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SSM TCAR (TRAUMA CARE AFTER RESUSCITATION)
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|NEW AND REVISED|CURRENTLY
TESTING
1. What is the primary focus of Trauma Care After Resuscitation
(TCAR)?
A) Perform surgical intervention in the trauma bay
B) Prevent secondary injury after stabilization
C) Replace emergency department resuscitation
D) Diagnose chronic health conditions in trauma patients
Rationale: TCAR focuses on preventing secondary complications such
as hypoxia, hypotension, and organ failure that occur after the initial
resuscitation phase. The goal is ongoing stabilization and critical care
to prevent further injury.
2. A patient is admitted to the trauma ICU 12 hours after a motor vehicle
crash. Which period is the focus of TCAR interventions?
A) First hour after injury (the “golden hour”)
B) 24-48 hours after injury (the “silver day” period)
C) Rehabilitation phase beginning at day 7
D) Prehospital phase
Rationale: TCAR specifically addresses the “Silver Day” period (24-48
hours post-injury), when complications like organ failure, infection,
and metabolic disturbances typically emerge.
3. The primary goal of the secondary survey in trauma care is to:
A) Identify immediate life-threatening conditions (A, B, C)
,2|Page
B) Detect all other injuries after initial stabilization
C) Prepare the patient for diagnostic imaging
D) Complete the primary survey
Rationale: After the primary survey (ABCDE) is completed and
life-threatening conditions are managed, the secondary survey is a
head-to-toe examination to identify all other injuries that may have
been missed initially.
4. A trauma patient has a base deficit of –8 mEq/L. What does this
indicate?
A) Metabolic alkalosis from vomiting
B) Ongoing tissue hypoperfusion
C) Respiratory acidosis from hypoventilation
D) Adequate resuscitation with balanced fluids
*Rationale: Normal base deficit is –2 to +2. A deficit of –8 indicates
significant metabolic acidosis from hypoperfusion, often seen in
hemorrhagic or septic shock.*
5. A 45-year-old male with blunt chest trauma from a motor vehicle
crash, now 18 hours post-injury, has increasing oxygen requirement
(from 2 L to 6 L nasal cannula) and bilateral crackles. What is the most
likely diagnosis?
A) Aspiration pneumonia
B) Pulmonary contusion evolution
C) Cardiogenic pulmonary edema
D) ARDS (Acute Respiratory Distress Syndrome)
Rationale: ARDS typically develops 12-48 hours after major trauma
due to systemic inflammatory response. Bilateral crackles with
increasing hypoxia after initial stabilization are classic for ARDS, not
just contusion.
6. Which of the following statements best describes knife wounds?
A) Velocity is high; temporary cavity is massive; damage is extensive
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B) Velocity is low; temporary cavity is insignificant; damage is
limited to structures directly in the blade‘s path
C) Velocity is low; temporary cavity depends on knife size; damage is
usually extensive
D) Velocity is high; temporary cavity is small; damage affects structures
at some distance
Rationale: Knife wounds are low-velocity injuries with no significant
temporary cavitation; damage is confined to the blade’s path.
7. Shock occurs when:
A) The sodium-potassium pump fails
B) ATP levels are less than lactic acid levels
C) Cellular oxygen demand is greater than supply
D) Aerobic metabolism exceeds anaerobic metabolism
Rationale: Shock is defined as inadequate tissue perfusion and
oxygenation, leading to cellular hypoxia.
8. A trauma patient with blunt abdominal injury presents with
tachycardia, hypotension, and a distended abdomen. Which organ is
most likely the source of bleeding?
A) Pancreas
B) Spleen
C) Small intestine
D) Gallbladder
Rationale: The spleen is the most commonly injured organ in blunt
abdominal trauma, especially from motor vehicle crashes and
left-sided impacts.
9. Which type of shock is most common immediately after traumatic
injury?
A) Distributive shock
B) Septic shock
, 4|Page
C) Hypovolemic shock
D) Cardiogenic shock
Rationale: Blood loss from trauma leads to hypovolemia, making
hypovolemic shock the most common type of shock in the immediate
post-injury period.
10. Which findings suggest a trauma patient is experiencing cardiogenic
shock?
A) Bradycardia, cyanosis, elevated mean arterial pressure
B) High shock index, mottling, and hypotension
C) Tachycardia, flushing, widened pulse pressure
D) Pallor, coarse breath sounds, hypertension
*Rationale: Cardiogenic shock in trauma presents with high shock
index (HR/SBP > 1), mottling due to poor perfusion, and hypotension,
often from blunt myocardial injury or pre-existing cardiac disease.*
11. Which organ is most sensitive to hypoxia in trauma patients?
A) Liver
B) Kidney
C) Brain
D) Skin
Rationale: The brain is highly sensitive to oxygen deprivation, and
even brief hypoxia can lead to irreversible neurological damage.
12. In trauma patients, the earliest sign of shock is often:
A) Hypotension
B) Tachycardia
C) Bradycardia
D) Cyanosis
Rationale: The body compensates for blood loss by increasing the
heart rate before blood pressure drops. Tachycardia is often the
earliest sign of shock.
SSM TCAR (TRAUMA CARE AFTER RESUSCITATION)
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|NEW AND REVISED|CURRENTLY
TESTING
1. What is the primary focus of Trauma Care After Resuscitation
(TCAR)?
A) Perform surgical intervention in the trauma bay
B) Prevent secondary injury after stabilization
C) Replace emergency department resuscitation
D) Diagnose chronic health conditions in trauma patients
Rationale: TCAR focuses on preventing secondary complications such
as hypoxia, hypotension, and organ failure that occur after the initial
resuscitation phase. The goal is ongoing stabilization and critical care
to prevent further injury.
2. A patient is admitted to the trauma ICU 12 hours after a motor vehicle
crash. Which period is the focus of TCAR interventions?
A) First hour after injury (the “golden hour”)
B) 24-48 hours after injury (the “silver day” period)
C) Rehabilitation phase beginning at day 7
D) Prehospital phase
Rationale: TCAR specifically addresses the “Silver Day” period (24-48
hours post-injury), when complications like organ failure, infection,
and metabolic disturbances typically emerge.
3. The primary goal of the secondary survey in trauma care is to:
A) Identify immediate life-threatening conditions (A, B, C)
,2|Page
B) Detect all other injuries after initial stabilization
C) Prepare the patient for diagnostic imaging
D) Complete the primary survey
Rationale: After the primary survey (ABCDE) is completed and
life-threatening conditions are managed, the secondary survey is a
head-to-toe examination to identify all other injuries that may have
been missed initially.
4. A trauma patient has a base deficit of –8 mEq/L. What does this
indicate?
A) Metabolic alkalosis from vomiting
B) Ongoing tissue hypoperfusion
C) Respiratory acidosis from hypoventilation
D) Adequate resuscitation with balanced fluids
*Rationale: Normal base deficit is –2 to +2. A deficit of –8 indicates
significant metabolic acidosis from hypoperfusion, often seen in
hemorrhagic or septic shock.*
5. A 45-year-old male with blunt chest trauma from a motor vehicle
crash, now 18 hours post-injury, has increasing oxygen requirement
(from 2 L to 6 L nasal cannula) and bilateral crackles. What is the most
likely diagnosis?
A) Aspiration pneumonia
B) Pulmonary contusion evolution
C) Cardiogenic pulmonary edema
D) ARDS (Acute Respiratory Distress Syndrome)
Rationale: ARDS typically develops 12-48 hours after major trauma
due to systemic inflammatory response. Bilateral crackles with
increasing hypoxia after initial stabilization are classic for ARDS, not
just contusion.
6. Which of the following statements best describes knife wounds?
A) Velocity is high; temporary cavity is massive; damage is extensive
,3|Page
B) Velocity is low; temporary cavity is insignificant; damage is
limited to structures directly in the blade‘s path
C) Velocity is low; temporary cavity depends on knife size; damage is
usually extensive
D) Velocity is high; temporary cavity is small; damage affects structures
at some distance
Rationale: Knife wounds are low-velocity injuries with no significant
temporary cavitation; damage is confined to the blade’s path.
7. Shock occurs when:
A) The sodium-potassium pump fails
B) ATP levels are less than lactic acid levels
C) Cellular oxygen demand is greater than supply
D) Aerobic metabolism exceeds anaerobic metabolism
Rationale: Shock is defined as inadequate tissue perfusion and
oxygenation, leading to cellular hypoxia.
8. A trauma patient with blunt abdominal injury presents with
tachycardia, hypotension, and a distended abdomen. Which organ is
most likely the source of bleeding?
A) Pancreas
B) Spleen
C) Small intestine
D) Gallbladder
Rationale: The spleen is the most commonly injured organ in blunt
abdominal trauma, especially from motor vehicle crashes and
left-sided impacts.
9. Which type of shock is most common immediately after traumatic
injury?
A) Distributive shock
B) Septic shock
, 4|Page
C) Hypovolemic shock
D) Cardiogenic shock
Rationale: Blood loss from trauma leads to hypovolemia, making
hypovolemic shock the most common type of shock in the immediate
post-injury period.
10. Which findings suggest a trauma patient is experiencing cardiogenic
shock?
A) Bradycardia, cyanosis, elevated mean arterial pressure
B) High shock index, mottling, and hypotension
C) Tachycardia, flushing, widened pulse pressure
D) Pallor, coarse breath sounds, hypertension
*Rationale: Cardiogenic shock in trauma presents with high shock
index (HR/SBP > 1), mottling due to poor perfusion, and hypotension,
often from blunt myocardial injury or pre-existing cardiac disease.*
11. Which organ is most sensitive to hypoxia in trauma patients?
A) Liver
B) Kidney
C) Brain
D) Skin
Rationale: The brain is highly sensitive to oxygen deprivation, and
even brief hypoxia can lead to irreversible neurological damage.
12. In trauma patients, the earliest sign of shock is often:
A) Hypotension
B) Tachycardia
C) Bradycardia
D) Cyanosis
Rationale: The body compensates for blood loss by increasing the
heart rate before blood pressure drops. Tachycardia is often the
earliest sign of shock.
