TCRN EXAM zm
Exam Solution zm
TCRN 2026 A+ GRADE ASSURED COMPLETE SOLUTION
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S AND VERIFIED ANSWERS (3BA5C)
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QUESTION 1 zm
2) An infant with a history of Trisomy 21 is being evaluated status post motor vehicle
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collision. The nurse anticipates which of the following may be related to traumatic inj
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ury rather than a history of Trisomy 21? Possible answer(s): atlantoaxial instability li
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mp extremities tongue obstruction bulging fontanels
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ANSWER
Bulging fontanels Limp extremities, tongue obstruction and atlantoaxial instability may all be commo
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n in patients with Down syndrome (Trisomy 21). Bulging fontanels are a sign of increased intracrani
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al pressure in the infant patient, and should be considered to be related to traumatic injury.
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QUESTION 2 zm
A patient presents following a motor vehicle collision and has an unstable pelvis. The
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PRIORITY intervention is: Possible answers: administration of analgesics. application o
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f a pelvic binder. initiation of massive transfusion protocol. infusion of crystalloid flui
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d
ANSWER
application of a pelvic binder. Pelvic fractures can result in blood loss of 3000mL. Use of a pelvic bi
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nder will assist to tamponade the bleeding in the pelvis and assist with hemostasis. Blood product t
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ransfusion is preferred over crystalloid infusion, however preventing further hemorrhage is the imm
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ediate priority. Analgesic administration is important but is not the first priority.
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QUESTION 3 zm
The nurse is caring for a patient who is morbidly obese. The patient sustained a head
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injury and requires intubation. When initially placing the patient on a ventilator, the
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nurse should anticipate an order for Possible answers: FiO2 of 21-25% PEEP of 5-
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10 cm H2O respiratory rate of 25-30 breaths/min. tidal volume of 750-1000 mL.
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ANSWER
,tidal volume of 750-
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1000 mL. Ventilator settings for a patient with obesity are based on ideal body weight and healthy l
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ungs. A PEEP of 5-
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10 H2O is often required in patients who are morbidly obese. A tidal volume of 750-
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
1000 mL is too high. Patients often require a FiO2 of at least 30. Even with a head injury, tachypne
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a with a respiratory rate of 25-30 is high for this patient.
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QUESTION 4 zm
The trauma program manager of a verified trauma center recognizes this important o
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utreach obligation to local rural area resources: Possible answers: Injury prevention s
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upplies Professional education Clinical practice guidelines Medical supply resources
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ANSWER
Professional education Trauma centers verified through the American College of Surgeons have an o
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bligation to extend education in the form of professional education, consultation, or community outr
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each. Medical and injury prevention supplies are not an obligation of a verified trauma center. Clinic
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al practice guidelines are institution specific and not an educational obligation for the verified traum
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a center to provide to other facilities.
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QUESTION 5 zm
When appropriately triaging patients, and in order to ensure they are all treated fairl
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y, the trauma nurse may encounter this type of ethical dilemma: Possible answers: Fid
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elity Veracity Justice Beneficence
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ANSWER
Justice Veracity is defined as truth telling; Fidelity is keeping one's promise; beneficence is to do go
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od; and justice is fairness.
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QUESTION 6 zm
The nurse is monitoring a patient for intracranial hypertension. The nurse should und
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erstand that which of the following increases cerebral blood volume? Possible answer
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s: hyperthermia elevated PaO2 hypothermia hypocapnia
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ANSWER
hyperthermia: Anything that causes an increase in metabolic rate (e.g. hyperthermia) can increase ce
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rebral blood flow. A reduction in metabolic rate (e.g. from hypothermia, hypocapnia) decreases cere
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bral blood flow. High PaO2 levels have not been shown to affect cerebral blood flow in either direct
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ion.
QUESTION 7 zm
, The nurse is caring for a patient with a C5 tetraplegic injury on hospital day two. The
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patient does not have any active bleeding. Mean arterial pressure is 60 mmHg. The n
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urse should anticipate orders to Possible answers: position the patient in reverse Tre
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ndelenburg. administer hypertonic saline. initiate vasopressors. maintain hypothermia.
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ANSWER
initiate vasopressors. Blood pressure in the spinal cord injured patient is first managed with isotonic
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crystalloid administration and once intravascular volume has been optimized, vasoactive agents are
zm zm zm zm zm zm zm zm zm zm zm zm zm
used. Patients with SCI are poikilothermic and need to maintain normothermia. Current guidelines re
zm zm zm zm zm zm zm zm zm zm zm zm zm
commend a systolic BP >90 mmHg and a MAP of 85-
zm zm zm zm zm zm zm zm zm zm
90 mmHg to optimize blood flow to the cord and prevent secondary injury. Placing a patient in reve
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rse Trendelenburg would not be indicated.
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QUESTION 8 zm
Placing a tourniquet on an extremity after a penetrating injury is what level of injury
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prevention? Primary tertiary quaternary secondary zm zm zm zm
ANSWER
Secondary A tourniquet is secondary injury prevention because it's aim is to reduce/eliminate blood
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mloss from initial injury. It does not prevent the penetrating injury itself (primary), and the healing p
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rocess is variable on additional factors aside from the tourniquet (tertiary). There is no quaternary l
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evel of injury prevention, however, quaternary injuries may be sustained from certain types of trau
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ma.
QUESTION 9 zm
The nurse recently admitted a patient to the floor following a motor vehicle collision
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earlier that morning. At the end of the shift, the patient complains of lower abdominal
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pain. Upon assessment, there is periumbilical bruising, known as which sign? Kehr C
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ullen Grey Turner Rovsingzm zm zm
ANSWER
Cullen Cullen sign is periumbical bruising indicative of intraperitoneal bleeding, Grey Turner sign is f
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lank bruising indicating retroperitoneal bleeding, Kehr sign is shoulder pain indicating intraperitonea
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l bleeding, Rovsing sign is right lower quadrant pain elicited by palpation of the left lower quadrant,
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indicative of appendicitis.
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QUESTION 10 zm
A patient arrives in the trauma bay after a motor vehicle crash with a past medical hi
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story of trisomy- zm zm
21. The PRIORITY intervention is: cervical spine immobilization supplemental oxygen
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application. large bore vascular access. capillary blood glucose measurement.
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ANSWER
Exam Solution zm
TCRN 2026 A+ GRADE ASSURED COMPLETE SOLUTION
zm zm zm zm zm zm
S AND VERIFIED ANSWERS (3BA5C)
zm zm zm zm
QUESTION 1 zm
2) An infant with a history of Trisomy 21 is being evaluated status post motor vehicle
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm z
collision. The nurse anticipates which of the following may be related to traumatic inj
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ury rather than a history of Trisomy 21? Possible answer(s): atlantoaxial instability li
zm zm zm zm zm zm zm zm zm zm zm zm
mp extremities tongue obstruction bulging fontanels
zm zm zm zm zm
ANSWER
Bulging fontanels Limp extremities, tongue obstruction and atlantoaxial instability may all be commo
zm zm zm zm zm zm zm zm zm zm zm zm
n in patients with Down syndrome (Trisomy 21). Bulging fontanels are a sign of increased intracrani
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
al pressure in the infant patient, and should be considered to be related to traumatic injury.
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
QUESTION 2 zm
A patient presents following a motor vehicle collision and has an unstable pelvis. The
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
PRIORITY intervention is: Possible answers: administration of analgesics. application o
zm zm zm zm zm zm zm zm zm
f a pelvic binder. initiation of massive transfusion protocol. infusion of crystalloid flui
zm zm zm zm zm zm zm zm zm zm zm zm
d
ANSWER
application of a pelvic binder. Pelvic fractures can result in blood loss of 3000mL. Use of a pelvic bi
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
nder will assist to tamponade the bleeding in the pelvis and assist with hemostasis. Blood product t
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ransfusion is preferred over crystalloid infusion, however preventing further hemorrhage is the imm
zm zm zm zm zm zm zm zm zm zm zm zm
ediate priority. Analgesic administration is important but is not the first priority.
zm zm zm zm zm zm zm zm zm zm zm
QUESTION 3 zm
The nurse is caring for a patient who is morbidly obese. The patient sustained a head
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injury and requires intubation. When initially placing the patient on a ventilator, the
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nurse should anticipate an order for Possible answers: FiO2 of 21-25% PEEP of 5-
zm zm zm zm zm zm zm zm zm zm zm zm zm
10 cm H2O respiratory rate of 25-30 breaths/min. tidal volume of 750-1000 mL.
zm zm zm zm zm zm zm zm zm zm zm zm
ANSWER
,tidal volume of 750-
zm zm zm
1000 mL. Ventilator settings for a patient with obesity are based on ideal body weight and healthy l
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ungs. A PEEP of 5-
zm zm zm zm
10 H2O is often required in patients who are morbidly obese. A tidal volume of 750-
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
1000 mL is too high. Patients often require a FiO2 of at least 30. Even with a head injury, tachypne
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
a with a respiratory rate of 25-30 is high for this patient.
zm zm zm zm zm zm zm zm zm zm zm
QUESTION 4 zm
The trauma program manager of a verified trauma center recognizes this important o
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utreach obligation to local rural area resources: Possible answers: Injury prevention s
zm zm zm zm zm zm zm zm zm zm zm
upplies Professional education Clinical practice guidelines Medical supply resources
zm zm zm zm zm zm zm zm
ANSWER
Professional education Trauma centers verified through the American College of Surgeons have an o
zm zm zm zm zm zm zm zm zm zm zm zm zm
bligation to extend education in the form of professional education, consultation, or community outr
zm zm zm zm zm zm zm zm zm zm zm zm zm
each. Medical and injury prevention supplies are not an obligation of a verified trauma center. Clinic
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
al practice guidelines are institution specific and not an educational obligation for the verified traum
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
a center to provide to other facilities.
zm zm zm zm zm zm
QUESTION 5 zm
When appropriately triaging patients, and in order to ensure they are all treated fairl
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y, the trauma nurse may encounter this type of ethical dilemma: Possible answers: Fid
zm zm zm zm zm zm zm zm zm zm zm zm zm
elity Veracity Justice Beneficence
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ANSWER
Justice Veracity is defined as truth telling; Fidelity is keeping one's promise; beneficence is to do go
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
od; and justice is fairness.
zm zm zm zm
QUESTION 6 zm
The nurse is monitoring a patient for intracranial hypertension. The nurse should und
zm zm zm zm zm zm zm zm zm zm zm zm
erstand that which of the following increases cerebral blood volume? Possible answer
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s: hyperthermia elevated PaO2 hypothermia hypocapnia
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ANSWER
hyperthermia: Anything that causes an increase in metabolic rate (e.g. hyperthermia) can increase ce
zm zm zm zm zm zm zm zm zm zm zm zm zm
rebral blood flow. A reduction in metabolic rate (e.g. from hypothermia, hypocapnia) decreases cere
zm zm zm zm zm zm zm zm zm zm zm zm zm
bral blood flow. High PaO2 levels have not been shown to affect cerebral blood flow in either direct
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ion.
QUESTION 7 zm
, The nurse is caring for a patient with a C5 tetraplegic injury on hospital day two. The
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patient does not have any active bleeding. Mean arterial pressure is 60 mmHg. The n
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urse should anticipate orders to Possible answers: position the patient in reverse Tre
zm zm zm zm zm zm zm zm zm zm zm zm
ndelenburg. administer hypertonic saline. initiate vasopressors. maintain hypothermia.
zm zm zm zm zm zm zm
ANSWER
initiate vasopressors. Blood pressure in the spinal cord injured patient is first managed with isotonic
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
crystalloid administration and once intravascular volume has been optimized, vasoactive agents are
zm zm zm zm zm zm zm zm zm zm zm zm zm
used. Patients with SCI are poikilothermic and need to maintain normothermia. Current guidelines re
zm zm zm zm zm zm zm zm zm zm zm zm zm
commend a systolic BP >90 mmHg and a MAP of 85-
zm zm zm zm zm zm zm zm zm zm
90 mmHg to optimize blood flow to the cord and prevent secondary injury. Placing a patient in reve
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
rse Trendelenburg would not be indicated.
zm zm zm zm zm
QUESTION 8 zm
Placing a tourniquet on an extremity after a penetrating injury is what level of injury
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
prevention? Primary tertiary quaternary secondary zm zm zm zm
ANSWER
Secondary A tourniquet is secondary injury prevention because it's aim is to reduce/eliminate blood
zm zm zm zm zm zm zm zm zm zm zm zm zm z
mloss from initial injury. It does not prevent the penetrating injury itself (primary), and the healing p
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
rocess is variable on additional factors aside from the tourniquet (tertiary). There is no quaternary l
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
evel of injury prevention, however, quaternary injuries may be sustained from certain types of trau
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ma.
QUESTION 9 zm
The nurse recently admitted a patient to the floor following a motor vehicle collision
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
earlier that morning. At the end of the shift, the patient complains of lower abdominal
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
pain. Upon assessment, there is periumbilical bruising, known as which sign? Kehr C
zm zm zm zm zm zm zm zm zm zm zm zm zm
ullen Grey Turner Rovsingzm zm zm
ANSWER
Cullen Cullen sign is periumbical bruising indicative of intraperitoneal bleeding, Grey Turner sign is f
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
lank bruising indicating retroperitoneal bleeding, Kehr sign is shoulder pain indicating intraperitonea
zm zm zm zm zm zm zm zm zm zm zm
l bleeding, Rovsing sign is right lower quadrant pain elicited by palpation of the left lower quadrant,
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
indicative of appendicitis.
zm zm zm
QUESTION 10 zm
A patient arrives in the trauma bay after a motor vehicle crash with a past medical hi
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
story of trisomy- zm zm
21. The PRIORITY intervention is: cervical spine immobilization supplemental oxygen
zm zm zm zm zm zm zm zm zm zm
application. large bore vascular access. capillary blood glucose measurement.
zm zm zm zm zm zm zm zm
ANSWER
