TCRN Practice Questions and Answers Updated 2026

TCRN Practice Questions and
Answers Updated 2026
AMtranscranialMdopplerMisMobtainedMforMaMpatientMwithMaMtraumaticMsubarachnoidMhe
morrhage.MTheMdopplerMisMpositiveMforMvasospasm.MTheMtraumaMnurseMwouldMexpectM
whichMofMtheMfollowingMmedicationsMtoMbeMprescribed?M-
MAnswerMAMvasospasmMisMaMknownMcomplicationMofMsubarachnoidMhemorrhages.MCalciu
mMchannelMblockersMareMusedMtoMpreventMorMreverseMvasospasmsMandMareMfrequently
MusedMinMtheMtreatmentMofMaMsubarachnoidMhemorrhage.MMetoprolol,MHydralazineMand
MLisinoprilMareMnotMcalciumMchannelMblockersMandMwouldMnotMbeMeffectiveMtoMpreven
tMandMtreatMvasospasmsMcausedMbyMaMsubarachnoidMhemorrhage



WhichMchamberMofMtheMheartMisMmostMlikelyMtoMbeMaffectedMinMbluntMcardiacMinjurie
s?M-
MAnswerMGivenMtheManatomicalMpositionMofMtheMheartMinMtheMchest,MtheMrightMventr
icleMisMmostMexposedMtoMtheManteriorMportionMofMtheMchestMwallMandMisMmostMlikel
yMtoMbeMinjuredMinMaMbluntMcardiacMinjury.MPatientsMwithMbluntMcardiacMinjuriesMfreq
uentlyMexperienceMsignsMofMrightMventricularMfailure.MAdditionalMfindingsMthatMareMasso
ciatedMwithMbluntMcardiacMinjuriesMincludeMhypotension,MatrialMfibrillation,MunexplainedM
sinusMtachycardia,MmultipleMPVCs,MSTMsegmentMchangesMandMrightMbundleMbranchMbloc
ks.MTheMleftMatrium,MrightMatriumMandMleftMventricleMareMlessMlikelyMtoMbeMinjuredMi
nMaMbluntMcardiacMinjury.



AMwidenedMmediastinumMisMnotedMonMtheMchestMx-
rayMofMaMtraumaticallyMinjuredMhypotensiveMpatient.MTheMtraumaMnurseMwouldManticipa
teMgatheringMwhichMofMtheMfollowingMpiecesMofMequipmentMasMtheMhighestMpriorityMin
MthisMscenario?M-MAnswerMAMwidenedMmediastinumMonMchestMx-
ray,MaccompaniedMbyMhypotension,MisMstronglyMindicativeMofManMaorticMinjury.MOneMof
MtheMmostMlife-
threateningMcomplicationsMofManMaorticMinjuryMisMbloodMloss,MwhichMcanMbeMtreatedM
byMgivingMbloodMproductsMviaMaMrapidMtransfuser.MAlthoughMpatientMassessmentMmayM
beMenhancedMbyMinsertingManMarterialMline,MthisMisMlessMofMaMpriorityMthanMgivingMfl
uidsMrapidly.MAMchestMtubeMisMplacedMinMtheMpleuralMspaceMratherMthanMtheMmediast
inumMandMisMthereforeMnotMindicatedMinMthisMscenario.MSimilarly,MthereMisMnothingMin
MthisMscenarioMthatMindicatesMaMpericardiocentesisMisMindicatedMsoMthisMisMnotMaMhig
herMpriorityMthanMpreparingMaMrapidMtransfuser.



AMproperlyMappliedMpelvicMbinderMsitsMacrossMthe:M-
MAnswerMAMproperlyMappliedMpelvicMbinderMisMappliedMacrossMtheMgreaterMtrochanters
MofMtheMfemur.MThisMallowsMforMoptimalMcompressionMofMtheMpelvisMtoMcontrolMblee
ding.MApplyingMitMacrossMtheMmidshaftMofMtheMfemurMisMtooMlowMandMwouldMprovide
MnoMtherapeuticMbenefit.MApplyingMitMacrossMtheMpelvicMringMorMtheMiliacMcrestsMisMt
ooMhighMandMcouldMactuallyMseparateMtheMpelvisMfurther,MincreasingMbleedingMandMint
ernalMdamage.

,TreatmentMforManMextraperitonealMbladderMruptureMwillMmostMlikelyMinclude:M-
MAnswerMBladderMlacerationsMthatMareMlocatedMbelowMtheMpelvicMperitoneumMareMdiag
nosedMasManMextraperitonealMbladderMrupture.MIfMaMlacerationMisMfoundMalongMwithMp
elvicMperitoneum,MitMwouldMthenMbeMclassifiedMasManMintraperitonealMbladderMrupture.
MManagementMofManMextraperitonealMbladderMruptureMinvolvesMurinaryMcatheterizationM
(urethralMorMsuprapubic)MtoMfacilitateMurinaryMdrainageMfromMtheMbladder.MIntraperitone
alMbladderMrupturesMrequireMsurgicalMinterventionMforMdefinitiveMclosure.MAnMisolatedMe
xtraperitonealMbladderMruptureMdoesMnotMrequireMemergentMsurgicalMrepairMorMintervent
ionalMradiology.



HyperextensionMofMtheMneckMisMknownMtoMcause:M-
MAnswerMHyperextensionMofMtheMneckM(theMheadMsnappingMbackwardsMcommonlyMseen
MinM"whiplash"Minjuries)McausesMcompressionMandMdamageMtoMtheMposteriorMportionMo
fMtheMspinalMcord.MInManteriorMcordMsyndrome,MtheMmechanismMofMinjuryMisMtheMop
positeMofMposteriorMcordMsyndromeM(aMhyperflexionMinjuryMwhereMtheMneckMhyperexte
ndsMforwardM-
MchinMtoMchest)McausingMinjuryMtoMtheManteriorMportionMofMtheMspinalMcord.MAMcaud
aMequinaMsyndromeMcausesMinjuryMtoMtheMsacralMnerveMrootsMwithinMtheMspinalMcanal
MandMisMcausedMbyMfallingMdirectlyMonMtheMsacrum.MBrown-
SequardMSyndromeMcausedMbyMpenetratingMtraumaMtoMtheMlateralMaspectMofMtheMspin
alMcordMwillMcauseMaMleftMtoMrightMphenomenonMinsteadMofMaMtopMdownMphenomen
on.



AMpatientMhasMaMZoneMIIMpenetratingMneckMinjuryMwithMpenetrationMthroughMtheMplat
ysma.MTheMtraumaMnurseMknowsMthatMthisMpatientMisMatMincreasedMriskMofMinjuryMto:
M-
MAnswerMTheMplatysmaMisMaMmuscleMinMtheMneckMthatMgivesMsupportMandMprotection
MtoMtheMvitalMstructuresMunderneathMit.MAnyMtimeMthereMisMpenetrationMthroughMthe
Mplatysma,MthereMisManMincreasedMriskMofMdamageMtoMtheMunderlyingMstructuresMinMt
heMneck.MTheMneckMisMdividedMintoMthreeMzones.MZoneMIMextendsMfromMtheMsternal
MnotchMandMclavicleMupMtoMtheMcricothyroidMcartilage.MZoneMIIMextendsMfromMtheMcri
cothyroidMcartilageMupwardMtoMtheMangleMofMtheMmandible.MZoneMIIIMextendsMfromMt
heMangleMofMtheMmandibleMtoMtheMbaseMofMtheMskull.MStructuresMfoundMinMZoneMIM
includeMtheMsubclavianMartery,MvertebralMartery,MlungMapices,Mtrachea,MthyroidMandMeso
phagus.MZoneMIIMincludesMtheMinternalMjugularMvein,Mesophagus,Mlarynx,MvagusMnerve,M
carotidMarteryMandMvertebralMartery.MZoneMIIIMincludesMtheMsalivaryMandMparotidMgland
s,McranialMnervesMIX-
XII,MvertebralMartery,MdistalMcarotidMartery,MandMdistalMjugularMvein.



AMpregnantMpatient'sMfundalMheightMisMpalpatedM6McmMaboveMtheMumbilicus.MWhatMis
MtheMestimatedMgestationalMageMofMtheMfetus?M-
MAnswerMFundalMheightMisMdefinedMasMtheMdistanceMfromMtheMpubicMboneMtoMtheMt
opMofMtheMuterusMinMcentimeters.MInMgeneral,MtheMfundusMreachesMtheMumbilicusMby

, M20Mweeks.MEveryMcentimeterMpastMthatMpointMisMmeasuredMasM1Mweek.MIfMeveryMo
neMcentimeterMaboveMtheMumbilicusMequalsMoneMweek,MthenMtheMpatientMisMapproxim
atelyM26MweeksMgestation.



AppropriateMcareMforManMamputatedMbodyMpartMincludes:M-
MAnswerMWhenMcaringMforManMamputatedMbodyMpart,MtheMtraumaMnurseMshouldMclea
nMtheMpartMremovingManyMdirtMandMdebris,MwrappingMtheMpartMinMaMslightlyMsalineM
moistenedMgauze,MandMthenMplacingMitMinMaMsealedMplasticMbag.MAtMthisMtime,MtheM
partMshouldMbeMplacedMinMaMsecondMbagMcontainingMaMmixtureMofMiceMandMwater.MI
tMisMimperativeMthatMtheMpartMdoesMnotMfreezeMorMdoesMnotMcomeMintoMcontactMwi
thMwaterM(whichMisMhypotonicMtoMbodyMtissue).MAlsoMensureMthatMtheMamputatedMpar
tMisMproperlyMlabeledMwithMtheMpatientMinformation.



DecontaminationMwithMwaterMisMdiscouragedMinMpatientsMexposedMtoMpowdered:M-
MAnswerMDryMchemicalsMthatMshouldMnotMbeMirrigatedMwithMwaterMincludeMdryMlime,
MelementalMmetalsM(includingMsodium,Mpotassium,MmagnesiumMlithiumMandMphosphorus)
MandMphenol.MWhenMexposedMtoMwaterMtheseMsubstancesMwillMcauseMaMharmfulMexot
hermicMorM"heatMproducing"MreactionMburningMtheMpatient'sMskin.MTheyMmayMalsoMrele
aseMpossibleMhazardousMbyproductsMintoMtheMair.MSulfuricMacid,MmuriaticMacidMandMce
mentMcanMallMbeMirrigatedMwithMcopiousMamountsMofMwaterM(althoughMaMmuchMofMt
heMdryMchemicalMasMpossibleMshouldMbeMbrushedMoffMbeforeMirrigationMwithMwaterMis
Minitiated)



HypovolemicMshockMisMmostMlikelyMtoMbeMcausedMby:M-
MAnswerMHypovolemicMshockMisMcausedMbyMfluidMlossM(e.g.MbleedingMorMdiarrhea)Mor
MthirdMspacingMofMfluids.MTheMinflammatoryMresponseMcausedMbyMaMburnMleadsMtoMc
apillaryMpermeabilityMresultingMinMtheMthirdMspacingMofMfluidsMwhichMresultsMinMhypovo
lemicMshock.MCervicalMspinalMinjuriesMcontributeMtoMneurogenicMratherMthanMhypovolemi
cMshock.MAlthoughManMepiduralMhematomaMcausesMbloodMloss,MtheMepiduralMspaceMis
MrelativelyMsmall,MsoMbloodMaccumulationMwouldMnotMbeMenoughMtoMresultMinMhypovo
lemicMshock.MAMtensionMpneumothoraxMwouldMcauseMobstructiveMshock.



TheMbestMmethodMforMassessingMcapillaryMrefillMonMaMtwo-
weekMoldMtraumaticallyMinjuredMneonateMisMtoMblanchMthe:M-
MAnswerMTheMcirculatoryMsystemMofMtheMneonateMisMnotMwellMdevelopedMandMperfusi
onMtoMtheMfingersMisMnotMcomplete,MthereforeMusingMtheMtipMofMtheMfingerMisMreser
vedMforMolderMchildren,MadolescentsMandMadults.MItMisMgenerallyMrecommendedMtoMuse
MtheMforehead,MsoleMofMtheMfoot,MtheMsternumMorMtheMpalmMofMtheMhandMasMopp
osedMtoMtheMskinMoverMtheMiliacMcrestMorMtheMtipMofMtheMchild'sMtongue



EnteralMfeedingsMareMinitiatedMonMaMtraumaticallyMinjuredMpatientMandMseveralMdaysMla
ter,MtheMtraumaMnurseMnotesMaMsignificantMelevationMinMserumMbloodMureaMnitrogenM