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. A patient with blunt chest trauma has paradoxical chest wall movement. Which intervention takes priority? → Administer high-flow oxygen and prepare for intubation
2. 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
3. An intubated trauma patient's ventilator shows rising peak airway pressures with sudden hemodynamic deterioration. What should the nurse suspect? → Tension pneumothorax
4. Which intervention is contraindicated in a patient with suspected esophageal perforation from trauma? → Nasogastric tube insertion by the nurse without further assessment
5. 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
6. 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
7. Cushing's triad, the late sign of increased ICP, includes which three findings? → Bradycardia, hypertension, and irregular respirations
8. 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
9. A trauma patient develops Beck's triad. Which intervention is MOST immediately appropriate? → Pericardiocentesis
10. A patient sustains a complete C5 spinal cord injury. Which functional finding would the nurse expect on assessment? → Intact elbow flexion but inability to extend the wrist
11. Which clinical finding best distinguishes neurogenic shock from hemorrhagic shock in a trauma patient with spinal cord injury? → Hypotension with bradycardia and warm vasodilated skin
12. Spinal shock is defined as which of the following phenomena following acute spinal cord injury? → Transient depression of all spinal reflexes and flaccid paralysis below the injury level
13. In a pediatric trauma patient, which finding MOST reliably indicates significant blood loss? → Tachycardia with altered mental status
14. Autonomic dysreflexia is a potentially life-threatening complication that occurs primarily in patients with spinal cord injuries at what level or above? → T6
15. Which position is recommended for patients with TBI to minimize ICP elevation? → Head of bed elevated 30 degrees with head midline
16. A patient with a complete T2 SCI is 48 hours post-injury. Which early complication poses the GREATEST immediate threat to life? → Deep vein thrombosis and pulmonary embolism
17. What does the L stand for when using the acronym AMPLE to quickly acquire crucial information about the patient's history? → last meal
18. A trauma nurse notices a pattern of preventable complications on the unit. The most appropriate professional response is to: → Present findings through the quality improvement process to identify systemic causes
19. When withdrawing and securing a pistol from a trauma victim's pocket, what should they first think about? → avoid touching the trigger.
20. What is the target systolic blood pressure for a hypotensive patient with a traumatic brain injury (TBI) per ATLS guidelines? → ≥90 mmHg
21. When checking intracranial pressure in an adult, the trauma nurse must be informed of what the usual range is? → 10 to 15 mm Hg.
22. Diffuse axonal injury (DAI) is best diagnosed by which imaging modality? → MRI of the brain
23. Which federal law requires healthcare workers to report suspected child abuse regardless of whether the family consents to the disclosure? → Mandatory reporting statutes
24. A patient with a traumatic brain injury has a sudden drop in GCS from 13 to 7 with ipsilateral pupil dilation. This is MOST consistent with: → Epidural hematoma
25. A patient with a complete C6 SCI is preparing for discharge. Which functional skill is a realistic independent goal for this injury level? → Independent intermittent self-catheterization using a tenodesis grip technique
26. Which crystalloid solution is preferred in damage control resuscitation for hemorrhagic shock? → Balanced resuscitation with PRBCs, FFP, and platelets in 1:1:1 ratio
27. Which clinical finding is the earliest sign of increasing intracranial pressure (ICP)? → Altered level of consciousness or restlessness
28. Which ECG finding is most associated with myocardial contusion following blunt chest trauma? → New right bundle branch block or ST-segment changes
29. A trauma patient arrives with a GCS of 8. What is the PRIORITY nursing intervention? → Prepare for definitive airway management
30. A trauma nurse who acts as a patient advocate is primarily responsible for: → Ensuring the patient's rights, preferences, and needs are communicated and protected