TCRN REVIEW 2025-2026 NEWEST
ACTUAL
EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES ALREADY GRADED A+
1)
The trauma nurse is caring for a 6-year-old child who sustained a tackle
while participating in a youth football game. The patient's mother states,
"He got the wind knocked out of him." Vital signs are:
HR 120 beats/min
BP 85/50 mmHg
RR 26 breaths/min
SpO2 92% (room air)
Based on the injury pattern, the nurse suspects which injury is MOST
likely?
Possible answer(s):
Cardiac contusion
Tension pneumothorax
Pulmonary contusion
Splenic rupture - ANSWER>>Pulmonary contusion
,The chest wall of a child allows for pulmonary contusions without rib
fractures. The child is not actively hypotensive or showing signs of a
tension pneumothorax. Cardiac contusion can lead to decreased cardiac
output, tachycardia, and ventricular ectopy. Splenic rupture will cause
hypotension, which this child is not experiencing.
2)
An infant with a history of Trisomy 21 is being evaluated status post motor
vehicle collision. The nurse anticipates which of the following may be
related to traumatic injury rather than a history of Trisomy 21?
Possible answer(s): atlantoaxial instability limp
extremities tongue obstruction bulging fontanels
- ANSWER>>Bulging fontanels
Limp extremities, tongue obstruction and atlantoaxial instability may all be
common in patients with Down syndrome (Trisomy 21). Bulging fontanels
are a sign of increased intracranial pressure in the infant patient, and
should be considered to be related to traumatic injury.
3)
An opportunity for improvement is identified following a patient delay
transferring to the operating room and a corrective action plan is
implemented. Which of the following provides the BEST example of loop
closure?
Possible answers:
,Communicating with the operating room staff on how to appropriately
schedule cases
Measuring the time to the operating room for the next 10 patients.
Documenting an educational letter sent to the involved surgeon
Recording discussion of the issue in peer review minutes -
ANSWER>>Measuring the time to the operating room for the next 10
patients.
Comments:
Effective performance improvement demonstrates that corrective action
has had the desired effect as determined by continuous monitoring and
evaluation. Demonstrating that the time to the operating room is within
limits is the best way to demonstrate effective loop closure of this
performance improvement event. The others are examples of actionable
items but they don't provide the best, complete loop closure that specific
measurable time objectives would.
During a debrief of a trauma activation, the surgeon is concerned that the
resuscitation effort was very disorganized from pre-hospital report and
throughout the initial trauma care. What is the BEST example of an
intervention to improve team communication in future resuscitations?
Possible answers:
Creating a standardized pre-hospital reporting tool
, Initiating pre-arrival huddles
Identifying roles upon patient arrival
Allowing silence for pre-hospital providers report - ANSWER>>Initiating
pre-arrival huddles
Clear communication of the patient plan, roles and responsibilities, and
providing an opportunity to discuss staff concerns are part of the pre-arrival
huddle. The team leader can communicate anticipated resuscitative goals,
clarify assignments, and assist in prioritizing care. Allowing pre-hospital
staff an uninterrupted opportunity to provide report as well as creating a
standardized tool will address the potential loss of pertinent information
during the pre-hospital hand-off but will not address the overall team
communication issue. Identification of roles should be done prior to the
patient arrival.
A patient is being transported by prehospital personnel after being involved
in a motor vehicle collision. The patient's assessment reveals an intact
airway and the following vitals:
BP: 110/72 (mmHg)HR: 119 (beats/min)RR: 26 (breaths/min)Glasgow
Coma Scale (GCS) score: 9
The MOST appropriate destination for transport is:
Possible answers:
level 3 trauma center 10 minutes away level
1 trauma center 20 minutes away level 2
ACTUAL
EXAM VERIFIED QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES ALREADY GRADED A+
1)
The trauma nurse is caring for a 6-year-old child who sustained a tackle
while participating in a youth football game. The patient's mother states,
"He got the wind knocked out of him." Vital signs are:
HR 120 beats/min
BP 85/50 mmHg
RR 26 breaths/min
SpO2 92% (room air)
Based on the injury pattern, the nurse suspects which injury is MOST
likely?
Possible answer(s):
Cardiac contusion
Tension pneumothorax
Pulmonary contusion
Splenic rupture - ANSWER>>Pulmonary contusion
,The chest wall of a child allows for pulmonary contusions without rib
fractures. The child is not actively hypotensive or showing signs of a
tension pneumothorax. Cardiac contusion can lead to decreased cardiac
output, tachycardia, and ventricular ectopy. Splenic rupture will cause
hypotension, which this child is not experiencing.
2)
An infant with a history of Trisomy 21 is being evaluated status post motor
vehicle collision. The nurse anticipates which of the following may be
related to traumatic injury rather than a history of Trisomy 21?
Possible answer(s): atlantoaxial instability limp
extremities tongue obstruction bulging fontanels
- ANSWER>>Bulging fontanels
Limp extremities, tongue obstruction and atlantoaxial instability may all be
common in patients with Down syndrome (Trisomy 21). Bulging fontanels
are a sign of increased intracranial pressure in the infant patient, and
should be considered to be related to traumatic injury.
3)
An opportunity for improvement is identified following a patient delay
transferring to the operating room and a corrective action plan is
implemented. Which of the following provides the BEST example of loop
closure?
Possible answers:
,Communicating with the operating room staff on how to appropriately
schedule cases
Measuring the time to the operating room for the next 10 patients.
Documenting an educational letter sent to the involved surgeon
Recording discussion of the issue in peer review minutes -
ANSWER>>Measuring the time to the operating room for the next 10
patients.
Comments:
Effective performance improvement demonstrates that corrective action
has had the desired effect as determined by continuous monitoring and
evaluation. Demonstrating that the time to the operating room is within
limits is the best way to demonstrate effective loop closure of this
performance improvement event. The others are examples of actionable
items but they don't provide the best, complete loop closure that specific
measurable time objectives would.
During a debrief of a trauma activation, the surgeon is concerned that the
resuscitation effort was very disorganized from pre-hospital report and
throughout the initial trauma care. What is the BEST example of an
intervention to improve team communication in future resuscitations?
Possible answers:
Creating a standardized pre-hospital reporting tool
, Initiating pre-arrival huddles
Identifying roles upon patient arrival
Allowing silence for pre-hospital providers report - ANSWER>>Initiating
pre-arrival huddles
Clear communication of the patient plan, roles and responsibilities, and
providing an opportunity to discuss staff concerns are part of the pre-arrival
huddle. The team leader can communicate anticipated resuscitative goals,
clarify assignments, and assist in prioritizing care. Allowing pre-hospital
staff an uninterrupted opportunity to provide report as well as creating a
standardized tool will address the potential loss of pertinent information
during the pre-hospital hand-off but will not address the overall team
communication issue. Identification of roles should be done prior to the
patient arrival.
A patient is being transported by prehospital personnel after being involved
in a motor vehicle collision. The patient's assessment reveals an intact
airway and the following vitals:
BP: 110/72 (mmHg)HR: 119 (beats/min)RR: 26 (breaths/min)Glasgow
Coma Scale (GCS) score: 9
The MOST appropriate destination for transport is:
Possible answers:
level 3 trauma center 10 minutes away level
1 trauma center 20 minutes away level 2
