TCRN Practice Questions WITH Answers
100% Pass
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
QUESTION: 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. 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.
QUESTION: 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.
QUESTION: 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.
QUESTION: 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.
QUESTION: Hyperextension of the neck is known to cause: -
CORRECT ANSWER: Hyperextension of the neck (the head snapping
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-
100% Pass
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
QUESTION: 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. 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.
QUESTION: 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.
QUESTION: 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.
QUESTION: 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.
QUESTION: Hyperextension of the neck is known to cause: -
CORRECT ANSWER: Hyperextension of the neck (the head snapping
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-
