TCRN TCRN Shock and Resuscitation 3

Question 1

A trauma patient with suspected hemorrhagic shock has a lactate of 6.2 mmol/L. What does this value primarily indicate?

Accepted Answer

Severe tissue hypoperfusion and anaerobic metabolism

Answer

A lactate greater than 4 mmol/L indicates severe tissue hypoperfusion and anaerobic metabolism, signaling significant hemorrhagic shock.

Question 2

Which parameter is the most sensitive early indicator of hemorrhagic shock in a healthy young trauma patient?

Accepted Answer

Tachycardia

Answer

Tachycardia is the earliest and most sensitive compensatory response to hemorrhage, occurring before a significant drop in blood pressure.

Question 3

A patient receives 2L of normal saline for hemorrhagic shock resuscitation. Which metabolic complication is a concern?

Accepted Answer

Hyperchloremic metabolic acidosis

Answer

Large volumes of normal saline deliver a high chloride load, causing hyperchloremic (non-anion gap) metabolic acidosis.

Question 4

In permissive hypotension strategy for penetrating trauma, what is the target systolic blood pressure before hemorrhage control?

Accepted Answer

80-90 mmHg

Answer

Permissive hypotension targets a systolic BP of 80-90 mmHg to maintain minimal perfusion while avoiding dislodgment of clots before surgical hemorrhage control.

Question 5

A blunt trauma patient has absent breath sounds on the left, tracheal deviation to the right, hypotension, and SpO2 of 82%. What is the immediate action?

Accepted Answer

Needle decompression of the left chest

Answer

Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression; do not delay for imaging in a hemodynamically unstable patient.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Shock and Resuscitation 3