TCRN trauma certified RN EXAM A+ GRADE ASSURED COMPLETE SOLUTIONS AND VERIFIED ANSWERS

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Exam Solution zm




TCRN 2026 A+ GRADE ASSURED COMPLETE SOLUTION
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S AND VERIFIED ANSWERS (3BA5C)
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QUESTION 1 zm




2) An infant with a history of Trisomy 21 is being evaluated status post motor vehicle
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collision. The nurse anticipates which of the following may be related to traumatic inj
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ury rather than a history of Trisomy 21? Possible answer(s): atlantoaxial instability li
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mp extremities tongue obstruction bulging fontanels
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ANSWER

Bulging fontanels Limp extremities, tongue obstruction and atlantoaxial instability may all be commo
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n in patients with Down syndrome (Trisomy 21). Bulging fontanels are a sign of increased intracrani
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al pressure in the infant patient, and should be considered to be related to traumatic injury.
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QUESTION 2 zm




A patient presents following a motor vehicle collision and has an unstable pelvis. The
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PRIORITY intervention is: Possible answers: administration of analgesics. application o
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f a pelvic binder. initiation of massive transfusion protocol. infusion of crystalloid flui
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d
ANSWER

application of a pelvic binder. Pelvic fractures can result in blood loss of 3000mL. Use of a pelvic bi
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nder will assist to tamponade the bleeding in the pelvis and assist with hemostasis. Blood product t
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ransfusion is preferred over crystalloid infusion, however preventing further hemorrhage is the imm
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ediate priority. Analgesic administration is important but is not the first priority.
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QUESTION 3 zm




The nurse is caring for a patient who is morbidly obese. The patient sustained a head
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injury and requires intubation. When initially placing the patient on a ventilator, the
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nurse should anticipate an order for Possible answers: FiO2 of 21-25% PEEP of 5-
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10 cm H2O respiratory rate of 25-30 breaths/min. tidal volume of 750-1000 mL.
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ANSWER

,tidal volume of 750-
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1000 mL. Ventilator settings for a patient with obesity are based on ideal body weight and healthy l
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ungs. A PEEP of 5-
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10 H2O is often required in patients who are morbidly obese. A tidal volume of 750-
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1000 mL is too high. Patients often require a FiO2 of at least 30. Even with a head injury, tachypne
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a with a respiratory rate of 25-30 is high for this patient.
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QUESTION 4 zm




The trauma program manager of a verified trauma center recognizes this important o
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utreach obligation to local rural area resources: Possible answers: Injury prevention s
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upplies Professional education Clinical practice guidelines Medical supply resources
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ANSWER

Professional education Trauma centers verified through the American College of Surgeons have an o
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bligation to extend education in the form of professional education, consultation, or community outr
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each. Medical and injury prevention supplies are not an obligation of a verified trauma center. Clinic
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al practice guidelines are institution specific and not an educational obligation for the verified traum
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a center to provide to other facilities.
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QUESTION 5 zm




When appropriately triaging patients, and in order to ensure they are all treated fairl
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y, the trauma nurse may encounter this type of ethical dilemma: Possible answers: Fid
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elity Veracity Justice Beneficence
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ANSWER

Justice Veracity is defined as truth telling; Fidelity is keeping one's promise; beneficence is to do go
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od; and justice is fairness.
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QUESTION 6 zm




The nurse is monitoring a patient for intracranial hypertension. The nurse should und
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erstand that which of the following increases cerebral blood volume? Possible answer
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s: hyperthermia elevated PaO2 hypothermia hypocapnia
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ANSWER

hyperthermia: Anything that causes an increase in metabolic rate (e.g. hyperthermia) can increase ce
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rebral blood flow. A reduction in metabolic rate (e.g. from hypothermia, hypocapnia) decreases cere
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bral blood flow. High PaO2 levels have not been shown to affect cerebral blood flow in either direct
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ion.



QUESTION 7 zm

, The nurse is caring for a patient with a C5 tetraplegic injury on hospital day two. The
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patient does not have any active bleeding. Mean arterial pressure is 60 mmHg. The n
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urse should anticipate orders to Possible answers: position the patient in reverse Tre
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ndelenburg. administer hypertonic saline. initiate vasopressors. maintain hypothermia.
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ANSWER

initiate vasopressors. Blood pressure in the spinal cord injured patient is first managed with isotonic
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crystalloid administration and once intravascular volume has been optimized, vasoactive agents are
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used. Patients with SCI are poikilothermic and need to maintain normothermia. Current guidelines re
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commend a systolic BP >90 mmHg and a MAP of 85-
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90 mmHg to optimize blood flow to the cord and prevent secondary injury. Placing a patient in reve
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rse Trendelenburg would not be indicated.
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QUESTION 8 zm




Placing a tourniquet on an extremity after a penetrating injury is what level of injury
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prevention? Primary tertiary quaternary secondary zm zm zm zm




ANSWER

Secondary A tourniquet is secondary injury prevention because it's aim is to reduce/eliminate blood
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mloss from initial injury. It does not prevent the penetrating injury itself (primary), and the healing p
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rocess is variable on additional factors aside from the tourniquet (tertiary). There is no quaternary l
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evel of injury prevention, however, quaternary injuries may be sustained from certain types of trau
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QUESTION 9 zm




The nurse recently admitted a patient to the floor following a motor vehicle collision
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earlier that morning. At the end of the shift, the patient complains of lower abdominal
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pain. Upon assessment, there is periumbilical bruising, known as which sign? Kehr C
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ullen Grey Turner Rovsingzm zm zm




ANSWER

Cullen Cullen sign is periumbical bruising indicative of intraperitoneal bleeding, Grey Turner sign is f
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lank bruising indicating retroperitoneal bleeding, Kehr sign is shoulder pain indicating intraperitonea
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l bleeding, Rovsing sign is right lower quadrant pain elicited by palpation of the left lower quadrant,
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indicative of appendicitis.
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QUESTION 10 zm




A patient arrives in the trauma bay after a motor vehicle crash with a past medical hi
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story of trisomy- zm zm



21. The PRIORITY intervention is: cervical spine immobilization supplemental oxygen
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application. large bore vascular access. capillary blood glucose measurement.
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ANSWER