TCRN PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS
GUARANTEED TO PASS.
⫸ A properly applied pelvic binder sits across the:. Ans: A properly
applied pelvic binder is applied across the greater trochanters of the
femur. This allows for optimal compression of the pelvis to control
bleeding. Applying it across the midshaft of the femur is too low and
would provide no therapeutic benefit. Applying it across the pelvic ring
or the iliac crests is too high and could actually separate the pelvis
further, increasing bleeding and internal damage.
⫸ Treatment for an extraperitoneal bladder rupture will most likely
include:. Ans: Bladder lacerations that are located below the pelvic
peritoneum are diagnosed as an extraperitoneal bladder rupture. If a
laceration is found along with pelvic peritoneum, it would then be
classified as an intraperitoneal bladder rupture. Management of an
extraperitoneal bladder rupture involves urinary catheterization (urethral
or suprapubic) to facilitate urinary drainage from the bladder.
Intraperitoneal bladder ruptures require surgical intervention for
definitive closure. An isolated extraperitoneal bladder rupture does not
require emergent surgical repair or interventional radiology.
⫸ Hyperextension of the neck is known to cause:. Ans: Hyperextension
of the neck (the head snapping backwards commonly seen in "whiplash"
,injuries) causes compression and damage to the posterior portion of the
spinal cord. In anterior cord syndrome, the mechanism of injury is the
opposite of posterior cord syndrome (a hyperflexion injury where the
neck hyperextends forward - chin to chest) causing injury to the anterior
portion of the spinal cord. A cauda equina syndrome causes injury to the
sacral nerve roots within the spinal canal and is caused by falling
directly on the sacrum. Brown-Sequard Syndrome caused by penetrating
trauma to the lateral aspect of the spinal cord will cause a left to right
phenomenon instead of a top down phenomenon.
⫸ A patient has a Zone II penetrating neck injury with penetration
through the platysma. The trauma nurse knows that this patient is at
increased risk of injury to:. Ans: The platysma is a muscle in the neck
that gives support and protection to the vital structures underneath it.
Any time there is penetration through the platysma, there is an increased
risk of damage to the underlying structures in the neck. The neck is
divided into three zones. Zone I extends from the sternal notch and
clavicle up to the cricothyroid cartilage. Zone II extends from the
cricothyroid cartilage upward to the angle of the mandible. Zone III
extends from the angle of the mandible to the base of the skull.
Structures found in Zone I include the subclavian artery, vertebral artery,
lung apices, trachea, thyroid and esophagus. Zone II includes the internal
jugular vein, esophagus, larynx, vagus nerve, carotid artery and vertebral
artery. Zone III includes the salivary and parotid glands, cranial nerves
IX-XII, vertebral artery, distal carotid artery, and distal jugular vein.
⫸ A pregnant patient's fundal height is palpated 6 cm above the
umbilicus. What is the estimated gestational age of the fetus?. Ans:
Fundal height is defined as the distance from the pubic bone to the top of
,the uterus in centimeters. In general, the fundus reaches the umbilicus by
20 weeks. Every centimeter past that point is measured as 1 week. If
every one centimeter above the umbilicus equals one week, then the
patient is approximately 26 weeks gestation.
⫸ Appropriate care for an amputated body part includes:. Ans: When
caring for an amputated body part, the trauma nurse should clean the
part removing any dirt and debris, wrapping the part in a slightly saline
moistened gauze, and then placing it in a sealed plastic bag. At this time,
the part should be placed in a second bag containing a mixture of ice and
water. It is imperative that the part does not freeze or does not come into
contact with water (which is hypotonic to body tissue). Also ensure that
the amputated part is properly labeled with the patient information.
⫸ Decontamination with water is discouraged in patients exposed to
powdered:. Ans: Dry chemicals that should not be irrigated with water
include dry lime, elemental metals (including sodium, potassium,
magnesium lithium and phosphorus) and phenol. When exposed to water
these substances will cause a harmful exothermic or "heat producing"
reaction burning the patient's skin. They may also release possible
hazardous byproducts into the air. Sulfuric acid, muriatic acid and
cement can all be irrigated with copious amounts of water (although a
much of the dry chemical as possible should be brushed off before
irrigation with water is initiated)
⫸ Hypovolemic shock is most likely to be caused by:. Ans:
Hypovolemic shock is caused by fluid loss (e.g. bleeding or diarrhea) or
third spacing of fluids. The inflammatory response caused by a burn
, leads to capillary permeability resulting in the third spacing of fluids
which results in hypovolemic shock. Cervical spinal injuries contribute
to neurogenic rather than hypovolemic shock. Although an epidural
hematoma causes blood loss, the epidural space is relatively small, so
blood accumulation would not be enough to result in hypovolemic
shock. A tension pneumothorax would cause obstructive shock.
⫸ The best method for assessing capillary refill on a two-week old
traumatically injured neonate is to blanch the:. Ans: The circulatory
system of the neonate is not well developed and perfusion to the fingers
is not complete, therefore using the tip of the finger is reserved for older
children, adolescents and adults. It is generally recommended to use the
forehead, sole of the foot, the sternum or the palm of the hand as
opposed to the skin over the iliac crest or the tip of the child's tongue
⫸ Enteral feedings are initiated on a traumatically injured patient and
several days later, the trauma nurse notes a significant elevation in serum
blood urea nitrogen (BUN) and creatinine. The trauma nurse should
suspect this may be caused by:. Ans: One of the effects of overfeeding
the traumatically injured patient is azotemia (elevated BUN and
creatinine) and the dietician should be notified of azotemia if it is noted
so that an adjustment in calories may be made. Insufficient protein in the
diet does not cause azotemia. Although bleeding ulcers may cause
elevations in blood urea nitrogen, they do not tend to cause elevations in
creatinine. Feeding a patient too quickly after trauma does not cause
elevations in BUN and creatinine
QUESTIONS WITH ANSWERS
GUARANTEED TO PASS.
⫸ A properly applied pelvic binder sits across the:. Ans: A properly
applied pelvic binder is applied across the greater trochanters of the
femur. This allows for optimal compression of the pelvis to control
bleeding. Applying it across the midshaft of the femur is too low and
would provide no therapeutic benefit. Applying it across the pelvic ring
or the iliac crests is too high and could actually separate the pelvis
further, increasing bleeding and internal damage.
⫸ Treatment for an extraperitoneal bladder rupture will most likely
include:. Ans: Bladder lacerations that are located below the pelvic
peritoneum are diagnosed as an extraperitoneal bladder rupture. If a
laceration is found along with pelvic peritoneum, it would then be
classified as an intraperitoneal bladder rupture. Management of an
extraperitoneal bladder rupture involves urinary catheterization (urethral
or suprapubic) to facilitate urinary drainage from the bladder.
Intraperitoneal bladder ruptures require surgical intervention for
definitive closure. An isolated extraperitoneal bladder rupture does not
require emergent surgical repair or interventional radiology.
⫸ Hyperextension of the neck is known to cause:. Ans: Hyperextension
of the neck (the head snapping backwards commonly seen in "whiplash"
,injuries) causes compression and damage to the posterior portion of the
spinal cord. In anterior cord syndrome, the mechanism of injury is the
opposite of posterior cord syndrome (a hyperflexion injury where the
neck hyperextends forward - chin to chest) causing injury to the anterior
portion of the spinal cord. A cauda equina syndrome causes injury to the
sacral nerve roots within the spinal canal and is caused by falling
directly on the sacrum. Brown-Sequard Syndrome caused by penetrating
trauma to the lateral aspect of the spinal cord will cause a left to right
phenomenon instead of a top down phenomenon.
⫸ A patient has a Zone II penetrating neck injury with penetration
through the platysma. The trauma nurse knows that this patient is at
increased risk of injury to:. Ans: The platysma is a muscle in the neck
that gives support and protection to the vital structures underneath it.
Any time there is penetration through the platysma, there is an increased
risk of damage to the underlying structures in the neck. The neck is
divided into three zones. Zone I extends from the sternal notch and
clavicle up to the cricothyroid cartilage. Zone II extends from the
cricothyroid cartilage upward to the angle of the mandible. Zone III
extends from the angle of the mandible to the base of the skull.
Structures found in Zone I include the subclavian artery, vertebral artery,
lung apices, trachea, thyroid and esophagus. Zone II includes the internal
jugular vein, esophagus, larynx, vagus nerve, carotid artery and vertebral
artery. Zone III includes the salivary and parotid glands, cranial nerves
IX-XII, vertebral artery, distal carotid artery, and distal jugular vein.
⫸ A pregnant patient's fundal height is palpated 6 cm above the
umbilicus. What is the estimated gestational age of the fetus?. Ans:
Fundal height is defined as the distance from the pubic bone to the top of
,the uterus in centimeters. In general, the fundus reaches the umbilicus by
20 weeks. Every centimeter past that point is measured as 1 week. If
every one centimeter above the umbilicus equals one week, then the
patient is approximately 26 weeks gestation.
⫸ Appropriate care for an amputated body part includes:. Ans: When
caring for an amputated body part, the trauma nurse should clean the
part removing any dirt and debris, wrapping the part in a slightly saline
moistened gauze, and then placing it in a sealed plastic bag. At this time,
the part should be placed in a second bag containing a mixture of ice and
water. It is imperative that the part does not freeze or does not come into
contact with water (which is hypotonic to body tissue). Also ensure that
the amputated part is properly labeled with the patient information.
⫸ Decontamination with water is discouraged in patients exposed to
powdered:. Ans: Dry chemicals that should not be irrigated with water
include dry lime, elemental metals (including sodium, potassium,
magnesium lithium and phosphorus) and phenol. When exposed to water
these substances will cause a harmful exothermic or "heat producing"
reaction burning the patient's skin. They may also release possible
hazardous byproducts into the air. Sulfuric acid, muriatic acid and
cement can all be irrigated with copious amounts of water (although a
much of the dry chemical as possible should be brushed off before
irrigation with water is initiated)
⫸ Hypovolemic shock is most likely to be caused by:. Ans:
Hypovolemic shock is caused by fluid loss (e.g. bleeding or diarrhea) or
third spacing of fluids. The inflammatory response caused by a burn
, leads to capillary permeability resulting in the third spacing of fluids
which results in hypovolemic shock. Cervical spinal injuries contribute
to neurogenic rather than hypovolemic shock. Although an epidural
hematoma causes blood loss, the epidural space is relatively small, so
blood accumulation would not be enough to result in hypovolemic
shock. A tension pneumothorax would cause obstructive shock.
⫸ The best method for assessing capillary refill on a two-week old
traumatically injured neonate is to blanch the:. Ans: The circulatory
system of the neonate is not well developed and perfusion to the fingers
is not complete, therefore using the tip of the finger is reserved for older
children, adolescents and adults. It is generally recommended to use the
forehead, sole of the foot, the sternum or the palm of the hand as
opposed to the skin over the iliac crest or the tip of the child's tongue
⫸ Enteral feedings are initiated on a traumatically injured patient and
several days later, the trauma nurse notes a significant elevation in serum
blood urea nitrogen (BUN) and creatinine. The trauma nurse should
suspect this may be caused by:. Ans: One of the effects of overfeeding
the traumatically injured patient is azotemia (elevated BUN and
creatinine) and the dietician should be notified of azotemia if it is noted
so that an adjustment in calories may be made. Insufficient protein in the
diet does not cause azotemia. Although bleeding ulcers may cause
elevations in blood urea nitrogen, they do not tend to cause elevations in
creatinine. Feeding a patient too quickly after trauma does not cause
elevations in BUN and creatinine
