TCRN ACTUAL CERTIFICATION PAPER
2026 QUESTIONS WITH ANSWERS FULL
SOLUTION.
⩥ Glycogenolysis. Answer- Breakdown of glucose stores in the liver to
provide increased circulating glucose, stimulated by Alpha receptors
⩥ Beta 1 Receptors. Answer- *Think: 1 heart
Cause increased heart rate and contractility
⩥ Beta 2 receptors. Answer- *Think: 2 lungs
Cause bronchodilation and increased respiratory rate
⩥ RAAS System. Answer- Increases resorption of sodium and water in
the kidneys to increase vascular volume, decreasing urine output
⩥ 3 hr. Sepsis Bundle. Answer- Lactic level
Blood cultures before antibiotics
Broad spectrum antibiotics
30 ml/kg fluid bolus for hypotension
,⩥ 6 hr. Sepsis Bundle. Answer- Repeat lactic
Start pressors if fluid bolus ineffective
Gain central access for pressors
⩥ Symptoms of Early Shock. Answer- Normotensive with
NARROWING pulse pressure
Tachycardia
Weak and thready pulse
Tachypnea with DEEP respirations
Normal lactic
Cool and clammy
Anxiety, impending doom
Decreased urine output
⩥ Symptoms of Late Shock. Answer- Hypotension
Tachycardia
Tachypnea with shallow respirations
Elevated lactic
Cool, clammy, and mottled skin
Confusion, decreased LOC
SUPER decreased to no urine output
,⩥ Stages of Shock. Answer- 1. Early (Compensatory)
2. Late (Decompensated)
3. Irreversible
⩥ Irreversible Shock Symptoms. Answer- MODS
Severe acidosis
Obtunded
Cardiac arrest
⩥ Trauma Triad of Death. Answer- Hypothermia
Acidosis
Coagulopathy
⩥ Symptoms of Hypothermia. Answer- Decreased cardiac output and
HR (reduced perfusion)
Vasoconstriction
Depressed CNS
Bleeding due to decreased coagulation
⩥ Symptoms of acidosis. Answer- Decreased myocardial contractility
Prolonged PTT
, Increased risk of dysrhythmias
SIRS
⩥ Explain the trauma triad of death. Answer- Hypothermia causes
coagulopathies which worsen acidosis, causing cardiac dysfunction and
further worsening shock
⩥ What blood product is administered for low fibrinogen levels?.
Answer- Cryo
⩥ What blood product is used to address increased PT/PTT?. Answer-
FFP
⩥ What blood product is used for thrombocytopenia?. Answer- Platelets
⩥ Where should tourniquets be placed in relation to the injury?. Answer-
As close to the bleed as possible to preserve as much limb as possible
⩥ Pneumoperitoneum. Answer- Air in the peritoneal cavity that is
related to a ruptured hollow organ
Displays as abdominal distention
⩥ Cullen's sign. Answer-
2026 QUESTIONS WITH ANSWERS FULL
SOLUTION.
⩥ Glycogenolysis. Answer- Breakdown of glucose stores in the liver to
provide increased circulating glucose, stimulated by Alpha receptors
⩥ Beta 1 Receptors. Answer- *Think: 1 heart
Cause increased heart rate and contractility
⩥ Beta 2 receptors. Answer- *Think: 2 lungs
Cause bronchodilation and increased respiratory rate
⩥ RAAS System. Answer- Increases resorption of sodium and water in
the kidneys to increase vascular volume, decreasing urine output
⩥ 3 hr. Sepsis Bundle. Answer- Lactic level
Blood cultures before antibiotics
Broad spectrum antibiotics
30 ml/kg fluid bolus for hypotension
,⩥ 6 hr. Sepsis Bundle. Answer- Repeat lactic
Start pressors if fluid bolus ineffective
Gain central access for pressors
⩥ Symptoms of Early Shock. Answer- Normotensive with
NARROWING pulse pressure
Tachycardia
Weak and thready pulse
Tachypnea with DEEP respirations
Normal lactic
Cool and clammy
Anxiety, impending doom
Decreased urine output
⩥ Symptoms of Late Shock. Answer- Hypotension
Tachycardia
Tachypnea with shallow respirations
Elevated lactic
Cool, clammy, and mottled skin
Confusion, decreased LOC
SUPER decreased to no urine output
,⩥ Stages of Shock. Answer- 1. Early (Compensatory)
2. Late (Decompensated)
3. Irreversible
⩥ Irreversible Shock Symptoms. Answer- MODS
Severe acidosis
Obtunded
Cardiac arrest
⩥ Trauma Triad of Death. Answer- Hypothermia
Acidosis
Coagulopathy
⩥ Symptoms of Hypothermia. Answer- Decreased cardiac output and
HR (reduced perfusion)
Vasoconstriction
Depressed CNS
Bleeding due to decreased coagulation
⩥ Symptoms of acidosis. Answer- Decreased myocardial contractility
Prolonged PTT
, Increased risk of dysrhythmias
SIRS
⩥ Explain the trauma triad of death. Answer- Hypothermia causes
coagulopathies which worsen acidosis, causing cardiac dysfunction and
further worsening shock
⩥ What blood product is administered for low fibrinogen levels?.
Answer- Cryo
⩥ What blood product is used to address increased PT/PTT?. Answer-
FFP
⩥ What blood product is used for thrombocytopenia?. Answer- Platelets
⩥ Where should tourniquets be placed in relation to the injury?. Answer-
As close to the bleed as possible to preserve as much limb as possible
⩥ Pneumoperitoneum. Answer- Air in the peritoneal cavity that is
related to a ruptured hollow organ
Displays as abdominal distention
⩥ Cullen's sign. Answer-
