TCRN TCRN Musculoskeletal and Wound Care 4

Question 1

A patient with a posterior hip dislocation is being reduced. Which post-reduction assessment is MOST critical?

Accepted Answer

Sciatic nerve function assessment

Answer

The sciatic nerve is at risk with posterior hip dislocation; post-reduction assessment of sciatic nerve function (foot dorsiflexion and plantar sensation) is essential.

Question 2

During initial trauma assessment, which finding in a wound bed is MOST consistent with a high-pressure injection injury requiring urgent surgical consult?

Accepted Answer

Small entry wound on the finger with a tense, painful digit out of proportion to appearance

Answer

High-pressure injection injuries create small entry wounds but massive internal destruction requiring emergent surgical decompression to prevent amputation.

Question 3

The Parkland formula for fluid resuscitation in a burn patient with 40% TBSA burn weighing 80 kg orders how much LR in the first 8 hours?

Accepted Answer

6,400 mL

Answer

Parkland formula: 4 mL × kg × %TBSA = 4 × 80 × 40 = 12,800 mL total; half (6,400 mL) is given in the first 8 hours from time of injury.

Question 4

A patient returns from the OR after open tibial fracture fixation. Which assessment finding requires IMMEDIATE intervention?

Accepted Answer

Absent dorsalis pedis pulse not present preoperatively

Answer

A new absent pulse post-fixation suggests vascular injury or compression from hardware, requiring immediate vascular surgery evaluation.

Question 5

Which wound closure method is MOST appropriate for a contaminated wound sustained 10 hours ago?

Accepted Answer

Delayed primary closure after 3-5 days of open wound management

Answer

Contaminated wounds or those older than 6-8 hours are left open for delayed primary closure to reduce infection risk.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Musculoskeletal and Wound Care 4