TCRN TC-Registered Nurse 4

Question 1

A patient with a suspected spinal cord injury at T4 presents with bradycardia and hypotension but warm, flushed skin. This presentation is MOST consistent with:

Accepted Answer

Neurogenic shock

Answer

Neurogenic shock results from loss of sympathetic tone after high spinal cord injury, causing hypotension with paradoxical bradycardia and warm, vasodilated skin.

Question 2

Which of the following is a definitive airway in trauma management?

Accepted Answer

Cuffed endotracheal tube

Answer

A cuffed endotracheal tube provides a definitive airway by protecting against aspiration and allowing controlled ventilation, which is the standard in trauma airway management.

Question 3

A trauma patient is on a ventilator and the nurse notes rising peak airway pressures with decreased breath sounds on the left. The MOST immediate action is to:

Accepted Answer

Perform immediate needle decompression on the left

Answer

Rising peak airway pressures with absent unilateral breath sounds in a ventilated trauma patient indicates tension pneumothorax requiring emergent needle decompression without delay for imaging.

Question 4

A motorcyclist without a helmet is brought in with a GCS of 9. CT shows epidural hematoma with midline shift. Which pupillary finding is MOST expected?

Accepted Answer

Unilateral fixed dilated pupil on the side of the hematoma (blown pupil)

Answer

Epidural hematoma causes ipsilateral uncal herniation compressing cranial nerve III, resulting in a fixed, dilated (blown) pupil on the same side as the hematoma.

Question 5

Permissive hypotension in a penetrating trauma patient WITHOUT head injury targets a systolic BP of approximately:

Accepted Answer

70–80 mmHg

Answer

Permissive hypotension targets a systolic BP of 70–80 mmHg in penetrating trauma without TBI to reduce clot disruption while maintaining organ perfusion until surgical hemorrhage control.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TC-Registered Nurse 4