1
TCRN Practice Questions 2025–
2026 – Complete Trauma Nursing
Exam Review with Detailed Answers
A transcranial doppler is obtained for a patient with a
traumatic subarachnoid hemorrhage. The doppler is
positive for vasospasm. The trauma nurse would expect
which of the following medications to be prescribed? -
Correct answer- A vasospasm is a known complication of
subarachnoid hemorrhages. Calcium channel blockers are
used to prevent or reverse vasospasms and are frequently
used in the treatment of a subarachnoid hemorrhage.
Metoprolol, Hydralazine and Lisinopril are not calcium
channel blockers and would not be effective to prevent
and treat vasospasms caused by a subarachnoid
hemorrhage
Which chamber of the heart is most likely to be affected
in blunt cardiac injuries? - Correct answer- Given the
anatomical position of the heart in the chest, the right
ventricle is most exposed to the anterior portion of the
chest wall and is most likely to be injured in a blunt
cardiac injury. Patients with blunt cardiac injuries
frequently experience signs of right ventricular failure.
1
, 2
Additional findings that are associated with blunt cardiac
injuries include hypotension, atrial fibrillation,
unexplained sinus tachycardia, multiple PVCs, ST
segment changes and right bundle branch blocks. The left
atrium, right atrium and left ventricle are less likely to be
injured in a blunt cardiac injury.
A widened mediastinum is noted on the chest x-ray of a
traumatically injured hypotensive patient. The trauma
nurse would anticipate gathering which of the following
pieces of equipment as the highest priority in this
scenario? - Correct answer- A widened mediastinum on
chest x-ray, accompanied by hypotension, is strongly
indicative of an aortic injury. One of the most life-
threatening complications of an aortic injury is blood loss,
which can be treated by giving blood products via a rapid
transfuser. Although patient assessment may be enhanced
by inserting an arterial line, this is less of a priority than
giving fluids rapidly. A chest tube is placed in the pleural
space rather than the mediastinum and is therefore not
indicated in this scenario. Similarly, there is nothing in
this scenario that indicates a pericardiocentesis is
indicated so this is not a higher priority than preparing a
rapid transfuser.
2
, 3
A properly applied pelvic binder sits across the: - Correct
answer- 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: - Correct answer- 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: - Correct
answer- Hyperextension of the neck (the head snapping
3
, 4
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: -
Correct answer- 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
4
TCRN Practice Questions 2025–
2026 – Complete Trauma Nursing
Exam Review with Detailed Answers
A transcranial doppler is obtained for a patient with a
traumatic subarachnoid hemorrhage. The doppler is
positive for vasospasm. The trauma nurse would expect
which of the following medications to be prescribed? -
Correct answer- A vasospasm is a known complication of
subarachnoid hemorrhages. Calcium channel blockers are
used to prevent or reverse vasospasms and are frequently
used in the treatment of a subarachnoid hemorrhage.
Metoprolol, Hydralazine and Lisinopril are not calcium
channel blockers and would not be effective to prevent
and treat vasospasms caused by a subarachnoid
hemorrhage
Which chamber of the heart is most likely to be affected
in blunt cardiac injuries? - Correct answer- Given the
anatomical position of the heart in the chest, the right
ventricle is most exposed to the anterior portion of the
chest wall and is most likely to be injured in a blunt
cardiac injury. Patients with blunt cardiac injuries
frequently experience signs of right ventricular failure.
1
, 2
Additional findings that are associated with blunt cardiac
injuries include hypotension, atrial fibrillation,
unexplained sinus tachycardia, multiple PVCs, ST
segment changes and right bundle branch blocks. The left
atrium, right atrium and left ventricle are less likely to be
injured in a blunt cardiac injury.
A widened mediastinum is noted on the chest x-ray of a
traumatically injured hypotensive patient. The trauma
nurse would anticipate gathering which of the following
pieces of equipment as the highest priority in this
scenario? - Correct answer- A widened mediastinum on
chest x-ray, accompanied by hypotension, is strongly
indicative of an aortic injury. One of the most life-
threatening complications of an aortic injury is blood loss,
which can be treated by giving blood products via a rapid
transfuser. Although patient assessment may be enhanced
by inserting an arterial line, this is less of a priority than
giving fluids rapidly. A chest tube is placed in the pleural
space rather than the mediastinum and is therefore not
indicated in this scenario. Similarly, there is nothing in
this scenario that indicates a pericardiocentesis is
indicated so this is not a higher priority than preparing a
rapid transfuser.
2
, 3
A properly applied pelvic binder sits across the: - Correct
answer- 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: - Correct answer- 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: - Correct
answer- Hyperextension of the neck (the head snapping
3
, 4
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: -
Correct answer- 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
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