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TCRN PRACTICE QUESTIONS WITH CORRECT ANSWERS
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TCRN PRACTICE QUESTIONS WITH CORRECT ANSWERS
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TCRN TEST QUESTIONS WITHCORRECT ANSWERS
Fluid sresuscitation sis sadministered sto sa straumatically sinjured spatient. sAfter
sresuscitation, sthe strauma snurse sevaluates sthe spatient's sresponse sto sthat sresuscitation
sto sdetermine swhether sadditional sfluids sshould sbe sadministered. sWhich sof sthe sfollowing
sfactors sis smost slikely sto simpact sthis sevaluation? s- scorrect sanswer s✔✔Beta-blockers
sblunt schanges sin sthe spulse sand sblood spressure. sThis smay sboth sreduce schanges
sassociated swith srecognizing shypovolemia sbut sit scan salso sreduce schanges sassociated
swith sthe sresponse sto streatment. sMany stimes sthe sblood spressure sfalls sand sthe spulse
srises swith shypovolemia sand sthe sopposite shappens safter sfluid sresuscitation. sWhen sthe
spatient sis son sbeta-blockers, sthese schanges smay snot soccur. sAlthough sit sis smore
sdifficult sto sassess sfor schanges sin sskin scolor sin sdark-skinned sindividuals, sskin schanges
sare sgenerally snot sused sto sevaluate sthe seffectiveness sof sfluid sresuscitation sand sfurther
sresuscitation swould snot sbe sbased son schanges sin sskin scolor. sThe spresence sof slower
sextremity strauma sdoes snot sinfluence sevaluation sof sfluid sresuscitation snor sthe sneed sfor
sadditional sfluids. sA sbody smass sindex sof s21 skg/m2 sis swithin snormal slimits sand sis
sunlikely sto saffect sresuscitation sor sthe sevaluation sof sresuscitation
50% spolyethylene sglycol swill sbe sused sas spart sof sthe streatment sfor: s- scorrect sanswer
s✔✔50% spolyethylene sglycol sis sknown sto sincrease sthe ssolubility sof sphenols sin swater
sand sshould sbe sused sas spart sof sthe sdecontamination sprocess sin spatients sexposed sto
sphenols. sIt swill shave sno stherapeutic seffect sfor spatients swith spancreatic strauma, scarbon
smonoxide spoisoning s(treated swith s100% soxygen) sor sacute srespiratory sdistress
ssyndrome s(treated swith sappropriate sventilator smanagement sand sprone spositioning)
A sreagent sstrip sthat stests sfor sglucose sis sused sin sthe sassessment sof sa straumatically
sinjured spatient. sWhat sinjury sis slikely ssuspected? s- scorrect sanswer s✔✔A sbasilar sskull
sfracture smay sresult sin sleakage sof scerebrospinal sfluid, swhich sis srich sin sglucose.
sReagent sstrips sthat stest sfor sglucose scan sbe sused sto sassist sthe sdiagnosis sof sbasilar
sskull sfracture sby schecking sfluid scoming sfrom sthe snose sor sears sfor sglucose. sA sreagent
sstrip sthat stests sfor sglucose swill snot sbe stherapeutic sin sassessing sfor sa sbladder srupture,
sdiffuse saxonal sinjury sor sa sruptured samniotic ssac.
When sadministering slarge svolumes sof sblood sproducts, sthe strauma snurse sshould
smonitor sfor swhich sof sthe sfollowing sfindings swhich scould sindicate shypocalcemia? s-
scorrect sanswer s✔✔A sclassic sfinding sassociated swith shypocalcemia sis sQT
sprolongation. sST selevation sis smore scommon swith scardiac sischemia sand snot
sassociated swith shypocalcemia. sTall speaked sT swaves sand sflattening sof sthe sP swave sare
sboth sassociated swith shyperkalemia, snot shypocalcemia
,The strauma snurse sknows sthat streatment sfor sa spatient swith snon-operative sabdominal
strauma shas sbeen seffective sif: s- scorrect sanswer s✔✔A sgoal sof streatment safter
sabdominal strauma sis sa sreturn sof sthe sbase sdeficit sto snormal. sThis sindicates sadequate
sfluid sresuscitation sand sis sassociated swith spositive soutcomes. sAlthough sserum samylase
slevels sshould sbe smonitored sbecause selevations sin sthese slevels smay sindicate
spancreatic sor sbowel strauma, schanges sin sserum samylase slevels sare snot sassociated
swith seffective streatment, sbut srather sassociated swith sthe sinjuries sthemselves.
sIntraabdominal spressures sshould sbe sbelow s10 smm sHg. sAn sintaabdominal spressure
sabove s12 smm sHg sindicates sintraabominal shypertension, sindicating sa sneed sfor sfurther.
sHyperrresonance sto spercussion sin sthe sabdomen sis san sindication sof shollow sorgan
sinjury sand sis snot sa sgoal sof streatment
Which sof sthe sfollowing sstatements, smade sby sa spatient sbeing sdischarged shome swith
sthe sdiagnosis sof sa shyphema, sindicates sFURTHER steaching sis swarranted? s- scorrect
sanswer s✔✔A shyphema sis sa scollection sof sblood sin sthe santerior schamber sof sthe seye.
sAn sisolated shyphema smay sbe streated sat shome sbut sthe spatient sshould sbe sencouraged
sto srest sand savoid sany sactivities swhich scould sincrease sintraocular spressure sand scause
sfurther sbleeding. sPatients swill sbe sencouraged sto skeep stheir shead selevated s30 sto s45
sdegrees son spillows, sto srest stheir seyes s(avoid sactivities ssuch sas swatching stelevision sor
sreading) sand sto swatch sfor ssigns sof snew sbleeding s(which scan sinclude svagal sstimulation
sin sthe sform sof snausea sand svomiting.) sIbuprofen sand sother smedications swhich scan
sincrease sthe srisk sof sbleeding sshould sbe savoided.
A sKleihauer-Betke stest smay sbe sused sto sdetermine: s- scorrect sanswer s✔✔A sKleihauer-
Betke stest sis sused sto sdetermine sthe spresence sof sfetal sblood sin smaternal scirculation
sand sis soften spositive sin spatients swith splacental sabruption. sThe sKleihauer-Betke stest sis
snot suseful sin sdetermining spain slevels snor swill sit shelp sdetermine sthe spresence sof
spancreatic strauma. sIt sis snot sassociated swith sacute srespiratory sdistress ssyndrome
Adoption sof sa smass stransfusion sprotocol sshould shelp sreduce sthe sincidence sof: s-
scorrect sanswer s✔✔A smass stransfusion sprotocol smay sprevent sthe sonset sof sa ssystemic
sinflammatory sresponse ssyndrome s(SIRS). sThe sonset sof sSIRS sis srelated sto stissue
strauma sand sprolonged stissue shypoxia. sEarly, saggressive sfluid sand sblood sresuscitation
smay sdecrease stissue shypoxia. sFat semboli sare sthe sresult sof sa slarge sbone sfracture sand
sthe sincidence sof sthese sis snot saffected sby sMTP. sPost-renal sfailure sis scaused sby
sobstructions sin sthe slower sgenitourinary stract sand sthe sincidence sof sthis scomplication sis
snot saltered sby sMTP. sAbdominal scompartment ssyndrome sis sthe sresult sof sexcessive
sfluid sin sthe speritoneum. sWhile sMTP sis snot sdirectly sassociated swith sabdominal
scompartment ssyndrome, sthe sfluids sadministered sduring sactivation sof sMTP scould
sworsen srather sthan sreduce sthe sincidence sof sabdominal scompartment ssyndrome
Which sof sthe sfollowing sgoals sof scare sis smost sappropriate sfor sa spatient swith sa smaxillary
sfracture? s- scorrect sanswer s✔✔A smaxillary sfracture scauses sloss sof sbony sstructure sto
sthe smid-face swhich scan scause sloss sof sintegrity sof sthe sairway. sThis scan sbe
sexacerbated sby sbleeding sand sedema sin sthe sairway, sfurther sputting sthe sability sto
smaintain sthe sairway sin sjeopardy. sWhen scaring sfor spatients swith sa smaxillary sfracture,
,smaintenance sof sairway sis salways sa shigh spriority. sAlterations sin svisual sacuity
sassociated swith smaxillary sfractures slikely soccurred sat sthe stime sof sinjury sand streatment
sis sunlikely sto salter sthis soutcome. sMaxillary sfractures sare snot ssplinted, sthey sare
ssurgically srepaired. sTreatment swill snot sreduce scerebrospinal sfluid sleakage; stherefore,
sthis sis snot sa sgoal sof scare
Which sof sthe sfollowing sblood surea snitrogen sratios sis sassociated swith seffective sfluid
sresuscitation? s- scorrect sanswer s✔✔A snormal sblood surea snitrogen s(BUN) sto screatinine
sratio sis s10:1 sand sindicates seffective srenal sfunctioning. sIf sthe sBUN sto screatinine sratio
sincreases, sthat sis san sindication sof shypovolemia s(e.g. s20:1, s30:1 sor s40:1)
One sgoal sof san seffective sperformance simprovement sprogram swould sbe sto sreduce sthe:
s- scorrect sanswer s✔✔A sperformance simprovement sprogram sis smeant sto simprove sthe
scare sdelivered. sImprovement sin scare sis smeasured sdifferently sby sdifferent speople.
sPatients stend sto smeasure ssuccess sby simproving squality soutcomes s(not sreducing
squantities sof soutcomes). sCare sproviders stend sto smeasure ssuccess sby sincreasing sthe
squality sof sthe scare sdelivery sprocess s(not sreducing sthe squality sof sthe sprocess). sPayors
stend sto smeasure ssuccess sthrough sreduced scosts. sReducing sthe snumber sof sproviders
sis snot sa sdirect sgoal sof sthe sperformance simprovement sprocess
The shighest spriority sintervention sfor sa spatient swith sindications sof sa sruptured suterus sis:
s- scorrect sanswer s✔✔A sruptured suterus scauses ssignificant sblood sloss sresulting sin slife-
threatening sblood sloss. sTherefore, sthe spriority sintervention swould sbe sinitiation sof san
sintravenous sline sso sthat sfluid sresuscitation scan sbe scommenced. sTransfer sto sthe
ssurgical ssuite swill salso sbe srequired sbut sthis sdoes snot sconstitute sa shigher spriority sthan
sinitiation sof san sintravenous sline. sTerbutaline smay sbe sused sto sabate spremature slabor
sbut shas sno stherapeutic seffect sfor sa sruptured suterus. sCardiotocographic smonitoring sis
snot sindicated sfor sa sruptured suterus sand sis snot sa shigher spriority sthan sinitiation sof san
sintravenous sline
Which sactivity smust sproceed smeasurement sof sbladder spressures sused sto smonitor
sabdominal scompartment ssyndrome? s- scorrect sanswer s✔✔A sset samount sof sfluid smust
sbe sadministered sinto sthe sbladder sbefore sbladder spressures scan sbe smeasured. sOnce
sthe sfluid sis sinstilled, sthe scatheter smust sbe sclamped suntil sthe smeasurement sis
scomplete. sAlthough sadministration sof sanalgesia sis snot scontraindicated, sit sis snot
srequired sto sobtain sa sbladder spressure. sThe shead sof sthe sbed sshould sbe sflat, snot
selevated s30 sdegrees sin sorder sto smeasure sbladder spressures. sThere sis sno sneed sto
sadminister s500 smL sboluses sof scrystalloid ssolution sprior sto smeasuring sbladder
spressure
The strauma snurse sknows sthat sthe sbest sway sto sincrease sfibrinogen slevels sin sa spatient
swith scoagulopathies sis sto sadminister: s- scorrect sanswer s✔✔A ssingle sbag sof
scryoprecipitate scontains s350 smg sof sfibrinogen. sAdministering seither sVitamin sK sor
splatelets swill snot selevate sfibrinogen slevels. sAlthough sfresh sfrozen splasma smay shave
ssome sfibrinogen sin sit, sthis sblood sproduct sdoes snot scontain sas smuch sfibrinogen sas
scryoprecipitate.
, Which sof sthe sfollowing sfindings sindicates sthat sthe sfamily smember sof sa straumatically
sinjured spatient shas sentered sa sstate sof scrisis? s- scorrect sanswer s✔✔A sstate sof scrisis sis
smarked sby sfailure sof susual scoping smechanisms. sThe sindividual scan sno slonger sfunction
snormally, soften sbecoming sanxious, sdisorganized sand spanicky. sThey smay sregress sand
sbecome sparalyzed, sbeing sunable sto smake ssimple sdecisions s(like sdeciding swhat sto seat
sfor sa smeal). sThey smay sdigress sto sless sfunctional sbehaviors slike sviolence sor ssubstance
sabuse. sComplaints sof snausea sand slack sof sappetite, sbad sdreams sinterrupting ssleep
sand sverbalizing sa sstrong sdesire sto sstay sclose sto san sinjured sloved sone sare sall
sexpected sresponses sthat smay soccur safter slearning sof sa sloved sone sbeing straumatically
sinjured sand sare snot sspecific ssymptoms sof sa sstate sof scrisis
Performing sa stertiary sexam son sa straumatically sinjured spatient sserves sthe spurpose sof: s-
scorrect sanswer s✔✔A stertiary sexam sis scarried sout s24 sto s72 shours safter sadmission s(and
smay sbe srepeated sespecially sif sa spatient sregains sconsciousness). sIt sinvolves sa srepeat
sof sthe sprimary sand ssecondary ssurvey sas swell sas sa sreview sof sthe spatient's sdiagnostic
sstudies sand sis suseful sin sidentifying sinjuries sthat smay shave sbeen smissed sduring sthe
sinitial sresuscitation. sThe scontrol sof shemorrhage sshould shave sbeen saccomplished sas
spart sof sthe sprimary ssurvey. sIf sa spatient scontinues sto shemorrhage sat sthe stime sof sthe
stertiary sexam, sthen stheir scondition sis slikely svery spoor. sRadiographic sstudies sshould sbe
sfacilitated sas spart sof sthe ssecondary sexam sand swill sthen sbe sreviewed sas spart sof sthe
stertiary sexam. sThe spurpose sof sthe stertiary sexam sis snot sto srecognize spsychosocial
strauma
A spercutaneous sdrain sis smost slikely sto sbe sinserted sfor sthe streatment sof sa: s- scorrect
sanswer s✔✔A surinoma sis sa scollection sof surine sin stissue soutside sof sthe srenal ssystem
sand soften sfollows san sinjury sto sthe sgenitourinary ssystem. sAlthough ssmall surinomas
smay sreabsorb swithout streatment, sothers scan sgo son sto sbecome sinfected sor scause
selectrolyte sdisturbances sand swill sneed sto sbe sdrained svia sinsertion sof sa spercutaneous
sdrain. sA shyphema sis sa scollection sof sblood sin sthe santerior schamber sof sthe seye sand sis
susually sallowed sto sreabsorb sover stime srather sthan sbeing sdrained. sFat semboli scannot
sbe sreduced swith sa sdrain sand sare streated swith shigh sflow soxygen sor sintubation swith
smechanical sventilation. sA sdiaphragmatic srupture swill srequire ssurgical sintervention sfor
srepair sand scannot sbe smanaged sby sa sdrain
Abdominal sperfusion spressures sdecrease. sThis sis smost slikely sdue sto san sincrease sin: s-
scorrect sanswer s✔✔Abdominal sperfusion spressures sare smeasured sby ssubtracting sthe
smean sarterial spressure sfrom sthe sintraabdominal spressure. sThe slower sthe smean
sarterial spressure sdrops sand sthe shigher sthe sintraabdominal spressure sclimbs, sthe slower
sthe sabdominal sperfusion spressure. sTherefore, san sincrease sin sintraabdominal spressure
swould scause sa sdecrease sin sabdominal sperfusion spressure. sAn sincrease sin ssystolic
sblood spressure sand scentral svenous spressure swould sall scause sthe smean sarterial
spressure sto sclimb, sand san selevated smean sarterial spressure scauses sabdominal
sperfusion spressure sto sincrease srather sthan sdecrease
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