TCRN Exam Questions and Answers Already
Graded A+ 2025
1. Most common mechanism of injury: Falls
2. Forms of energy: -mechanical
-gravitational
-thermal
-chemical
3. Types of trauma: -blunt
-penetrating
-burn
-other
4. Blunt trauma: accounts most injuries sustained
frontal impact
-aortic & cardiac injury, rib fxs, liver & spleen
-dash board posterior hip fx/dislocation, femur, knee injury
lateral impact
-head/facial, c spine, clavicle, pelvic, liver/spleen
rear end
-low velocity, neck hyperextension/hyperflexn
rollover
-DAI
ejection
-risk of death 4x greater
,pedestrian vs car
-tib/fib fx, truncal, head
injurybicycle
-head and abdominal injury from handlebar
falls
-4 stories 50% will die
-calcaneous, pelvis, spine, arm fx
5. Penetrating Trauma: lower incidence higher mortality
GSW
Stab: low velocity higher direct damage to organs
Burn: thermal or inhalation
Other: Hanging, strangulation , suffocation, drowning
6. Waddell's Triad: -femoral shaft fx
-intrathoracic and abdominal injury
-contralateral head injury
7. Newton's three laws of motion: 1. object at rest will stay at rest, object in motion
will stay in motion
2. Force: F=ma applying force produces acceleration (think seatbelt sign)
3. Action & Rxn: Every action there is an equal and opposite reaction
8. ABCDE "do your job" Primary Survey: Airway obstruction is major cause of
preventable trauma deaths
Hemorrhage is the most common cause of mortality in trauma
Airway-get definitive airway
Circulation-IV access and IVF
Disability-assess LOC GCS scale
Exposure-get your pt naked! temperature control
,-hypothermia=acidosis, coagulopathy, low O2
Hemorrhage Control-STOP THE BLEED replace volume loss, use tourniquet-note
tourniquet time
-<6yo IO access preferred over central line
MTP
-1:1:1 pRBC:plasma:platelet
-pt receiving >10 units pRBC w/in 24 hrs admit
9. When is a definitive airway needed?: Edema, hemorrhage, fracture to obstruct
airway and an ET/NT cannot be placed
-closed head injury w/ GCS <8
-unresponsive
-neuromuscular paralysis
-apnea
-sustained seizure activity
-inability to protect lower airway from blood/secretion
10. Breathing Assessment: -rate
-depth
-effort
-symmetry
-watch for tension pneumothorax!!
11. Open pneumothorax dressing: 3 sided dressing
12. Confirm airway placement: -cords visualized
-chest rise and fall
-auscultate
-CO2 detector
, -pulse ox
-CXR
13. Adult IVF bolus: 1-2 liters if no contraindication
14. Pediatric IVF bolus: 20ml/kg
15. Secondary Survey: a head-to-toe physical assessment; an additional assess-
ment of a patient to determine the existence of any injuries other than those found in
the primary survey, history or scene detail
16. Cardiac Output (L/min): HR (beats/min) x SV (cc/beat)
17. Shock Definition: State in which perfusion is compromised @ cellular level d/t:
-insufficient oxygen delivery
-increased oxygen consumption
-ineffective oxygen utilization
18. Hypovolemic Shock: most common type shock: significant loss circulating
volume most common source acute blood loss (hemorrhage)
-AMS first sign of shock
-Tachycardia >120 very concerning-one of 1st signs
-Cool clammy skin d/t vasoconstriction
-prolonged CRT
-Narrowed pulse pressure (40-50mm)
-Hypotension
-Decreased UO
-adult 0.5mL/kg/hr
-child 1mL/kghr
-toddler 1.5 mL/kg/hr
-Infant 2mL/kg/hr
Graded A+ 2025
1. Most common mechanism of injury: Falls
2. Forms of energy: -mechanical
-gravitational
-thermal
-chemical
3. Types of trauma: -blunt
-penetrating
-burn
-other
4. Blunt trauma: accounts most injuries sustained
frontal impact
-aortic & cardiac injury, rib fxs, liver & spleen
-dash board posterior hip fx/dislocation, femur, knee injury
lateral impact
-head/facial, c spine, clavicle, pelvic, liver/spleen
rear end
-low velocity, neck hyperextension/hyperflexn
rollover
-DAI
ejection
-risk of death 4x greater
,pedestrian vs car
-tib/fib fx, truncal, head
injurybicycle
-head and abdominal injury from handlebar
falls
-4 stories 50% will die
-calcaneous, pelvis, spine, arm fx
5. Penetrating Trauma: lower incidence higher mortality
GSW
Stab: low velocity higher direct damage to organs
Burn: thermal or inhalation
Other: Hanging, strangulation , suffocation, drowning
6. Waddell's Triad: -femoral shaft fx
-intrathoracic and abdominal injury
-contralateral head injury
7. Newton's three laws of motion: 1. object at rest will stay at rest, object in motion
will stay in motion
2. Force: F=ma applying force produces acceleration (think seatbelt sign)
3. Action & Rxn: Every action there is an equal and opposite reaction
8. ABCDE "do your job" Primary Survey: Airway obstruction is major cause of
preventable trauma deaths
Hemorrhage is the most common cause of mortality in trauma
Airway-get definitive airway
Circulation-IV access and IVF
Disability-assess LOC GCS scale
Exposure-get your pt naked! temperature control
,-hypothermia=acidosis, coagulopathy, low O2
Hemorrhage Control-STOP THE BLEED replace volume loss, use tourniquet-note
tourniquet time
-<6yo IO access preferred over central line
MTP
-1:1:1 pRBC:plasma:platelet
-pt receiving >10 units pRBC w/in 24 hrs admit
9. When is a definitive airway needed?: Edema, hemorrhage, fracture to obstruct
airway and an ET/NT cannot be placed
-closed head injury w/ GCS <8
-unresponsive
-neuromuscular paralysis
-apnea
-sustained seizure activity
-inability to protect lower airway from blood/secretion
10. Breathing Assessment: -rate
-depth
-effort
-symmetry
-watch for tension pneumothorax!!
11. Open pneumothorax dressing: 3 sided dressing
12. Confirm airway placement: -cords visualized
-chest rise and fall
-auscultate
-CO2 detector
, -pulse ox
-CXR
13. Adult IVF bolus: 1-2 liters if no contraindication
14. Pediatric IVF bolus: 20ml/kg
15. Secondary Survey: a head-to-toe physical assessment; an additional assess-
ment of a patient to determine the existence of any injuries other than those found in
the primary survey, history or scene detail
16. Cardiac Output (L/min): HR (beats/min) x SV (cc/beat)
17. Shock Definition: State in which perfusion is compromised @ cellular level d/t:
-insufficient oxygen delivery
-increased oxygen consumption
-ineffective oxygen utilization
18. Hypovolemic Shock: most common type shock: significant loss circulating
volume most common source acute blood loss (hemorrhage)
-AMS first sign of shock
-Tachycardia >120 very concerning-one of 1st signs
-Cool clammy skin d/t vasoconstriction
-prolonged CRT
-Narrowed pulse pressure (40-50mm)
-Hypotension
-Decreased UO
-adult 0.5mL/kg/hr
-child 1mL/kghr
-toddler 1.5 mL/kg/hr
-Infant 2mL/kg/hr
