TCRN Trauma Certified Registered Nursing 4

Question 1

A trauma patient with a pelvic fracture suddenly develops hemodynamic instability. The PRIORITY nursing intervention is:

Accepted Answer

Apply a commercial pelvic binder or sheet wrap

Answer

A pelvic binder reduces pelvic volume, providing tamponade of venous and arterial bleeding from an unstable pelvic fracture, and is the immediate priority before imaging or surgery.

Question 2

Which laboratory value is the BEST early indicator of tissue hypoperfusion in a trauma patient?

Accepted Answer

Serum lactate

Answer

Serum lactate reflects anaerobic metabolism from tissue hypoperfusion and rises early in shock before other markers change significantly.

Question 3

A patient presents with a traumatic amputation of the right hand. After hemorrhage control, proper handling of the amputated part includes:

Accepted Answer

Wrapping in moist sterile gauze, placing in a sealed bag, then on ice

Answer

The amputated part should be wrapped in moist sterile gauze, placed in a sealed plastic bag, and then placed on ice to cool without freezing the tissue.

Question 4

In damage control resuscitation, the target ratio for packed red blood cells (pRBCs), fresh frozen plasma (FFP), and platelets is:

Accepted Answer

1:1:1

Answer

A 1:1:1 ratio of pRBCs:FFP:platelets mimics whole blood and is the current evidence-based standard for damage control resuscitation in hemorrhagic shock.

Question 5

Which spinal injury pattern is associated with a 'chance fracture'?

Accepted Answer

Flexion-distraction injury at the thoracolumbar junction from lap belt use

Answer

A Chance fracture is a horizontal fracture through all three columns of a vertebra caused by flexion-distraction force, classically from a lap belt in a crash.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Trauma Certified Registered Nursing 4