TCRN Trauma Certified Registered Nursing 5

Question 1

A patient with a suspected cervical spine injury needs airway management. Which technique is preferred?

Accepted Answer

Oral intubation with manual in-line stabilization (MILS)

Answer

Oral intubation with manual in-line stabilization maintains spinal alignment while securing a definitive airway and is the recommended approach in trauma.

Question 2

A restrained driver in an MVC complains of left shoulder pain after abdominal trauma with no external injury. This finding most likely suggests:

Accepted Answer

Kehr's sign indicating splenic injury with diaphragmatic irritation

Answer

Kehr's sign is referred left shoulder pain caused by diaphragmatic irritation from blood or fluid pooling near the spleen, a hallmark of splenic injury.

Question 3

When performing a secondary survey on a trauma patient, the TCRN discovers a pelvic instability on rock testing. The appropriate next action is:

Accepted Answer

Apply a pelvic binder and avoid further manipulation

Answer

Once pelvic instability is detected, further manipulation worsens hemorrhage; a pelvic binder should be applied and the pelvis should not be retested.

Question 4

A trauma patient receives tranexamic acid (TXA). The medication is MOST effective when administered within what time frame from injury?

Accepted Answer

Within 3 hours

Answer

The CRASH-2 trial demonstrated TXA is most effective within 3 hours of injury; administration after 3 hours may increase mortality.

Question 5

Which acid-base disturbance is MOST commonly seen in the early phase of severe hemorrhagic shock?

Accepted Answer

Metabolic acidosis with elevated anion gap

Answer

Tissue hypoperfusion leads to anaerobic metabolism and lactic acid accumulation, producing a high anion gap metabolic acidosis.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN Trauma Certified Registered Nursing 5