TCRN Cheat Sheet 2026

The 30 highest-yield TCRN facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. An Rh-negative pregnant trauma patient at 20 weeks gestation requires Rh immunoglobulin (RhoGAM). What is the standard initial dose and timing? → 300 mcg within 72 hours
2. A morbidly obese trauma patient (BMI 48) requires endotracheal intubation. Which airway challenge is most likely compared to a non-obese patient? → Rapid oxygen desaturation due to reduced functional residual capacity
3. A patient with blunt abdominal trauma is noted to have bile-stained peritoneal fluid on diagnostic peritoneal lavage. Which injury is most likely? → Duodenal or biliary tract injury
4. A trauma patient arrives with a Glasgow Coma Scale (GCS) score of 8. Which component breakdown best reflects this score? → Eye opening 2, Verbal 2, Motor 4
5. Which Gustilo-Anderson classification of open fracture carries the highest risk of infection and amputation? → Type IIIC
6. Which spinal injury pattern is associated with a 'chance fracture'? → Flexion-distraction injury at the thoracolumbar junction from lap belt use
7. A patient with blunt chest trauma has paradoxical chest wall movement. Which intervention takes priority? → Administer high-flow oxygen and prepare for intubation
8. A trauma patient with spinal cord injury at T6 complains of severe headache and has a BP of 220/115 mmHg. What condition should the nurse immediately suspect? → Autonomic dysreflexia
9. During massive transfusion, which electrolyte imbalance is most commonly associated with rapid infusion of packed red blood cells? → Hypocalcemia
10. Permissive hypotension in a penetrating trauma patient WITHOUT head injury targets a systolic BP of approximately: → 70–80 mmHg
11. A trauma nurse is subpoenaed to testify about a patient's care. The nurse's best source of information during testimony is: → The contemporaneous medical record documented at the time of care
12. An intubated trauma patient's ventilator shows rising peak airway pressures with sudden hemodynamic deterioration. What should the nurse suspect? → Tension pneumothorax
13. A burn patient develops hoarseness, stridor, and oropharyngeal edema 2 hours after a house fire. What is the priority intervention? → Perform early endotracheal intubation
14. Which intervention is contraindicated in a patient with suspected esophageal perforation from trauma? → Nasogastric tube insertion by the nurse without further assessment
15. Which of the following is an indication for emergent surgical airway (cricothyrotomy) in a trauma patient? → Failed intubation with inability to ventilate by BVM
16. When caring for a patient in a halo vest cervical stabilization device, what item is MOST critical to keep immediately at the bedside at all times? → A wrench or tool to quickly remove the anterior vest bolts for chest access
17. When assessing pupils in a TBI patient, which finding indicates the most critical concern? → One fixed, dilated pupil on the side of a known hematoma
18. Which fluid is the PREFERRED initial resuscitation fluid for hemorrhagic shock according to current ATLS guidelines? → Warm lactated Ringer's solution
19. Which burn wound finding indicates the need for skin grafting rather than expectation of spontaneous healing? → Deep partial-thickness burn not healed by 14–21 days
20. At which level of complete cervical spinal cord injury would a patient most likely require permanent mechanical ventilation? → C3
21. Cushing's triad, the late sign of increased ICP, includes which three findings? → Bradycardia, hypertension, and irregular respirations
22. In damage control resuscitation, the target ratio for packed red blood cells (pRBCs), fresh frozen plasma (FFP), and platelets is: → 1:1:1
23. A trauma patient receives 10 units of PRBCs during massive transfusion. Which complication is specifically associated with this volume of transfusion? → Transfusion-associated circulatory overload (TACO)
24. During resuscitation of a trauma patient with hemorrhagic shock, which finding indicates successful resuscitation? → Lactate clearance of >10% per hour
25. A trauma patient develops acute agitation, tachycardia, diaphoresis, and hypertension 6 hours after admission. The nurse should FIRST consider: → Alcohol withdrawal
26. When calculating fluid resuscitation using the Parkland formula for a 70 kg patient with 30% TBSA burns, what is the total 24-hour lactated Ringer's volume? → 8,400 mL
27. A trauma patient's arterial blood gas shows: pH 7.28, PaCO2 38, HCO3 16, PaO2 92 on 4L NC. This pattern is MOST consistent with: → Metabolic acidosis
28. Which medication is the FIRST-LINE treatment for anaphylaxis in a trauma patient who develops a hypersensitivity reaction to blood products? → Epinephrine 0.3 mg IM
29. A trauma patient develops Beck's triad. Which intervention is MOST immediately appropriate? → Pericardiocentesis
30. Which finding is most characteristic of carbon monoxide poisoning in a burn patient? → Cherry-red skin color