TCRN REAL EXAM QUESTIONS WITH
CORRECT EXPLAINED ANSWERS ||
100% GUARANTEED PASS!!
<RECENT VERSION>
A+
1. A 4-year-old child weighing 16 kg arrives in the trauma unit shortly after
being burned. The Modified Parkland Burn formula is used to calculate fluid
requirements for this child and fluid resuscitation is initiated at 150 mL per
hour. What percentage of this child's body is burned? - ANSWER ✔ When
using the Modified Parkland Burn formula for pediatric patients, the child's
weight in kilograms is multiplied by 3 mL which is then multiplied by the
total body surface area that is burned. This calculates the total fluid
recommended in the first 24 hours after a patient is burned. One-half of this
total should be delivered in the first 8 hours after the burn. So if a child
receives 150 mL of fluid in the first hour of resuscitation, that means the
child would receive 1200 mL in the first eight hours after the burn (150 mL
times 8). If that is half of the total calculated using the Modified Parkland
Burn formula, then the total amount would be 2400 mL (1200 mL times 2).
To get to the number 2400 mL, the child's weight in kilogram (16 kg) would
have been multiplied by 3 mL and then by the total body surface area
burned. So if 2400 mL (24 hour total) is divided by the weight (16 kg) and
that is divided by 3 mL - the resulting number is 50 meaning that 50% of the
child's body is burned
2. A trauma nurse uses the Modified Parkland Burn Formula to calculate fluid
requirements on an adult patient weighing 65 kg and determines that the
patient requires 6600 mL of fluid in the 24 hours after the burn. If the patient
arrived in the trauma unit shortly after the burn and remains in the
resuscitation room for 2 hours, how much fluid should the patient receive? -
, ANSWER ✔ When using the Modified Parkland Burn formula, one-half of
the calculated 24 hour fluid requirement should be given in the first eight
hours after the burn. If the patient requires 6600 mL of fluid, one half of that
is 3300 mL (therefore, the patient should receive 3300 mL in the first eight
hours after the burn). This should be equally distributed over those eight
hours, so 3300 mL divided by eight hours is 412.5 mL per hour. If the
patient is in the resuscitation room for 2 hours, they will require 825 mL of
fluid (412.5 times two). 275 mL, 412, mL and 550 mL are all inadequate
amounts using the Modified Parkland Burn formula
3. ETCO2 - ANSWER ✔ -End tital carbon dioxide
-Ideally kept at 35
-This measures CO2 at the end of an exhaled breath and provides
information regarding adequacy of circulatory flow
4. Wounds to which areas of the body carries the LOWEST risk of infection? -
ANSWER ✔ The more vascular the area, the lower the risk of infection.
Therefore, wounds to the face and scalp have the lowest risk of infection
because they are highly vascular. The following list shows the risk of
infection of an area of the body from highest risk to lowest risk: Leg and
thigh, arms, feet, chest, back, face, scalp
5. Which motor or sensory functions is most likely to be maintained in a partial
cord injury involving the cervical spine? - ANSWER ✔ The nerve which
innervates the great toe and the rectum is protected deep inside the spinal
cord and may be preserved in a partial cord injury. If this is the case, the
patient may be able to flex the great toe despite paralysis and loss of
sensation to other areas of the body. Maintenance of bladder tone, the
cremasteric reflex and peri-umbilical sensation are not commonly associated
with a partial cord injury
6. A pregnant patient is transported to the ED after a traumatic incident. The
patient's pants and underclothing are wet and the trauma nurse wants to
determine if the fluid is from a spontaneous void related to the trauma or
whether it is possible premature rupture of the membranes. Fluid in the
vaginal canal is tested with nitrazine paper. Which pH, noted on the
nitrazine paper, is most consistent with premature rupture of the
, membranes?5. - ANSWER ✔ The pH of amniotic fluid is usually neutral
(around 7.5). Urine is often acidic (4.6 - 6.0). A pH of 8.5 is more alkali then
both amniotic fluid and urine
7. A patient presents with an expanding hematoma in the neck secondary to
trauma to the carotid artery with significant respiratory distress. The initial
treatment for this condition is: - ANSWER ✔ The priority of care is always
to stem life-threatening blood loss followed by activities to protect the
airway. In this scenario, there is significant blood loss and indications that
the airway is compromised. Both deficits may be temporarily managed by
applying direct pressure over the site of bleeding to stem the loss of blood
and reduce the size of the expanding hematoma. A nasopharyngeal airway
does not extend into the neck and would not stem bleeding nor protect from
airway collapse. While elevating the head of the bed 90 degrees is not
wrong, it would not take higher priority over stemming blood loss from the
application of direct pressure. Similarly, the initiation of 100% oxygen via
non-rebreather mask is not inappropriate but would not stem blood loss nor
protect the collapsing airway, therefore it is not a higher priority than the
application of direct pressure over the site of bleeding
8. What is the most likely reason that an institutional review board (IRB)
would reject a research proposal? - ANSWER ✔ The purpose of the IRB is
to guard the rights of the subjects. The IRB will ensure that the study does
not put any vulnerable populations in harm, that subjects are not put into any
unnecessary danger, that subjects are made aware of the risks and benefits of
being in the study, that they consent to the study and that they can withdraw
at any point. If these things are not proven to the IRB, then the IRB may
reject the study. The IRB focuses on the protection of subjects rather than
the logistics of the study itself (e.g. the hypothesis, the number of subjects or
the literature review)
9. The trauma nurse knows that the symptoms of multi-organ dysfunction
syndrome often starts within: - ANSWER ✔ The symptoms of multi-organ
dysfunction syndrome (MODS) often start a week to ten days after the onset
of trauma. Although factors, such as hypoxia and inadequate fluid
resuscitation, which contribute to MODS may occur shortly after the
traumatic event, the actual onset of symptoms is usually delayed
, 10.The symptoms of spinal shock are most likely to occur: - ANSWER ✔ The
symptoms of spinal shock (flaccid paralysis, absent reflexes, lack of sensory
function, impaired thermoregulation, bowel distension/ileus) tend to occur
immediately after the injury but resolve within minutes, hours or days after
the injury. Spinal shock does not occur intermittently for the remainder of
the patient's life. Once it resolves, it does not recur.
11.Goals of effective prehospital trauma care include initiating resuscitation,
providing safe and timely transport and: - ANSWER ✔ The third goal of
effective prehospital trauma care is preventing further injury to the patient.
This may be accomplished by utilizing appropriate treatment protocols and
being involved in local performance improvement programs. Although
education may be provided to patients as part of pre-hospital care, this is not
a recognized goal and is often difficult in the field because the type and
extent of injuries is not known. The goal of prehospital trauma care is not to
provide definitive care but rather to provide life-saving care involving
maintenance of airway and breathing, hemorrhage control, stabilization of
fractures and spinal motion restriction if appropriate for the patient. Not all
patient's require spinal motion restriction so it is not a goal of prehospital
trauma care to provide this to all patients
12.A trauma nurse is collecting data from the hospital trauma registry. Which
tasks is she most likely working on? - ANSWER ✔ The trauma registry
contains community specific data about exact injury patterns that have
presented to that trauma center. This can be used to determine what areas of
focus are appropriate to develop an injury prevention program for a
community. The trauma registry does not collect specific data on patient
hand-off. This information may have to be gleaned by reviewing written
records of report or observing patient handoff encounters. The trauma
registry does not generally contain financial data that can be used to
determine appropriate funding. This information is more likely to be
obtained from hospital financial records. Although outcomes of trauma
resuscitation may be gleaned from the trauma registry, it would be difficult
to assess if those outcomes are related to the number of trauma team
members present in the resuscitation based on trauma registry information
alone
13.The incorporation of evidence-based practice into care may increase patient
safety by: - ANSWER ✔ The use of evidence-based practice allows
CORRECT EXPLAINED ANSWERS ||
100% GUARANTEED PASS!!
<RECENT VERSION>
A+
1. A 4-year-old child weighing 16 kg arrives in the trauma unit shortly after
being burned. The Modified Parkland Burn formula is used to calculate fluid
requirements for this child and fluid resuscitation is initiated at 150 mL per
hour. What percentage of this child's body is burned? - ANSWER ✔ When
using the Modified Parkland Burn formula for pediatric patients, the child's
weight in kilograms is multiplied by 3 mL which is then multiplied by the
total body surface area that is burned. This calculates the total fluid
recommended in the first 24 hours after a patient is burned. One-half of this
total should be delivered in the first 8 hours after the burn. So if a child
receives 150 mL of fluid in the first hour of resuscitation, that means the
child would receive 1200 mL in the first eight hours after the burn (150 mL
times 8). If that is half of the total calculated using the Modified Parkland
Burn formula, then the total amount would be 2400 mL (1200 mL times 2).
To get to the number 2400 mL, the child's weight in kilogram (16 kg) would
have been multiplied by 3 mL and then by the total body surface area
burned. So if 2400 mL (24 hour total) is divided by the weight (16 kg) and
that is divided by 3 mL - the resulting number is 50 meaning that 50% of the
child's body is burned
2. A trauma nurse uses the Modified Parkland Burn Formula to calculate fluid
requirements on an adult patient weighing 65 kg and determines that the
patient requires 6600 mL of fluid in the 24 hours after the burn. If the patient
arrived in the trauma unit shortly after the burn and remains in the
resuscitation room for 2 hours, how much fluid should the patient receive? -
, ANSWER ✔ When using the Modified Parkland Burn formula, one-half of
the calculated 24 hour fluid requirement should be given in the first eight
hours after the burn. If the patient requires 6600 mL of fluid, one half of that
is 3300 mL (therefore, the patient should receive 3300 mL in the first eight
hours after the burn). This should be equally distributed over those eight
hours, so 3300 mL divided by eight hours is 412.5 mL per hour. If the
patient is in the resuscitation room for 2 hours, they will require 825 mL of
fluid (412.5 times two). 275 mL, 412, mL and 550 mL are all inadequate
amounts using the Modified Parkland Burn formula
3. ETCO2 - ANSWER ✔ -End tital carbon dioxide
-Ideally kept at 35
-This measures CO2 at the end of an exhaled breath and provides
information regarding adequacy of circulatory flow
4. Wounds to which areas of the body carries the LOWEST risk of infection? -
ANSWER ✔ The more vascular the area, the lower the risk of infection.
Therefore, wounds to the face and scalp have the lowest risk of infection
because they are highly vascular. The following list shows the risk of
infection of an area of the body from highest risk to lowest risk: Leg and
thigh, arms, feet, chest, back, face, scalp
5. Which motor or sensory functions is most likely to be maintained in a partial
cord injury involving the cervical spine? - ANSWER ✔ The nerve which
innervates the great toe and the rectum is protected deep inside the spinal
cord and may be preserved in a partial cord injury. If this is the case, the
patient may be able to flex the great toe despite paralysis and loss of
sensation to other areas of the body. Maintenance of bladder tone, the
cremasteric reflex and peri-umbilical sensation are not commonly associated
with a partial cord injury
6. A pregnant patient is transported to the ED after a traumatic incident. The
patient's pants and underclothing are wet and the trauma nurse wants to
determine if the fluid is from a spontaneous void related to the trauma or
whether it is possible premature rupture of the membranes. Fluid in the
vaginal canal is tested with nitrazine paper. Which pH, noted on the
nitrazine paper, is most consistent with premature rupture of the
, membranes?5. - ANSWER ✔ The pH of amniotic fluid is usually neutral
(around 7.5). Urine is often acidic (4.6 - 6.0). A pH of 8.5 is more alkali then
both amniotic fluid and urine
7. A patient presents with an expanding hematoma in the neck secondary to
trauma to the carotid artery with significant respiratory distress. The initial
treatment for this condition is: - ANSWER ✔ The priority of care is always
to stem life-threatening blood loss followed by activities to protect the
airway. In this scenario, there is significant blood loss and indications that
the airway is compromised. Both deficits may be temporarily managed by
applying direct pressure over the site of bleeding to stem the loss of blood
and reduce the size of the expanding hematoma. A nasopharyngeal airway
does not extend into the neck and would not stem bleeding nor protect from
airway collapse. While elevating the head of the bed 90 degrees is not
wrong, it would not take higher priority over stemming blood loss from the
application of direct pressure. Similarly, the initiation of 100% oxygen via
non-rebreather mask is not inappropriate but would not stem blood loss nor
protect the collapsing airway, therefore it is not a higher priority than the
application of direct pressure over the site of bleeding
8. What is the most likely reason that an institutional review board (IRB)
would reject a research proposal? - ANSWER ✔ The purpose of the IRB is
to guard the rights of the subjects. The IRB will ensure that the study does
not put any vulnerable populations in harm, that subjects are not put into any
unnecessary danger, that subjects are made aware of the risks and benefits of
being in the study, that they consent to the study and that they can withdraw
at any point. If these things are not proven to the IRB, then the IRB may
reject the study. The IRB focuses on the protection of subjects rather than
the logistics of the study itself (e.g. the hypothesis, the number of subjects or
the literature review)
9. The trauma nurse knows that the symptoms of multi-organ dysfunction
syndrome often starts within: - ANSWER ✔ The symptoms of multi-organ
dysfunction syndrome (MODS) often start a week to ten days after the onset
of trauma. Although factors, such as hypoxia and inadequate fluid
resuscitation, which contribute to MODS may occur shortly after the
traumatic event, the actual onset of symptoms is usually delayed
, 10.The symptoms of spinal shock are most likely to occur: - ANSWER ✔ The
symptoms of spinal shock (flaccid paralysis, absent reflexes, lack of sensory
function, impaired thermoregulation, bowel distension/ileus) tend to occur
immediately after the injury but resolve within minutes, hours or days after
the injury. Spinal shock does not occur intermittently for the remainder of
the patient's life. Once it resolves, it does not recur.
11.Goals of effective prehospital trauma care include initiating resuscitation,
providing safe and timely transport and: - ANSWER ✔ The third goal of
effective prehospital trauma care is preventing further injury to the patient.
This may be accomplished by utilizing appropriate treatment protocols and
being involved in local performance improvement programs. Although
education may be provided to patients as part of pre-hospital care, this is not
a recognized goal and is often difficult in the field because the type and
extent of injuries is not known. The goal of prehospital trauma care is not to
provide definitive care but rather to provide life-saving care involving
maintenance of airway and breathing, hemorrhage control, stabilization of
fractures and spinal motion restriction if appropriate for the patient. Not all
patient's require spinal motion restriction so it is not a goal of prehospital
trauma care to provide this to all patients
12.A trauma nurse is collecting data from the hospital trauma registry. Which
tasks is she most likely working on? - ANSWER ✔ The trauma registry
contains community specific data about exact injury patterns that have
presented to that trauma center. This can be used to determine what areas of
focus are appropriate to develop an injury prevention program for a
community. The trauma registry does not collect specific data on patient
hand-off. This information may have to be gleaned by reviewing written
records of report or observing patient handoff encounters. The trauma
registry does not generally contain financial data that can be used to
determine appropriate funding. This information is more likely to be
obtained from hospital financial records. Although outcomes of trauma
resuscitation may be gleaned from the trauma registry, it would be difficult
to assess if those outcomes are related to the number of trauma team
members present in the resuscitation based on trauma registry information
alone
13.The incorporation of evidence-based practice into care may increase patient
safety by: - ANSWER ✔ The use of evidence-based practice allows
