Trauma Certified Registered Nurse
TCRN EXAM PREP QUESTIONS WITH
CORRECT EXPLAINED ANSWERS ||
100% GUARANTEED PASS!!
<RECENT VERSION>
1. Primary cause of spinal cord injuries - ANSWER ✔ direct trauma
2. Secondary cause of spinal cord injuries - ANSWER ✔ decreased perfusion
or oxygenation to the site of injury
3. Neurogenic shock - ANSWER ✔ loss of both vasomotor tone and
sympathetic innervations
4. Neurogenic shock is seen with a spinal cord injury at the level of BLANK or
higher - ANSWER ✔ T5
5. Complete spinal cord injury - ANSWER ✔ When the patient exhibits a
complete absence of sensation and voluntary motor function below the level
of the injury
6. Incomplete spinal cord injury - ANSWER ✔ patients who still have some
sensation or motor function or a combination of both below the level of
injury
,7. Types of incomplete spinal cord injuries - ANSWER ✔ -Anterior Cord
Syndrome
-Central Cord Syndrome
-Brown Sequard Syndrome
8. Examples of penetrating head wounds - ANSWER ✔ -GSW
-Stabbing/piercing
9. Examples of blunt head wounds - ANSWER ✔ Falls, MVC, bicycle,
pedestrian incidents, assaults
10.Which symptoms are most consistent with a mandibular fracture? -
ANSWER ✔ Patients who have a mandibular fracture will have
malocclusion (malalignment of the upper and lower teeth when biting
down), trismus (an inability to open the mouth), pain upon movement and
facial asymmetry. Periorbital bruising (raccoon eyes) are associated with a
basilar skull fracture. Diplopia, or double vision, is a finding in a patient
with fractures of the bones of the orbit
11.The lab reports myoglobin in the urine of a patient who has sustained a crush
injury. The trauma nurse knows this finding puts the patient at risk for: -
ANSWER ✔ The correct answer is renal failure. Myoglobin is a molecule
found the muscles that stores oxygen within the muscles for later use. When
a patient has a severe muscle damage, this molecule is released into the
blood stream and is carried to the kidneys where it may cause obstruction of
the glomeruli resulting in renal failure. Myoglobin in the urine is not
associated with cardiac, hepatic or respiratory failure.
12.TEG - ANSWER ✔ TEG monitors whole dynamic process of hemostasis
from clot formation to clot dissolution
13.Stomach injury - ANSWER ✔ Rare, more common in children. Penetrating
trauma most common cause. May find free air on cxr/fua. Pain to
epigastric/abd area, tenderness, signs of peritonitis. Bloody output from
gastric tube. Surgical intervention, is gastric content leakage, copious
peritoneal irrigation and delayed primary closure
,14.Large intestine - ANSWER ✔ Rectal injuries may be associated with severe
pelvic fracture. Lethal due to sepsis related to fecal contamination. Most are
due to penetrating trauma. Transverse colon most often injured. Most
injuries are contusions. Laparotomy with primary repair and colostomy is
performed when perforation to the colon or rectum is suspected. Abscesses
can be percutaneously drained.
15.Liver injuries - ANSWER ✔ Commonly injured due to size and location.
Cause of injury is blunt and penetrating trauma. MVC most common cause.
Greatest mortality risk is hemorrhage.
High velocity GSW cause more widespread damage that creates massive
hemorrhage. Suspect liver injury in any patient with blunt injury to right
side. FAST scan to rule out free fluid. CT scan in hemodynamically stable
patient. Graded I to IV.
16.Treatment of liver injuries - ANSWER ✔ Nonoperative in select patient. OR
for complex lacerations/arterial blush. Angioembolization for patients with
contrast pooling or arterial blush. Pack and stabilize bleeding and return to
OR 24-36 hours later for removal of packing and definitive management of
liver/possible closure. Aggressive intraoperative resuscitation to prevent
hypothermia, coagulopathy and hemodynamic stability. Damage control
surgery.
17.Hemobilia - ANSWER ✔ In patients with liver injury RUQ pain and
jaundice may present days and weeks post injury so follow up care is
important
18.Splenic injuries - ANSWER ✔ Most commonly injured intra-abd organ.
25% of all blunt visceral injuries. LUQ trauma, lower rib fractures to left.
Kehr's sign is caused by blood irritation to the phrenic nerve that causes
referred pain to the left shoulder. CT scan is the imagining of choice for
stable patients.
19.Acute splenic rupture triad - ANSWER ✔ left hemidiaphragm elevation, left
lower lobe atelectasis and pleural effusion not commonly present and not a
reliable sign
20.Treatment of splenic injury - ANSWER ✔ Nonoperative management,
splenectomy/partial splenectomy, possible damage control. More focused on
, salvage of spleen. If patient has a splenectomy patient must receve
vaccinations prior to discharge for H
influenza/meningococcal/pneumococcal vaccine
21.Overwhelming Postsplenectomy Sepsis - ANSWER ✔ Rare, more common
in children. 1-5 years after surgery. Flu like symptoms, shock from sepsis
and DIC followed by death. Preventative measures include vaccinations and
education.
22.Pancreas - ANSWER ✔ uncommon injury. If ductal tears, digestive
enzymes invade. Major therapeutic challenge for clinical team. Most are
associated with intra-abdominal injury and are found intraoperatively.
GSW/Stab wounds are frequently the cause.
23.Retroperitoneal injury - ANSWER ✔ Associated with blunt trauma
involving pelvic fractures
24.Abdominal vascular injury - ANSWER ✔ Usually occur with pelvic,
thoracic or visceral injury. Retroperitoneal hematoma in conjunction with
pelvic or spine trauma can contain up to 4 L of blood.
25.Pitfalls of abdominal trauma - ANSWER ✔ failure to suspect intra-
abdominal injury from mechanism of injury, failure to fully evaluate
complaints of abdominal pain following blunt abdominal injury, failure to
perform timely operative intervention, failure to recognize hemodynamic
compromise and delay surgery for further diagnostic tests
26.Most common mechanism of injury - ANSWER ✔ Falls
27.Forms of energy - ANSWER ✔ -mechanical
-gravitational
-thermal
-chemical
28.Types of trauma - ANSWER ✔ -blunt
-penetrating
-burn
-other
TCRN EXAM PREP QUESTIONS WITH
CORRECT EXPLAINED ANSWERS ||
100% GUARANTEED PASS!!
<RECENT VERSION>
1. Primary cause of spinal cord injuries - ANSWER ✔ direct trauma
2. Secondary cause of spinal cord injuries - ANSWER ✔ decreased perfusion
or oxygenation to the site of injury
3. Neurogenic shock - ANSWER ✔ loss of both vasomotor tone and
sympathetic innervations
4. Neurogenic shock is seen with a spinal cord injury at the level of BLANK or
higher - ANSWER ✔ T5
5. Complete spinal cord injury - ANSWER ✔ When the patient exhibits a
complete absence of sensation and voluntary motor function below the level
of the injury
6. Incomplete spinal cord injury - ANSWER ✔ patients who still have some
sensation or motor function or a combination of both below the level of
injury
,7. Types of incomplete spinal cord injuries - ANSWER ✔ -Anterior Cord
Syndrome
-Central Cord Syndrome
-Brown Sequard Syndrome
8. Examples of penetrating head wounds - ANSWER ✔ -GSW
-Stabbing/piercing
9. Examples of blunt head wounds - ANSWER ✔ Falls, MVC, bicycle,
pedestrian incidents, assaults
10.Which symptoms are most consistent with a mandibular fracture? -
ANSWER ✔ Patients who have a mandibular fracture will have
malocclusion (malalignment of the upper and lower teeth when biting
down), trismus (an inability to open the mouth), pain upon movement and
facial asymmetry. Periorbital bruising (raccoon eyes) are associated with a
basilar skull fracture. Diplopia, or double vision, is a finding in a patient
with fractures of the bones of the orbit
11.The lab reports myoglobin in the urine of a patient who has sustained a crush
injury. The trauma nurse knows this finding puts the patient at risk for: -
ANSWER ✔ The correct answer is renal failure. Myoglobin is a molecule
found the muscles that stores oxygen within the muscles for later use. When
a patient has a severe muscle damage, this molecule is released into the
blood stream and is carried to the kidneys where it may cause obstruction of
the glomeruli resulting in renal failure. Myoglobin in the urine is not
associated with cardiac, hepatic or respiratory failure.
12.TEG - ANSWER ✔ TEG monitors whole dynamic process of hemostasis
from clot formation to clot dissolution
13.Stomach injury - ANSWER ✔ Rare, more common in children. Penetrating
trauma most common cause. May find free air on cxr/fua. Pain to
epigastric/abd area, tenderness, signs of peritonitis. Bloody output from
gastric tube. Surgical intervention, is gastric content leakage, copious
peritoneal irrigation and delayed primary closure
,14.Large intestine - ANSWER ✔ Rectal injuries may be associated with severe
pelvic fracture. Lethal due to sepsis related to fecal contamination. Most are
due to penetrating trauma. Transverse colon most often injured. Most
injuries are contusions. Laparotomy with primary repair and colostomy is
performed when perforation to the colon or rectum is suspected. Abscesses
can be percutaneously drained.
15.Liver injuries - ANSWER ✔ Commonly injured due to size and location.
Cause of injury is blunt and penetrating trauma. MVC most common cause.
Greatest mortality risk is hemorrhage.
High velocity GSW cause more widespread damage that creates massive
hemorrhage. Suspect liver injury in any patient with blunt injury to right
side. FAST scan to rule out free fluid. CT scan in hemodynamically stable
patient. Graded I to IV.
16.Treatment of liver injuries - ANSWER ✔ Nonoperative in select patient. OR
for complex lacerations/arterial blush. Angioembolization for patients with
contrast pooling or arterial blush. Pack and stabilize bleeding and return to
OR 24-36 hours later for removal of packing and definitive management of
liver/possible closure. Aggressive intraoperative resuscitation to prevent
hypothermia, coagulopathy and hemodynamic stability. Damage control
surgery.
17.Hemobilia - ANSWER ✔ In patients with liver injury RUQ pain and
jaundice may present days and weeks post injury so follow up care is
important
18.Splenic injuries - ANSWER ✔ Most commonly injured intra-abd organ.
25% of all blunt visceral injuries. LUQ trauma, lower rib fractures to left.
Kehr's sign is caused by blood irritation to the phrenic nerve that causes
referred pain to the left shoulder. CT scan is the imagining of choice for
stable patients.
19.Acute splenic rupture triad - ANSWER ✔ left hemidiaphragm elevation, left
lower lobe atelectasis and pleural effusion not commonly present and not a
reliable sign
20.Treatment of splenic injury - ANSWER ✔ Nonoperative management,
splenectomy/partial splenectomy, possible damage control. More focused on
, salvage of spleen. If patient has a splenectomy patient must receve
vaccinations prior to discharge for H
influenza/meningococcal/pneumococcal vaccine
21.Overwhelming Postsplenectomy Sepsis - ANSWER ✔ Rare, more common
in children. 1-5 years after surgery. Flu like symptoms, shock from sepsis
and DIC followed by death. Preventative measures include vaccinations and
education.
22.Pancreas - ANSWER ✔ uncommon injury. If ductal tears, digestive
enzymes invade. Major therapeutic challenge for clinical team. Most are
associated with intra-abdominal injury and are found intraoperatively.
GSW/Stab wounds are frequently the cause.
23.Retroperitoneal injury - ANSWER ✔ Associated with blunt trauma
involving pelvic fractures
24.Abdominal vascular injury - ANSWER ✔ Usually occur with pelvic,
thoracic or visceral injury. Retroperitoneal hematoma in conjunction with
pelvic or spine trauma can contain up to 4 L of blood.
25.Pitfalls of abdominal trauma - ANSWER ✔ failure to suspect intra-
abdominal injury from mechanism of injury, failure to fully evaluate
complaints of abdominal pain following blunt abdominal injury, failure to
perform timely operative intervention, failure to recognize hemodynamic
compromise and delay surgery for further diagnostic tests
26.Most common mechanism of injury - ANSWER ✔ Falls
27.Forms of energy - ANSWER ✔ -mechanical
-gravitational
-thermal
-chemical
28.Types of trauma - ANSWER ✔ -blunt
-penetrating
-burn
-other
