TCRN PRACTICE UPDATED ACTUAL Questions and CORRECT Answers
1. When monitoring ICP in an adult, the trauma C. Less than or equal to 15
nurse must be aware the normal range is:
a. <5 -7-15 supine in an adult
b. <10 -If bleeding occurs within the
c. <15 brain, the brain first attempts to
d. <20 compensate by decreasing the
volume of CSF through increased
absorption and decreasing blood
blow, but when the brain can no
longer compensate, the ICP be-
gins to rise very rapidly, resulting
in compression of the tissue and
sometimes brain shift and her-
niation syndromes. If the condi-
tion is not immediately reversed,
it can result in death within a very
short period of time.
2. A patient with a gunshot wound to the abdomen, D: Small intestine
the trauma nurse should anticipate that the organ
most likely to be injured is the With a GSW to the abdomen the
a. colon trauma nurse should anticipate
b. stomach that the organ most likely to be
c. liver injured is the small intestine (ma-
d. Small intestine jority of the time)
3. A 38 year old male receives mannitol to decrease A: hyperkalemia
ICP resulting from a TBI and exhibits cardiac ar-
rhythmias. Which of the following electrolyte ab- Mannitol is administered for
normalities associated with mannitol administra- treatment of cerebral edema, it
tion is most likely the cause of arrhythmias? may result in fluid and elec-
trolyte imbalance with hyper-
, a. hyperkalemia kalemia which can cause cardiac
b. hypokalemia arrhythmias.
c. hypernatremia
d. hypermagnesemia
4. What is mannitol? treatment for cerebral edema
Mannitol is an osmotic diuretic
that increases excretion of both
sodium and water, which will
then cause increase in potassi-
um levels, but will helped reduce
intracranial pressure and brain
mass in TBI patients.
Side ettects: nausea, vomiting,
hypotension, tachycardia, fever
and urticaria
5. If a handgun is found in the pocket of a trauma C: avoid touching the trigger
victim, the first consideration when removing and
securing the gun is to: All guns should be considered
loaded so avoiding touching the
a. place it in a paper bag trigger is the first consideration.
b. arrange for security personnel to remove the
gun. The gun should be removed
c. avoid touching the trigger wearing gloves and handled
d. call the police carefully to avoid disturbing fin-
gerprints or gun powder residue.
It should be placed in a secure
container, never a paper bag.
6.
, If a patient with facial fractures has dentoalveolar B: 30 minutes
trauma with avulsion of permanent teeth, reim-
plantation should ideally be carried out within: Reimplantation should ideally be
carried out within 30 minutes be-
a. 15 minutes cause saving the tooth is often
b. 30 minutes not possible after two hours or if
c. 60 minutes the root is desiccated.
d. 120 minutes If the tooth cannot be immedi-
ately re-implanted, they should
be stored in a moist environment,
such as NS
7. When utilizing the AMPLE acronym to rapidly ob- A: last meal
tain important information about the patients his-
tory, the L stands for: A= allergies
M= medications
a. last meal P= PMHX & surgeries
b. length of time since injury L= last meal
c. legal directives E= Events/ Environment associat-
d. loss of blood ed with injury
8. An 10 month old boy climbed out of his highchair D: evacuation of hematoma
and fell onto a tile floor, the boy hit his head. At
48 hours he experienced fever, weakness on the Acute subdural hematoma, which
right side, seizure, poor feeding and pronounced is most common in children <1
lethargy, indicating a subdural hematoma. Which and often results from falls.
emergent treatment is most indicated? Evacuation of the hematoma
needs to be immediate because
a. insertion of an intracranial pressure-monitoring it presses directly on the brain
device. and can lead to death.
An ICP monitoring device may be
b. intravenous mannitol inserted during surgery to moni-
tor pressure
1. When monitoring ICP in an adult, the trauma C. Less than or equal to 15
nurse must be aware the normal range is:
a. <5 -7-15 supine in an adult
b. <10 -If bleeding occurs within the
c. <15 brain, the brain first attempts to
d. <20 compensate by decreasing the
volume of CSF through increased
absorption and decreasing blood
blow, but when the brain can no
longer compensate, the ICP be-
gins to rise very rapidly, resulting
in compression of the tissue and
sometimes brain shift and her-
niation syndromes. If the condi-
tion is not immediately reversed,
it can result in death within a very
short period of time.
2. A patient with a gunshot wound to the abdomen, D: Small intestine
the trauma nurse should anticipate that the organ
most likely to be injured is the With a GSW to the abdomen the
a. colon trauma nurse should anticipate
b. stomach that the organ most likely to be
c. liver injured is the small intestine (ma-
d. Small intestine jority of the time)
3. A 38 year old male receives mannitol to decrease A: hyperkalemia
ICP resulting from a TBI and exhibits cardiac ar-
rhythmias. Which of the following electrolyte ab- Mannitol is administered for
normalities associated with mannitol administra- treatment of cerebral edema, it
tion is most likely the cause of arrhythmias? may result in fluid and elec-
trolyte imbalance with hyper-
, a. hyperkalemia kalemia which can cause cardiac
b. hypokalemia arrhythmias.
c. hypernatremia
d. hypermagnesemia
4. What is mannitol? treatment for cerebral edema
Mannitol is an osmotic diuretic
that increases excretion of both
sodium and water, which will
then cause increase in potassi-
um levels, but will helped reduce
intracranial pressure and brain
mass in TBI patients.
Side ettects: nausea, vomiting,
hypotension, tachycardia, fever
and urticaria
5. If a handgun is found in the pocket of a trauma C: avoid touching the trigger
victim, the first consideration when removing and
securing the gun is to: All guns should be considered
loaded so avoiding touching the
a. place it in a paper bag trigger is the first consideration.
b. arrange for security personnel to remove the
gun. The gun should be removed
c. avoid touching the trigger wearing gloves and handled
d. call the police carefully to avoid disturbing fin-
gerprints or gun powder residue.
It should be placed in a secure
container, never a paper bag.
6.
, If a patient with facial fractures has dentoalveolar B: 30 minutes
trauma with avulsion of permanent teeth, reim-
plantation should ideally be carried out within: Reimplantation should ideally be
carried out within 30 minutes be-
a. 15 minutes cause saving the tooth is often
b. 30 minutes not possible after two hours or if
c. 60 minutes the root is desiccated.
d. 120 minutes If the tooth cannot be immedi-
ately re-implanted, they should
be stored in a moist environment,
such as NS
7. When utilizing the AMPLE acronym to rapidly ob- A: last meal
tain important information about the patients his-
tory, the L stands for: A= allergies
M= medications
a. last meal P= PMHX & surgeries
b. length of time since injury L= last meal
c. legal directives E= Events/ Environment associat-
d. loss of blood ed with injury
8. An 10 month old boy climbed out of his highchair D: evacuation of hematoma
and fell onto a tile floor, the boy hit his head. At
48 hours he experienced fever, weakness on the Acute subdural hematoma, which
right side, seizure, poor feeding and pronounced is most common in children <1
lethargy, indicating a subdural hematoma. Which and often results from falls.
emergent treatment is most indicated? Evacuation of the hematoma
needs to be immediate because
a. insertion of an intracranial pressure-monitoring it presses directly on the brain
device. and can lead to death.
An ICP monitoring device may be
b. intravenous mannitol inserted during surgery to moni-
tor pressure
