FREE TC-Registered Nurse Questions and Answers

Question 1

Which of the following patients is least likely to require monitoring of intracranial pressure?

Accepted Answer

Fifty-year old female with head injury, Glasgow coma score of 14, and BP of 95/60.

Answer

Most patients with mild to severe head injuries and a Glasgow coma score of 13 to 15 do not need ICP monitoring. If a person is >40, postures, and has hypotension (90 systolic), they usually need to be monitored if they have suffered a significant head injury (even with a normal CT scan). With subarachnoid and intraventricular hemorrhage, cerebrovascular accident, brain tumors, brain abscesses/infections, and hydrocephalus, ICP monitoring may be necessary. ICP threshold values range from 20 to 25 mm HG for adults and 20 mm HG for children.

Question 2

Of the following, which is a strict no-no for nasotracheal intubation?

Accepted Answer

Apnea.

Answer

Nasotracheal intubation is completely contraindicated in cases of apnea. The main warning signs are a clinched jaw but with an intact gag reflex and acute respiratory distress due to a suspected or verified cervical spine injury. Depending on where the fractures are and how severe they are, facial and skull fractures may occasionally be contraindicated. The nares must be large enough to accommodate sizes 7 to 8 endotracheal tubes. Prior to inserting the tube, an anti-decongestant, such as phenylephrine 0.5 mg, is typically given to the nose.

Question 3

The patient's temperature should typically be decreased and maintained at? with targeted temperature management (TTM), also known as therapeutic hypothermia.

Accepted Answer

32 to 36° C.

Answer

The patient's temperature should typically be decreased and maintained at 32 to 36° C with targeted temperature management (TTM), also known as therapeutic hypothermia.  (Normal temperature is around 37° C). TTM is normally kept for 24 hours or so. In cases of sepsis, recent surgery (within two weeks), coagulopathy, or pre-existing coma, hypothermia is not advised. Ice packs, cooling blankets, helmets, and cool infusions or instillations can all be used to cool someone down.

Question 4

Which of the following best describes the statement made by a coworker to a recently recruited trauma nurse: "The suggestions you made were a complete waste of time, and if you want to get along with the staff you need to stop trying to make changes."

Accepted Answer

Horizontal/Lateral violence.

Answer

Horizontal/lateral violence happens when a peer or coworker utilizes threats, insults, rudeness, or even physical violence against another person. Others may be victimized or intimidated into obedient behavior. Horizontal aggression can be overt or subtle. In addition to creating a hostile work atmosphere and eroding self-confidence, horizontal violence also lowers staff morale and increases absenteeism. According to studies, more than half of nurses have encountered horizontal violence at work. There should be a code of conduct and a strategy in place for dealing with horizontal violence at each institution.

Question 5

What does the trauma nurse anticipate the patient to do if the paramedic reports that a patient is in transit with a Glasgow Coma Score of 7?

Accepted Answer

be intubated and comatose.

Answer

The trauma nurse anticipates that a patient in transit who has a Glasgow Coma Score of 7 will be intubated and unconscious.  Scores of eight or less signify significant brain damage and a high probability of passing away.  Oftentimes, intracranial pressure is increased.  The range of GSCs is 3 (the lowest and most severe) to 15 (the highest score):
- Mild: 13-15. consciousness for a brief period of time.
- Modest: 9 to 12. Possible localized neurological deficits: confused but able to follow simple instructions.
- Serious 8. The survivor is comatose and needs ventilator support; they most certainly have neurological damage.

TCRN Exam Practice Test

TCRN Exam Practice Test

FREE TC-Registered Nurse Questions and Answers