TCRN REVIEW 2025-2026 NEWEST
ACTUAL
EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES
The patient has injuries as a result of a high-risk auto crash that need to be
addressed at a trauma center. A level 1 trauma center provides the highest
level of trauma care with in-house neurosurgery coverage and is closer
than the level 2 center. A level 3 trauma center is not required to provide
continuous in-house neurosurgery coverage. Due to the patient's GCS less
than or equal to 13, the patient should be evaluated by the closest trauma
center with preferential evaluation at the highest-level trauma center.
A patient presents following a motor vehicle collision and has an unstable
pelvis. The PRIORITY intervention is:
Possible ANSWERs:
administration of analgesics. application of a pelvic binder. initiation
of massive transfusion protocol. infusion of crystalloid fluid -
ANSWER>>application of a pelvic binder.
Pelvic fractures can result in blood loss of 3000mL. Use of a pelvic binder
will assist to tamponade the bleeding in the pelvis and assist with
hemostasis. Blood product transfusion is preferred over crystalloid infusion,
however preventing further hemorrhage is the immediate priority. Analgesic
,administration is important but is not the first priority.
,The nurse is caring for a patient who is morbidly obese. The patient
sustained a head injury and requires intubation. When initially placing the
patient on a ventilator, the nurse should anticipate an order for
Possible ANSWERs:
FiO2 of 21-25%
PEEP of 5-10 cm H2O respiratory rate of 25-30 breaths/min. tidal
volume of 750-1000 mL. - ANSWER>>tidal volume of 750-1000 mL.
Ventilator settings for a patient with obesity are based on ideal body weight
and healthy lungs. A PEEP of 5-10 H2O is often required in patients who
are morbidly obese. A tidal volume of 750-1000 mL is too high. Patients
often require a FiO2 of at least 30. Even with a head injury, tachypnea with
a respiratory rate of 25-30 is high for this patient.
The trauma program manager of a verified trauma center recognizes this
important outreach obligation to local rural area resources:
Possible ANSWERs:
Injury prevention supplies
Professional education
Clinical practice guidelines
Medical supply resources - ANSWER>>Professional education
, Trauma centers verified through the American College of Surgeons have an
obligation to extend education in the form of professional education,
consultation, or community outreach. Medical and injury prevention
supplies are not an obligation of a verified trauma center. Clinical practice
guidelines are institution specific and not an educational obligation for the
verified trauma center to provide to other facilities.
When appropriately triaging patients, and in order to ensure they are all
treated fairly, the trauma nurse may encounter this type of ethical dilemma:
Possible ANSWERs:
Fidelity
Veracity
Justice
Beneficence - ANSWER>>Justice
Veracity is defined as truth telling; Fidelity is keeping one's promise;
beneficence is to do good; and justice is fairness.
A patient who is currently 30 weeks pregnant presents to the emergency
department after a motor vehicle collision. The patient has absent breath
sounds on the right and an oxygen saturation of 75% and falling despite
supplemental oxygen placement. What intervention should the nurse
anticipate?
Possible
ANSWERs:
ACTUAL
EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES
The patient has injuries as a result of a high-risk auto crash that need to be
addressed at a trauma center. A level 1 trauma center provides the highest
level of trauma care with in-house neurosurgery coverage and is closer
than the level 2 center. A level 3 trauma center is not required to provide
continuous in-house neurosurgery coverage. Due to the patient's GCS less
than or equal to 13, the patient should be evaluated by the closest trauma
center with preferential evaluation at the highest-level trauma center.
A patient presents following a motor vehicle collision and has an unstable
pelvis. The PRIORITY intervention is:
Possible ANSWERs:
administration of analgesics. application of a pelvic binder. initiation
of massive transfusion protocol. infusion of crystalloid fluid -
ANSWER>>application of a pelvic binder.
Pelvic fractures can result in blood loss of 3000mL. Use of a pelvic binder
will assist to tamponade the bleeding in the pelvis and assist with
hemostasis. Blood product transfusion is preferred over crystalloid infusion,
however preventing further hemorrhage is the immediate priority. Analgesic
,administration is important but is not the first priority.
,The nurse is caring for a patient who is morbidly obese. The patient
sustained a head injury and requires intubation. When initially placing the
patient on a ventilator, the nurse should anticipate an order for
Possible ANSWERs:
FiO2 of 21-25%
PEEP of 5-10 cm H2O respiratory rate of 25-30 breaths/min. tidal
volume of 750-1000 mL. - ANSWER>>tidal volume of 750-1000 mL.
Ventilator settings for a patient with obesity are based on ideal body weight
and healthy lungs. A PEEP of 5-10 H2O is often required in patients who
are morbidly obese. A tidal volume of 750-1000 mL is too high. Patients
often require a FiO2 of at least 30. Even with a head injury, tachypnea with
a respiratory rate of 25-30 is high for this patient.
The trauma program manager of a verified trauma center recognizes this
important outreach obligation to local rural area resources:
Possible ANSWERs:
Injury prevention supplies
Professional education
Clinical practice guidelines
Medical supply resources - ANSWER>>Professional education
, Trauma centers verified through the American College of Surgeons have an
obligation to extend education in the form of professional education,
consultation, or community outreach. Medical and injury prevention
supplies are not an obligation of a verified trauma center. Clinical practice
guidelines are institution specific and not an educational obligation for the
verified trauma center to provide to other facilities.
When appropriately triaging patients, and in order to ensure they are all
treated fairly, the trauma nurse may encounter this type of ethical dilemma:
Possible ANSWERs:
Fidelity
Veracity
Justice
Beneficence - ANSWER>>Justice
Veracity is defined as truth telling; Fidelity is keeping one's promise;
beneficence is to do good; and justice is fairness.
A patient who is currently 30 weeks pregnant presents to the emergency
department after a motor vehicle collision. The patient has absent breath
sounds on the right and an oxygen saturation of 75% and falling despite
supplemental oxygen placement. What intervention should the nurse
anticipate?
Possible
ANSWERs:
