TCRN Trauma Certified Registered Nursing 3

Question 1

A patient involved in a high-speed MVC presents with hypotension, distended neck veins, and muffled heart sounds. This triad is MOST consistent with:

Accepted Answer

Cardiac tamponade

Answer

Beck's triad—hypotension, distended neck veins, and muffled heart sounds—is the classic presentation of cardiac tamponade from pericardial blood accumulation.

Question 2

When using the Parkland formula for fluid resuscitation in a 70 kg adult with 40% TBSA burns, how much lactated Ringer's should be given in the first 8 hours?

Accepted Answer

5,600 mL

Answer

Parkland formula: 4 mL × kg × %TBSA = 4×70×40=11,200 mL total; half (5,600 mL) is given in the first 8 hours post-burn.

Question 3

A pediatric trauma patient weighing 20 kg requires a fluid bolus for suspected hemorrhagic shock. The appropriate initial bolus is:

Accepted Answer

400 mL lactated Ringer's

Answer

Pediatric initial fluid resuscitation is 20 mL/kg of isotonic crystalloid; 20 mL × 20 kg = 400 mL.

Question 4

Which mechanism of injury is MOST associated with a duodenal hematoma in a pediatric patient?

Accepted Answer

Direct blow to the epigastrium from bicycle handlebars

Answer

Handlebar injuries cause a direct compressive force to the epigastrium, trapping the duodenum against the spine and causing hematoma formation.

Question 5

A TCRN is caring for a patient with a traumatic brain injury. The cerebral perfusion pressure (CPP) is calculated as:

Accepted Answer

MAP minus ICP

Answer

CPP = MAP − ICP; the target CPP in TBI management is typically 60-70 mmHg to ensure adequate cerebral blood flow.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Trauma Certified Registered Nursing 3