TCRN TCRN Shock and Resuscitation 5

Question 1

A trauma patient with known coagulopathy and hemorrhagic shock has a fibrinogen level of 80 mg/dL. Which product should be prioritized?

Accepted Answer

Cryoprecipitate

Answer

Cryoprecipitate is the most concentrated source of fibrinogen and is indicated when fibrinogen is critically low (below 100-150 mg/dL) in coagulopathic hemorrhage.

Question 2

When managing hemorrhagic shock with a junctional wound (groin/axilla) where direct pressure is ineffective, what device is recommended?

Accepted Answer

Junctional tourniquet (e.g., JETT or SAM-JT)

Answer

Junctional tourniquets like the JETT or SAM-JT are designed to control hemorrhage in anatomical junctions where limb tourniquets cannot be applied.

Question 3

A patient presents with anaphylactic shock with refractory hypotension despite epinephrine. The patient takes lisinopril daily. Why may epinephrine be less effective?

Accepted Answer

ACE inhibitor use is associated with bradykinin accumulation causing refractory vasodilation

Answer

ACE inhibitors block bradykinin breakdown, leading to bradykinin accumulation that causes severe vasodilation refractory to epinephrine in anaphylaxis.

Question 4

Which finding on point-of-care ultrasound (POCUS/FAST exam) indicates a hemodynamically significant pericardial effusion causing obstructive shock?

Accepted Answer

Right ventricular diastolic collapse

Answer

Right ventricular diastolic collapse on ultrasound is the hallmark sign of cardiac tamponade causing hemodynamically significant pericardial effusion.

Question 5

A pediatric trauma patient weighing 20 kg is in hemorrhagic shock. What is the initial fluid bolus dose?

Accepted Answer

300 mL of normal saline

Answer

Pediatric initial fluid resuscitation for hemorrhagic shock is 10-20 mL/kg; for a 20 kg child, 300 mL represents a 15 mL/kg bolus within this range.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Shock and Resuscitation 5