TCRN TCRN Special Patient Populations 5

Question 1

A morbidly obese trauma patient (BMI 48) requires endotracheal intubation. Which airway challenge is most likely compared to a non-obese patient?

Accepted Answer

Rapid oxygen desaturation due to reduced functional residual capacity

Answer

Morbidly obese patients have significantly reduced FRC and increased oxygen consumption, leading to rapid desaturation during apneic periods even with pre-oxygenation.

Question 2

A trauma patient with a known history of alcohol use disorder (AUD) is admitted and becomes agitated with tremors and diaphoresis 24 hours later. What is the priority intervention?

Accepted Answer

IV thiamine followed by benzodiazepine-based CIWA protocol

Answer

Alcohol withdrawal can be life-threatening; IV thiamine prevents Wernicke's encephalopathy and benzodiazepines (guided by CIWA scoring) are first-line treatment for withdrawal symptoms.

Question 3

A trauma patient with spinal cord injury at T6 complains of severe headache and has a BP of 220/115 mmHg. What condition should the nurse immediately suspect?

Accepted Answer

Autonomic dysreflexia

Answer

Autonomic dysreflexia (AD) is a sudden hypertensive crisis in patients with SCI at T6 or above triggered by noxious stimuli below the injury level, most commonly a full bladder.

Question 4

A trauma patient with sickle cell disease is admitted with long bone fractures. Which additional complication should the nurse monitor for that non-sickle cell patients do not face?

Accepted Answer

Vaso-occlusive crisis triggered by hypoxia, dehydration, and stress

Answer

Trauma-induced hypoxia, dehydration, acidosis, and physiologic stress can trigger vaso-occlusive crisis in sickle cell patients, adding significant morbidity beyond the primary injury.

Question 5

A trauma patient is brought in by EMS after a high-speed crash. The patient is combative with pinpoint pupils and bradycardia. What substance should the nurse suspect?

Accepted Answer

Opioid toxidrome

Answer

Pinpoint (miotic) pupils, CNS depression, and bradycardia are classic signs of opioid toxidrome; the combativeness may reflect hypoxic agitation or head injury co-occurring with opioid effects.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Special Patient Populations 5