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. An intubated trauma patient's ventilator shows rising peak airway pressures with sudden hemodynamic deterioration. What should the nurse suspect? → Tension pneumothorax
3. Which intervention is contraindicated in a patient with suspected esophageal perforation from trauma? → Nasogastric tube insertion by the nurse without further assessment
4. 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
5. 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
6. At which level of complete cervical spinal cord injury would a patient most likely require permanent mechanical ventilation? → C3
7. Cushing's triad, the late sign of increased ICP, includes which three findings? → Bradycardia, hypertension, and irregular respirations
8. 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
9. 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
10. 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
11. Which incomplete spinal cord syndrome has the POOREST prognosis for functional motor recovery? → Anterior cord syndrome
12. Autonomic dysreflexia is a potentially life-threatening complication that occurs primarily in patients with spinal cord injuries at what level or above? → T6
13. Which position is recommended for patients with TBI to minimize ICP elevation? → Head of bed elevated 30 degrees with head midline
14. 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
15. What does the L stand for when using the acronym AMPLE to quickly acquire crucial information about the patient's history? → last meal
16. When withdrawing and securing a pistol from a trauma victim's pocket, what should they first think about? → avoid touching the trigger.
17. What is the target systolic blood pressure for a hypotensive patient with a traumatic brain injury (TBI) per ATLS guidelines? → ≥90 mmHg
18. When checking intracranial pressure in an adult, the trauma nurse must be informed of what the usual range is? → 10 to 15 mm Hg.
19. Diffuse axonal injury (DAI) is best diagnosed by which imaging modality? → MRI of the brain
20. Which intervention is the HIGHEST priority nursing action to prevent pressure injury in a patient with a complete thoracic spinal cord injury? → Repositioning every 2 hours using log-roll technique to maintain spinal alignment
21. 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
22. Which clinical finding is the earliest sign of increasing intracranial pressure (ICP)? → Altered level of consciousness or restlessness
23. Which ECG finding is most associated with myocardial contusion following blunt chest trauma? → New right bundle branch block or ST-segment changes
24. A patient with a high thoracic SCI is noted to have a body temperature that mirrors the room temperature. The nurse documents this as: → Poikilothermia
25. Neurogenic shock following spinal cord injury is characterized by which hemodynamic pattern? → Hypotension with bradycardia and warm, vasodilated extremities
26. Which chest injury is characterized by multiple rib fractures in two or more places creating a free-floating segment? → Flail chest
27. In Brown-Séquard syndrome from right-sided spinal cord hemisection, the nurse expects which deficits on the RIGHT (ipsilateral) side? → Loss of motor function and proprioception
28. A severely injured trauma patient is developing the 'trauma triad of death.' Which of the following components is NOT part of this lethal triad? → Hypocalcemia
29. The patient's temperature should typically be decreased and maintained at? with targeted temperature management (TTM), also known as therapeutic hypothermia. → 32 to 36° C.
30. Which of the following interventions is the priority for a hemodynamically unstable patient with a severe pelvic fracture and a positive FAST exam? → Application of a pelvic binder and transfer to the operating room.