TCRN TCR-Nurse 2 — Questions and Answers
Question 1: A trauma patient arrives with a GCS of 8. What is the PRIORITY nursing intervention?
- Obtain IV access
- Prepare for definitive airway management (Correct answer)
- Apply cervical collar
- Administer supplemental oxygen via non-rebreather mask
Correct answer: Prepare for definitive airway management
A GCS ≤8 indicates inability to protect the airway, making definitive airway management (intubation) the priority intervention.
Question 2: Which assessment finding is MOST consistent with a tension pneumothorax?
- Bilateral breath sounds with dullness to percussion
- Tracheal deviation away from the affected side with absent breath sounds (Correct answer)
- Tracheal deviation toward the affected side with crackles
- Symmetric chest rise with SpO2 of 88%
Correct answer: Tracheal deviation away from the affected side with absent breath sounds
Tension pneumothorax causes tracheal deviation away from the affected (collapsed) side due to mediastinal shift, along with absent breath sounds.
Question 3: A patient with blunt abdominal trauma has a positive FAST exam. The patient is hemodynamically unstable. What is the appropriate next step?
- CT scan of the abdomen and pelvis
- Diagnostic peritoneal lavage
- Immediate surgical intervention (Correct answer)
- Repeat FAST exam in 30 minutes
Correct answer: Immediate surgical intervention
A hemodynamically unstable patient with free fluid on FAST requires immediate surgery; delaying for CT increases mortality risk.
Question 4: When calculating the Revised Trauma Score (RTS), which THREE parameters are used?
- GCS, respiratory rate, and systolic BP (Correct answer)
- GCS, heart rate, and oxygen saturation
- Systolic BP, heart rate, and respiratory rate
- GCS, pupils, and systolic BP
Correct answer: GCS, respiratory rate, and systolic BP
The Revised Trauma Score uses Glasgow Coma Scale, respiratory rate, and systolic blood pressure, each coded 0–4.
Question 5: A patient presents with paradoxical chest wall movement and severe respiratory distress after a motor vehicle crash. Which injury is MOST likely?
- Open pneumothorax
- Hemothorax
- Flail chest (Correct answer)
- Cardiac tamponade
Correct answer: Flail chest
Paradoxical movement (segment moves inward on inspiration) is the hallmark of flail chest, caused by fractures of three or more consecutive ribs in two places.
Question 6: Which medication is the FIRST-LINE treatment for anaphylaxis in a trauma patient who develops a hypersensitivity reaction to blood products?
- Diphenhydramine 50 mg IV
- Methylprednisolone 125 mg IV
- Epinephrine 0.3 mg IM (Correct answer)
- Albuterol nebulized treatment
Correct answer: Epinephrine 0.3 mg IM
Epinephrine 0.3 mg IM (anterolateral thigh) is the first-line treatment for anaphylaxis regardless of context.
Question 7: A patient with a C5 spinal cord injury would be expected to retain which motor function?
- Wrist extension
- Hand grip
- Elbow flexion (Correct answer)
- Diaphragmatic breathing only
Correct answer: Elbow flexion
C5 innervates the biceps, allowing elbow flexion; wrist extension requires C6, hand grip requires C7–C8.
TCRN TCR-Nurse 2
A trauma patient arrives with a GCS of 8.
What is the PRIORITY nursing intervention?