TCAR POST TEST EXAM 2026/2027, HIGH YIELD PRACTICE QUESTIONS
AND A NEW UPDATED STUDY GUIDE COMPLETE ACCURATE
QUESTIONS AND CORRECT SOLUTIONS WITH DETAILED RATIONALES
(100% CORRECT VERIFIED ANSWERS) NEWEST UPDATED VERSION
2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED
TCAR POST APPROVED EXAM
1. A trauma patient arrives with signs of profound hemorrhagic shock.
Which finding best supports the need for resuscitative endovascular
balloon occlusion of the aorta (REBOA)?
A) Systolic blood pressure of 90 mmHg with a palpable radial pulse
B) Non-compressible torso hemorrhage with systolic BP <90 mmHg
after 1-liter crystalloid
C) Isolated traumatic brain injury with a Glasgow Coma Scale score of
14
D) Bilateral femur fractures with a normal abdominal exam
Correct Answer: B – Non-compressible torso hemorrhage with systolic
BP <90 mmHg after 1-liter crystalloid
Rationale: REBOA is indicated for non-compressible torso hemorrhage
(e.g., abdominal or pelvic bleeding) with persistent hypotension despite
initial resuscitation. Option A shows borderline pressure with palpable
pulse, not an indication. Option C is a primary brain injury, not
hemorrhagic shock. Option D involves long bone fractures, which are
compressible or manageable with other means.
2. A patient in traumatic cardiac arrest has received 10 minutes of CPR
with no signs of life. The rhythm is asystole. What is the most
appropriate next action?
,A) Continue CPR and administer 3 mg of epinephrine
B) Perform a bilateral finger thoracotomy
C) Declare resuscitation efforts futile
D) Initiate massive transfusion protocol and transport
Correct Answer: C – Declare resuscitation efforts futile
*Rationale: In traumatic cardiac arrest, prolonged asystole with no
reversible causes (e.g., tension pneumothorax, hypovolemia) after 10-15
minutes of high-quality CPR has nearly 0% survival. TCAR guidelines
emphasize terminating futile efforts. Finger thoracotomy (B) is for
tension pneumothorax, not asystole without respiratory distress signs. *
3. Which laboratory value is most concerning for impending
coagulopathy in a severely injured trauma patient?
A) Platelet count 180,000/µL
B) INR 1.2
C) Ionized calcium 0.8 moll/L
D) Fibrinogen 250 mg/ld.
Correct Answer: C – Ionized calcium 0.8 moll/L
*Rationale: Hypocalcemia (ionized calcium <1.0 moll/L) worsens
coagulopathy by impairing platelet function and clotting factor activity,
especially after massive transfusion of citrated blood products. Option A
and D are normal; Option B is mildly elevated but not critical. *
,4. A blunt trauma patient has a pelvic fracture and becomes hypotensive
after log-rolling. You suspect ongoing pelvic bleeding. Which
intervention should occur first?
A) Apply a pelvic binder
B) Administer tranexamic acid (TXA)
C) Perform diagnostic peritoneal lavage
D) Order a CT angiogram
Correct Answer: A – Apply a pelvic binder
Rationale: For unstable pelvic fractures with hypotension, mechanical
stabilization with a pelvic binder reduces pelvic volume, tamponades
bleeding, and should be applied immediately. TXA (B) is adjunctive but
not first. DPL (C) is invasive and rarely used. CT (D) delays
stabilization in a hypotensive patient.
5. Which statement correctly describes the use of whole blood in trauma
resuscitation?
A) Whole blood is contraindicated in patients with known liver disease
B) Low-titer group O whole blood (LTOWB) can be used in place of
1:1:1 ratio component therapy
C) Whole blood must be cross-matched before administration in all
trauma patients
D) Whole blood is only indicated for pediatric trauma patients
Correct Answer: B – Low-titer group O whole blood (LTOWB) can be
used in place of 1:1:1 ratio component therapy
, *Rationale: LTOWB provides balanced resuscitation (RBCs, plasma,
platelets) and is preferred over 1:1:1 components in many TCAR
protocols. Option A is false; liver disease is not a contraindication.
Option C is false; LTOWB can be given uncross-matched in
emergencies. Option D is false; it is used in adults as well. *
6. A patient sustains a Grade IV liver laceration and remains
hypotensive despite 2 units of packed RBCs and 1 unit of plasma. What
is the next best step?
A) Administer 1 gram of tranexamic acid over 10 minutes
B) Perform angioembolization of the hepatic artery
C) Repeat FAST exam
D) Transfer to operating room for laparotomy
Correct Answer: D – Transfer to operating room for laparotomy
Rationale: Ongoing hemodynamic instability after initial resuscitation
from a high-grade solid organ injury indicates failure of non-operative
management. Operative intervention (damage control laparotomy) is
indicated. Angioembolization (B) is for stable patients with arterial
blush. TXA (A) is adjuvant not definitive.
7. Which finding on the primary survey is most consistent with tension
pneumothorax in a mechanically ventilated trauma patient?
A) Jugular venous distension and absent breath sounds on the left
B) Hypotension, tracheal deviation to the right, and absent breath sounds
on the left
C) Hypoxia with bilateral crackles on auscultation
AND A NEW UPDATED STUDY GUIDE COMPLETE ACCURATE
QUESTIONS AND CORRECT SOLUTIONS WITH DETAILED RATIONALES
(100% CORRECT VERIFIED ANSWERS) NEWEST UPDATED VERSION
2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED
TCAR POST APPROVED EXAM
1. A trauma patient arrives with signs of profound hemorrhagic shock.
Which finding best supports the need for resuscitative endovascular
balloon occlusion of the aorta (REBOA)?
A) Systolic blood pressure of 90 mmHg with a palpable radial pulse
B) Non-compressible torso hemorrhage with systolic BP <90 mmHg
after 1-liter crystalloid
C) Isolated traumatic brain injury with a Glasgow Coma Scale score of
14
D) Bilateral femur fractures with a normal abdominal exam
Correct Answer: B – Non-compressible torso hemorrhage with systolic
BP <90 mmHg after 1-liter crystalloid
Rationale: REBOA is indicated for non-compressible torso hemorrhage
(e.g., abdominal or pelvic bleeding) with persistent hypotension despite
initial resuscitation. Option A shows borderline pressure with palpable
pulse, not an indication. Option C is a primary brain injury, not
hemorrhagic shock. Option D involves long bone fractures, which are
compressible or manageable with other means.
2. A patient in traumatic cardiac arrest has received 10 minutes of CPR
with no signs of life. The rhythm is asystole. What is the most
appropriate next action?
,A) Continue CPR and administer 3 mg of epinephrine
B) Perform a bilateral finger thoracotomy
C) Declare resuscitation efforts futile
D) Initiate massive transfusion protocol and transport
Correct Answer: C – Declare resuscitation efforts futile
*Rationale: In traumatic cardiac arrest, prolonged asystole with no
reversible causes (e.g., tension pneumothorax, hypovolemia) after 10-15
minutes of high-quality CPR has nearly 0% survival. TCAR guidelines
emphasize terminating futile efforts. Finger thoracotomy (B) is for
tension pneumothorax, not asystole without respiratory distress signs. *
3. Which laboratory value is most concerning for impending
coagulopathy in a severely injured trauma patient?
A) Platelet count 180,000/µL
B) INR 1.2
C) Ionized calcium 0.8 moll/L
D) Fibrinogen 250 mg/ld.
Correct Answer: C – Ionized calcium 0.8 moll/L
*Rationale: Hypocalcemia (ionized calcium <1.0 moll/L) worsens
coagulopathy by impairing platelet function and clotting factor activity,
especially after massive transfusion of citrated blood products. Option A
and D are normal; Option B is mildly elevated but not critical. *
,4. A blunt trauma patient has a pelvic fracture and becomes hypotensive
after log-rolling. You suspect ongoing pelvic bleeding. Which
intervention should occur first?
A) Apply a pelvic binder
B) Administer tranexamic acid (TXA)
C) Perform diagnostic peritoneal lavage
D) Order a CT angiogram
Correct Answer: A – Apply a pelvic binder
Rationale: For unstable pelvic fractures with hypotension, mechanical
stabilization with a pelvic binder reduces pelvic volume, tamponades
bleeding, and should be applied immediately. TXA (B) is adjunctive but
not first. DPL (C) is invasive and rarely used. CT (D) delays
stabilization in a hypotensive patient.
5. Which statement correctly describes the use of whole blood in trauma
resuscitation?
A) Whole blood is contraindicated in patients with known liver disease
B) Low-titer group O whole blood (LTOWB) can be used in place of
1:1:1 ratio component therapy
C) Whole blood must be cross-matched before administration in all
trauma patients
D) Whole blood is only indicated for pediatric trauma patients
Correct Answer: B – Low-titer group O whole blood (LTOWB) can be
used in place of 1:1:1 ratio component therapy
, *Rationale: LTOWB provides balanced resuscitation (RBCs, plasma,
platelets) and is preferred over 1:1:1 components in many TCAR
protocols. Option A is false; liver disease is not a contraindication.
Option C is false; LTOWB can be given uncross-matched in
emergencies. Option D is false; it is used in adults as well. *
6. A patient sustains a Grade IV liver laceration and remains
hypotensive despite 2 units of packed RBCs and 1 unit of plasma. What
is the next best step?
A) Administer 1 gram of tranexamic acid over 10 minutes
B) Perform angioembolization of the hepatic artery
C) Repeat FAST exam
D) Transfer to operating room for laparotomy
Correct Answer: D – Transfer to operating room for laparotomy
Rationale: Ongoing hemodynamic instability after initial resuscitation
from a high-grade solid organ injury indicates failure of non-operative
management. Operative intervention (damage control laparotomy) is
indicated. Angioembolization (B) is for stable patients with arterial
blush. TXA (A) is adjuvant not definitive.
7. Which finding on the primary survey is most consistent with tension
pneumothorax in a mechanically ventilated trauma patient?
A) Jugular venous distension and absent breath sounds on the left
B) Hypotension, tracheal deviation to the right, and absent breath sounds
on the left
C) Hypoxia with bilateral crackles on auscultation
