TCAR POST TEST EXAM / ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES | LATEST UPDATE 2026/2027 | GRADED A+.

TCAR POST TEST EXAM / ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES | LATEST UPDATE 2026/2027 | GRADED A+. A patient involved in a high-speed MVC is found unresponsive with irregular respirations and unequal pupils. Which injury is most likely responsible? A. Basilar skull fracture B. Epidural hematoma C. Diffuse axonal injury D. Subdural hematoma Answer: C. Diffuse axonal injury Rationale: Rapid acceleration-deceleration causes widespread shearing of axons, leading to coma and abnormal respirations without focal bleeding. Epidural and subdural bleeds usually have a lucid interval; basilar fractures present with raccoon eyes or otorrhea. 2. During the primary survey, which assessment finding takes highest priority for immediate intervention? A. Absent radial pulses bilaterally B. Diminished breath sounds on the right C. Open femur fracture with bleeding D. GCS score of 10 Answer: B. Diminished breath sounds on the right Rationale: Airway and breathing come before circulation. Diminished breath sounds suggest tension pneumothorax or hemothorax—lifethreatening until decompressed. 3. A trauma patient with blunt abdominal injury presents with tachycardia, hypotension, and distended abdomen. Which organ is most likely the source of bleeding? A. Pancreas B. Spleen C. Small intestine D. Gallbladder Answer: B. Spleen Rationale: The spleen is the most commonly injured organ in blunt abdominal trauma, especially from MVCs and left-sided impacts. 5. A patient with a suspected pelvic fracture becomes hypotensive and tachycardic. What should the nurse do first? A. Apply a pelvic binder B. Start two large-bore IV lines C. Insert Foley catheter to check urine output D. Prepare for CT scan Answer: A. Apply a pelvic binder Rationale: Stabilizing the pelvis reduces pelvic volume and venous bleeding— key in hemorrhage control before IV or imaging. 6. A 6-year-old is struck by a car and presents with unequal breath sounds, tracheal deviation, and hypotension. What’s the most appropriate immediate intervention? A. Obtain chest X-ray B. Needle decompression in 2nd ICS midclavicular C. Intubate the child D. Administer IV fluids Answer: B. Needle decompression Rationale: Signs indicate tension pneumothorax—an emergency requiring immediate decompression before imaging or intubation. 7. In trauma resuscitation, what best indicates effective fluid resuscitation? A. MAP above 70 mm Hg B. Urine output ≥ 0.5 mL/kg/hr C. HR < 90 bpm D. Improved capillary refill Answer: B. Urine output ≥ 0.5 mL/kg/hr Rationale: Adequate renal perfusion reflects restored end-organ perfusion; urine output is the most reliable bedside indicator. 8. A 25-year-old with a basilar skull fracture should be monitored closely for: A. Airway obstruction B. Intracranial hemorrhage C. CSF leak D. Carotid dissection Answer: C. CSF leak Rationale: Basilar fractures often tear the dura, causing CSF rhinorrhea or otorrhea, creating infection risk (meningitis). 9. A patient has a chest tube placed for hemothorax. Output suddenly stops, and the patient becomes tachypneic and hypotensive. The nurse suspects: A. Tube dislodgement or kinking B. Re-expansion pulmonary edema C. Resolution of bleeding D. Infection Answer: A. Tube dislodgement or kinking Rationale: Sudden cessation of drainage with distress suggests obstruction or displacement of the tube—requires immediate assessment. 10. Which trauma patient should the nurse triage first for evaluation? A. 40-year-old with femur fracture B. 25-year-old with open chest wound C. 60-year-old with scalp laceration D. 19-year-old with arm fracture and stable vitals Answer: B. 25-year-old with open chest wound Rationale: Sucking chest wounds threaten ventilation and oxygenation— lifethreatening; immediate occlusive dressing required. 11. Which finding in a spinal cord injury patient suggests neurogenic shock? A. Cool, clammy skin and tachycardia B. Warm, dry skin and bradycardia C. Hypertension and tachycardia D. Weak peripheral pulses with diaphoresis Answer: B. Warm, dry skin and bradycardia Rationale: Loss of sympathetic tone causes vasodilation and unopposed parasympathetic activity → hypotension, bradycardia, warm dry skin. 4. When performing the secondary survey, the nurse’s primary goal is to: A. Identify immediate life-threatening conditions B. Maintain airway patency C. Detect all other injuries after initial stabilization D. Prepare for diagnostic imaging Answer: C. Detect all other injuries after initial stabilization Rationale: After the primary survey (ABCs) is complete and lifethreatening issues are managed, the secondary survey is a head-to-toe assessment for additional injuries. 12. In a penetrating abdominal trauma, which action should be avoided? A. Cover protruding viscera with moist dressing B. Remove the impaled object to control bleeding C. Monitor for hypovolemic shock