating mmroom mmis mmwithin mmlimits mmis mmthe mmbest mmway mmto mmdemonstrate
mmeffective mmloop mmclosure mmof mmthis mmperformance mmimprovement mmevent. mmThe
mmothers mmare mmexamples mmof mmactionable mmitems mmbut mmthey mmdon't mmprovide
mmthe mmbest, mmcomplete mmloop mmclosure mmthat mmspecific mmmeasurable mmtime
mmobjectives mmwould.
During mma mmdebrief mmof mma mmtrauma mmactivation, mmthe mmsurgeon mmis mmconcerned
mmthat mmthe mmresuscitation mmeffort mmwas mmvery mmdisorganized mmfrom mmpre-
hospital mmreport mmand mmthroughout mmthe mminitial mmtrauma mmcare. mmWhat mmis mmthe
mmBEST mmexample mmof mman mmintervention mmto mmimprove mmteam mmcommunication
mmin mmfuture mmresuscitations?
Possible mmanswers:
Creating mma mmstandardized mmpre-hospital mmreporting mmtool
Initiating mmpre-arrival mmhuddles
Identifying mmroles mmupon mmpatient mmarrival
,Allowing mmsilence mmfor mmpre-hospital mmproviders mmreport mm- mmAnswer mmInitiating
mmpre-arrival mmhuddles
Clear mmcommunication mmof mmthe mmpatient mmplan, mmroles mmand mmresponsibilities,
mmand mmproviding mman mmopportunity mmto mmdiscuss mmstaff mmconcerns mmare mmpart
mmof mmthe mmpre-arrival mmhuddle. mmThe mmteam mmleader mmcan mmcommunicate
mmanticipated mmresuscitative mmgoals, mmclarify mmassignments, mmand mmassist mmin
mmprioritizing mmcare. mmAllowing mmpre-hospital mmstaff mman mmuninterrupted
mmopportunity mmto mmprovide mmreport mmas mmwell mmas mmcreating mma mmstandardized
mmtool mmwill mmaddress mmthe mmpotential mmloss mmof mmpertinent mminformation mmduring
mmthe mmpre-hospital mmhand-off mmbut mmwill mmnot mmaddress mmthe mmoverall mmteam
mmcommunication mmissue. mmIdentification mmof mmroles mmshould mmbe mmdone mmprior
mmto mmthe mmpatient mmarrival.
A mmpatient mmis mmbeing mmtransported mmby mmprehospital mmpersonnel mmafter mmbeing
mminvolved mmin mma mmmotor mmvehicle mmcollision. mmThe mmpatient's mmassessment
mmreveals mman mmintact mmairway mmand mmthe mmfollowing mmvitals:
BP: mm110/72 mm(mmHg)HR: mm119 mm(beats/min)RR: mm26 mm(breaths/min)Glasgow
mmComa mmScale mm(GCS) mmscore: mm9
The mmMOST mmappropriate mmdestination mmfor mmtransport mmis:
Possible mmanswers:
level mm3 mmtrauma mmcenter mm10 mmminutes mmaway
level mm1 mmtrauma mmcenter mm20 mmminutes mmaway
level mm2 mmtrauma mmcenter mm30 mmminutes mmaway
non-trauma mmcenter mm5 mmminutes mmaway mm- mmAnswer mmlevel mm1 mmtrauma
mmcenter mm20 mmminutes mmaway
The mmpatient mmhas mminjuries mmas mma mmresult mmof mma mmhigh-risk mmauto mmcrash
mmthat mmneed mmto mmbe mmaddressed mmat mma mmtrauma mmcenter. mmA mmlevel mm1
mmtrauma mmcenter mmprovides mmthe mmhighest mmlevel mmof mmtrauma mmcare mmwith
mmin-house mmneurosurgery mmcoverage mmand mmis mmcloser mmthan mmthe mmlevel mm2
mmcenter. mmA mmlevel mm3 mmtrauma mmcenter mmis mmnot mmrequired mmto mmprovide
mmcontinuous mmin-house mmneurosurgery mmcoverage. mmDue mmto mmthe mmpatient's
mmGCS mmless mmthan mmor mmequal mmto mm13, mmthe mmpatient mmshould mmbe
mmevaluated mmby mmthe mmclosest mmtrauma mmcenter mmwith mmpreferential mmevaluation
mmat mmthe mmhighest-level mmtrauma mmcenter.
A mmpatient mmpresents mmfollowing mma mmmotor mmvehicle mmcollision mmand mmhas mman
mmunstable mmpelvis. mmThe mmPRIORITY mmintervention mmis:
Possible mmanswers:
administration mmof mmanalgesics.
, application mmof mma mmpelvic mmbinder.
initiation mmof mmmassive mmtransfusion mmprotocol.
infusion mmof mmcrystalloid mmfluid mm- mmAnswer mmapplication mmof mma mmpelvic mmbinder.
Pelvic mmfractures mmcan mmresult mmin mmblood mmloss mmof mm3000mL. mmUse mmof mma
mmpelvic mmbinder mmwill mmassist mmto mmtamponade mmthe mmbleeding mmin mmthe
mmpelvis mmand mmassist mmwith mmhemostasis. mmBlood mmproduct mmtransfusion mmis
mmpreferred mmover mmcrystalloid mminfusion, mmhowever mmpreventing mmfurther
mmhemorrhage mmis mmthe mmimmediate mmpriority. mmAnalgesic mmadministration mmis
mmimportant mmbut mmis mmnot mmthe mmfirst mmpriority.
The mmnurse mmis mmcaring mmfor mma mmpatient mmwho mmis mmmorbidly mmobese. mmThe
mmpatient mmsustained mma mmhead mminjury mmand mmrequires mmintubation. mmWhen
mminitially mmplacing mmthe mmpatient mmon mma mmventilator, mmthe mmnurse mmshould
mmanticipate mman mmorder mmfor
Possible mmanswers:
FiO2 mmof mm21-25%
PEEP mmof mm5-10 mmcm mmH2O
respiratory mmrate mmof mm25-30 mmbreaths/min.
tidal mmvolume mmof mm750-1000 mmmL. mm- mmAnswer mmtidal mmvolume mmof mm750-1000
mmmL.
Ventilator mmsettings mmfor mma mmpatient mmwith mmobesity mmare mmbased mmon mmideal
mmbody mmweight mmand mmhealthy mmlungs. mmA mmPEEP mmof mm5-10 mmH2O mmis
mmoften mmrequired mmin mmpatients mmwho mmare mmmorbidly mmobese. mmA mmtidal
mmvolume mmof mm750-1000 mmmL mmis mmtoo mmhigh. mmPatients mmoften mmrequire mma
mmFiO2 mmof mmat mmleast mm30. mmEven mmwith mma mmhead mminjury, mmtachypnea mmwith
mma mmrespiratory mmrate mmof mm25-30 mmis mmhigh mmfor mmthis mmpatient.
The mmtrauma mmprogram mmmanager mmof mma mmverified mmtrauma mmcenter
mmrecognizes mmthis mmimportant mmoutreach mmobligation mmto mmlocal mmrural mmarea
mmresources:
Possible mmanswers:
Injury mmprevention mmsupplies
Professional mmeducation
Clinical mmpractice mmguidelines
Medical mmsupply mmresources mm- mmAnswer mmProfessional mmeducation
Trauma mmcenters mmverified mmthrough mmthe mmAmerican mmCollege mmof mmSurgeons
mmhave mman mmobligation mmto mmextend mmeducation mmin mmthe mmform mmof
mmprofessional mmeducation, mmconsultation, mmor mmcommunity mmoutreach. mmMedical
mmand mminjury mmprevention mmsupplies mmare mmnot mman mmobligation mmof mma
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