TCRN TCR-Nurse 4

Question 1

A patient arrives after a high-speed MVC with a seat-belt sign across the abdomen. Which injury pattern should the trauma nurse suspect?

Accepted Answer

Chance fracture with hollow viscus injury

Answer

A seat-belt sign across the abdomen is classically associated with Chance fractures (lumbar flexion-distraction) and hollow viscus (bowel) injuries from the lap belt.

Question 2

Which crystalloid solution is preferred in damage control resuscitation for hemorrhagic shock?

Accepted Answer

Balanced resuscitation with PRBCs, FFP, and platelets in 1:1:1 ratio

Answer

Damage control resuscitation uses PRBCs, FFP, and platelets in a 1:1:1 ratio to replicate whole blood and correct trauma-induced coagulopathy.

Question 3

A geriatric trauma patient takes beta-blockers daily. Which assessment finding may be masked by this medication?

Accepted Answer

Tachycardia

Answer

Beta-blockers blunt the compensatory tachycardia response to hemorrhage, making heart rate an unreliable indicator of shock in these patients.

Question 4

A patient with a pelvic fracture from a crush injury has ongoing hemodynamic instability despite resuscitation. Which intervention should the trauma nurse anticipate FIRST?

Accepted Answer

Application of a pelvic binder

Answer

A pelvic binder is the immediate intervention to reduce pelvic volume and tamponade venous bleeding before more definitive treatment.

Question 5

Tranexamic acid (TXA) is MOST effective when given within what time frame after injury?

Accepted Answer

Within 3 hours

Answer

TXA reduces mortality when given within 3 hours of injury; evidence from the CRASH-2 trial shows no benefit and possible harm when given after 3 hours.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCR-Nurse 4