TheoryTCRN Trauma Nurse Practice 202
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30 free TCRN Trauma Nurse Practice 202 questions
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TCRN Trauma Nurse Practice 202
Which of the following patients are at the lowest risk for complications after a compound fracture?
Correct — D. Answer: Patients with a history of diabetes Several factors increase a patient's risk of complications after a compound fracture. These include poor nutritional status, a compromised immune system, and taking medications like corticosteroids. Patients with diabetes may face challenges in healing but are at the lowest risk compared to those with the other conditions described. -
TCRN Trauma Nurse Practice 202
Which of the following is not a factor that increases the risk of infection in a burn wound?
Correct — B. Answer: The presence of superficial burns Superficial burns, while painful, generally do not significantly increase the risk of infection. They affect only the outermost layer of skin and typically heal without complications. The presence of eschar can create an environment conducive to bacterial growth. Poor nutritional status of the patient and prolonged hospitalization also increases the risk of infection developing. -
TCRN Trauma Nurse Practice 202
Which of the following statements is accurate regarding patients with electrical burns?
Correct — B. Answer: Electrical burns can cause internal injuries without significant external damage Electrical burns can lead to significant internal injuries such as muscle damage, nerve damage, and organ injuries without obvious external signs on the skin. It is crucial to monitor patients with electrical burns for potential cardiac arrhythmias and other internal complications. -
TCRN Trauma Nurse Practice 202
A patient is brought to the ER with a segmental fracture of the right femur. What type of force is most likely to cause this type of fracture?
Correct — A. Answer: Axial compression Axial compression forces are applied along the axis of the bone, often resulting in segmental fractures when the bone is compressed internally. Shear forces involve sliding actions that occur in parallel planes, causing different fracture patterns. Torsion forces involve twisting, potentially leading to spiral fractures. Bending forces refer to an application that causes compression on one side and tension on the other, producing transverse or oblique fractures. -
TCRN Trauma Nurse Practice 202
An elderly patient presents with a severe tibial fracture following a motor vehicle collision. For how many days after the injury should the trauma nurse remain vigilant for signs of developing compartment syndrome?
Correct — A. Answer: 3 days The risk of compartment syndrome is highest within the first 72 hours (3 days) following the injury due to the potential for swelling and increased pressure within the muscle compartments. After this period, the likelihood of compartment syndrome decreases significantly. -
TCRN Trauma Nurse Practice 202
A 52-year-old male construction worker fell from a height and was pinned under heavy machinery for an extended period, sustaining a crush injury to his right arm. Upon examination, the right arm has extensive soft tissue damage and compromised circulation. What is the most likely necessary treatment for this type of injury?
Correct — D. Answer: Amputation of the extremity Crush injuries that lead to extensive soft tissue damage, compromised circulation, and potential nerve involvement often necessitate amputation due to the severity of the damage and limited efficacy of grafts in such cases. While amputation might be necessary, it is not likely to be fatal if treated with amputation, as opposed to attempting skin and/or muscle grafts, which are generally ineffective for extensive crush injuries. -
TCRN Trauma Nurse Practice 202
Which of the following conditions is least likely to contribute to secondary cervical spine injury?
Correct — C. Answer: Hypothermia Secondary injuries to the cervical spine can occur after an initial trauma and can exacerbate the primary injury. Hypotension, ischemia, and edema can all contribute to secondary cervical spine injury. Hypothermia, however, is less likely to contribute and may even have a protective effect. -
TCRN Trauma Nurse Practice 202
A 30-year-old male construction worker falls from a height of 10 feet while working on scaffolding. He lands directly on his feet. Based on the mechanism of injury, which of the following vertebrae is most likely to be injured?
Correct — D. Answer: L1 Vertical compression injuries often occur in individuals who land on their feet from significant heights. The impact force travels upward through the legs and pelvis, frequently causing fractures in the lumbar vertebrae due to the axial load. L1 is the most commonly affected vertebra in such scenarios. L1 is part of the upper lumbar spine, which is susceptible to injury due to the vertical compression forces. -
TCRN Trauma Nurse Practice 202
What is the most critical initial step in the management of a patient with a neck stab wound?
Correct — D. Answer: Airway management In cases of neck trauma, particularly with a stab wound, the most critical initial step is to ensure the airway is secure and not compromised, as airway obstruction is a life-threatening condition. While controlling bleeding is crucial, it follows after airway management. Infection prevention is important for long-term care but not immediately life-threatening. Assessing neurological deficits is also essential but secondary to ensuring airway patency. -
TCRN Trauma Nurse Practice 202
A nurse is evaluating a 25-year-old male who was elbowed in the throat during a basketball game. Which of the following findings one hour after the injury is not consistent with a minor throat trauma?
Correct — D. Answer: Difficulty breathing Difficulty breathing is not expected with minor throat trauma and could indicate a more severe injury such as airway obstruction or a significant laryngeal injury. Mild hoarseness, slight pain swallowing, and minor bruising are common findings with minor throat trauma. -
TCRN Trauma Nurse Practice 202
Damage to the cribriform plate would most likely be expected with which of the following fractures?
Correct — C. Answer: Le Fort II A Le Fort II fracture is a pyramidal fracture that extends from the nasal bone through the infraorbital rims, lacrimal bones, and can reach the cribriform plate. This fracture pattern leads to proximity with the cribriform plate. A Le Fort I fracture, also known as a horizontal maxillary fracture, does not involve the cribriform plate. A Le Fort III fracture, a craniofacial disjunction, extends higher and involves the orbital walls and zygomatic arches, but not primarily the cribriform plate. A mandibular fracture is related to the lower jaw and does not affect the cribriform plate. -
TCRN Trauma Nurse Practice 202
An unconscious patient arrives at the emergency department following a severe head injury that resulted in a basal skull fracture. What clinical signs should the trauma nurse assess for to confirm this diagnosis?
Correct — A. Answer: Battle's sign, Raccoon eyes, CSF rhinorrhea, CSF otorrhea Basal skull fractures often result in certain hallmark signs due to the anatomical location of the injury. Battle's sign refers to bruising behind the ears, while Raccoon eyes indicate bruising around the eyes. Cerebrospinal fluid (CSF) rhinorrhea and CSF otorrhea are indicative of CSF leakage from the nose and ears, respectively. -
TCRN Trauma Nurse Practice 202
Which of the following statements is not true regarding the administration of hypertonic saline in patients with traumatic brain injury?
Correct — C. Answer: The mechanism of beneficial action for hypertonic saline is well understood The mechanism of action for hypertonic saline is not completely understood, similar to mannitol. Current understanding suggests that hypertonic saline reduces intracranial pressure by creating an osmotic gradient that draws water out of brain cells and into the bloodstream. Hypertonic saline solutions must be administered with care to avoid complications. They should ideally be given through a central line because peripheral administration can cause vein irritation or infiltration. It is crucial to monitor serum sodium and osmolality levels when administering hypertonic saline to prevent hypernatremia and other electrolyte imbalances. -
TCRN Trauma Nurse Practice 202
When managing a pediatric trauma patient, it is essential to recognize normal physiological differences compared to adults. Which of the following respiratory parameters is least affected by age in children?
Correct — A. Answer: Tidal volume Tidal volume generally remains stable across different ages in children when adjusted for body size. Respiratory rate varies significantly with age, being higher in younger children and decreasing as they grow older. Oxygen saturation is an important indicator that should be consistently high but can be influenced by various conditions, including age-related respiratory efficiency. Lung compliance can also change with age due to developmental and anatomical changes in the lungs. -
TCRN Trauma Nurse Practice 202
A geriatric patient with head trauma has a normal initial CT scan. Which of the following interventions is best for this patient?
Correct — A. Answer: Monitor the patient in the hospital and get an order for an MRI Head injuries in geriatric patients can sometimes present with subtle or delayed symptoms, and a normal CT scan initially does not rule out significant injuries. An MRI can provide more detailed imaging to identify potential complications such as hemorrhage or brain lesions that may not be visible on a CT scan. Hospital monitoring allows for immediate intervention if the patient's condition deteriorates. -
TCRN Trauma Nurse Practice 202
A 29-year-old male with a history of epilepsy is brought to the emergency department after experiencing a severe head trauma in a bicycle accident without wearing a helmet. Which of the following is a consideration for this patient?
Correct — C. Answer: The risk of seizure activity may increase due to head trauma Head trauma can act as a precipitating factor for seizures in patients with a history of epilepsy. The mechanical force on the brain during trauma can disrupt neuronal functions, potentially increasing the frequency and severity of seizures. Wearing a helmet significantly reduces the risk of head injury and consequently the risk of triggering seizure activity in epileptics. -
TCRN Trauma Nurse Practice 202
An elderly patient presents with signs of physical abuse. The trauma nurse understands that which of the following is true for elderly patients?
Correct — D. Answer: Elderly patients are at higher risk for abuse by caregivers. Statistics show that elderly patients have a higher likelihood of suffering from abuse, particularly by their caregivers. Abuse can be physical, emotional, or financial. It is crucial for healthcare professionals to be aware of these risks and to take appropriate measures to safeguard elderly patients. -
TCRN Trauma Nurse Practice 202
Which laboratory value should be monitored closely in a patient with severe crush injuries to anticipate complications?
Correct — C. Answer: Creatine Kinase Severe crush injuries can lead to rhabdomyolysis, where muscle breakdown products such as creatine kinase are released into the bloodstream. Elevated levels of creatine kinase can indicate muscle damage and potential kidney injury. Lactate, BUN, and myoglobin are also relevant but not as critical initially as creatine kinase in assessing the extent of muscle damage in these patients. -
TCRN Trauma Nurse Practice 202
A patient recovering from a spinal cord injury (SCI) is able to independently perform daily activities and return to their previous level of employment. How would this patient be described using the ASIA Impairment Scale?
Correct — C. Answer: ASIA E The ASIA Impairment Scale is used to classify the severity of spinal cord injuries. The scale ranges from A to E: A - Complete: No motor or sensory function is preserved in the sacral segments S4-S5. B - Incomplete: Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5. C - Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade less than 3. D - Incomplete: Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of 3 or more. E - Normal: Motor and sensory functions are normal. Therefore, a patient who can independently perform daily activities and return to their previous level of employment would be classified as ASIA E. -
TCRN Trauma Nurse Practice 202
Which of the following conditions is least likely to be a common complication in pediatric patients who experience a traumatic injury?
Correct — A. Answer: Deep vein thrombosis (DVT) Deep vein thrombosis (DVT) is uncommon in pediatric patients who suffer from traumatic injuries. DVT typically occurs in the adult population or children with specific risk factors (e.g., congenital thrombophilia). In contrast, complications such as internal bleeding, fractures, and traumatic brain injury (TBI) are more prevalent in pediatric trauma cases. -
TCRN Trauma Nurse Practice 202
In a mass casualty incident, which age group is most likely to have the highest mortality rate?
Correct — D. Answer: 75 years old to 85 years old. Older adults tend to have higher mortality rates in mass casualty incidents due to factors such as pre-existing health conditions and frailty, making it harder for them to survive severe injuries. -
TCRN Trauma Nurse Practice 202
During which phase of trauma care is the patient's ability to manage chronic pain most assessed?
Correct — B. Answer: Reintegration phase There are four main phases of trauma care. These include: 1. Resuscitation phase: Immediate stabilization after trauma. 2. Critical care and intermediate care phase: Full medical stabilization is the focus. 3. Rehabilitation phase: The patient regains as much normal function as possible. 4. Reintegration phase: The patient resumes post-trauma life. Chronic pain will be addressed in the rehab phase, but the patient's ability to manage it independently becomes crucial during the reintegration phase, as they learn to live with and adapt to their long-term condition. -
TCRN Trauma Nurse Practice 202
Which of the following is not recommended at the bedside of a patient with a chest tube?
Correct — C. Answer: A manual resuscitator bag with a face mask A manual resuscitator bag with a face mask is typically kept at the bedside of a patient with a tracheostomy tube but not for a patient with a chest tube. For a patient with a chest tube, it is recommended to keep a pair of chest tube clamps, an occlusive dressing, and a bottle of sterile water at the bedside. -
TCRN Trauma Nurse Practice 202
A patient falls from a 40-foot ladder and lands directly on their buttocks. What type of spine injury is likely to occur?
Correct — C. Answer: Axial loading injury Impact absorbed by the buttocks will be transferred up the spine, which can cause an axial loading injury. This type of injury is due to energy being applied along the axis of the spine. Rotational injury occurs when one end of the spine is twisted relative to the other end, and hyperextension injury is caused when the head is thrown back too far. -
TCRN Trauma Nurse Practice 202
The nurse is assessing a trauma patient for the development of abdominal compartment syndrome. At what intra-abdominal pressure is medical intervention typically indicated to prevent this condition?
Correct — B. Answer: 20 mm Hg Medical intervention is typically indicated when intra-abdominal pressure reaches 20 mm Hg to prevent abdominal compartment syndrome. Intra-abdominal pressures in the range of 2 to 7 mm Hg are considered normal, while pressures of 12 mm Hg indicate the onset of intra-abdominal hypertension. -
TCRN Trauma Nurse Practice 202
Which of the following findings is most indicative of severe abdominal trauma?
Correct — B. Answer: Periumbilical ecchymosis (Cullen's sign) Cullen's sign is characterized by periumbilical ecchymosis, which typically indicates retroperitoneal or intra-abdominal bleeding due to high-force trauma. While absent bowel sounds can be related to abdominal trauma, they are nonspecific. Hematuria may be present with trauma but does not specifically indicate the severity, and rebound tenderness indicates peritoneal irritation but is not as specific as Cullen's sign for severe injury. -
TCRN Trauma Nurse Practice 202
What is the correct formula to calculate the estimated bladder pressure (EBP) using intraperitoneal pressure (IPP) and abdominal wall compliance (AWC)?
Correct — A. Answer: $$\frac{IPP + (2 \times AWC)}{3}$$ The correct calculation for EBP is $$\frac{IPP + (2 \times AWC)}{3}$$. EBP estimation takes into account the intraperitoneal pressure and the compliance of the abdominal wall, and provides a better estimate of the actual bladder pressure. -
TCRN Trauma Nurse Practice 202
Which of the following findings is most unlikely in a patient with a ruptured spleen?
Correct — D. Answer: Muffled heart sounds Muffled heart sounds are commonly associated with cardiac tamponade, not with a ruptured spleen. Findings consistent with a ruptured spleen include left upper quadrant pain, hypotension, and referred pain to the left shoulder (Kehr's sign). -
TCRN Trauma Nurse Practice 202
A trauma nurse is assisting a patient who is an expectant mother and has just experienced a miscarriage. The patient's spouse requests that a religious ritual be performed for the lost fetus. The nurse understands that contacting a clergy to perform this ritual will help to alleviate which of the following forms of psychological stress injury?
Correct — B. Answer: Moral injury Moral injury is caused by inner conflict due to behaviors or witnessing behaviors that violate moral values. The patient's spouse may experience moral injury if the religious ritual is not performed. Grief injury is caused by the loss of cherished people, things, or parts of one's self. Grief injury is likely to occur due to the loss of the fetus, regardless of whether the religious ritual is performed or not. Fatigue injury describes a psychological stress injury caused by the accumulation of stress over time without sufficient rest and recovery. Trauma injury is caused by the experience of death, provoking terror, horror, or helplessness. -
TCRN Trauma Nurse Practice 202
A trauma nurse observes a colleague documenting a patient's vital signs inaccurately in an extremely busy emergency department. Which ethical principle should prompt the trauma nurse to address this documentation error?
Correct — B. Answer: Veracity The principle of veracity involves truth-telling and honesty. The trauma nurse should correct the documentation error to ensure that the patient's medical records are accurate and truthful. Autonomy refers to allowing individuals to make their own decisions. Beneficence involves doing good and promoting the well-being of others. Justice involves treating others fairly and equitably.
TCRN Trauma Nurse Practice 202 sample questions
Tap any question below to reveal the answer and a plain-English explanation.
TCRN Trauma Nurse Practice 202 Which of the following is not recommended at the bedside of a patient with a chest tube?
A. An occlusive dressing
B. A bottle of sterile water
C. A manual resuscitator bag with a face mask ✓
D. A pair of chest tube clamps
Correct — C. Answer: A manual resuscitator bag with a face mask A manual resuscitator bag with a face mask is typically kept at the bedside of a patient with a tracheostomy tube but not for a patient with a chest tube. For a patient with a chest tube, it is recommended to keep a pair of chest tube clamps, an occlusive dressing, and a bottle of sterile water at the bedside.
TCRN Trauma Nurse Practice 202 A patient falls from a 40-foot ladder and lands directly on their buttocks. What type of spine injury is likely to occur?
A. Hyperextension injury
B. This will not cause a spine injury
C. Axial loading injury ✓
D. Rotational injury
Correct — C. Answer: Axial loading injury Impact absorbed by the buttocks will be transferred up the spine, which can cause an axial loading injury. This type of injury is due to energy being applied along the axis of the spine. Rotational injury occurs when one end of the spine is twisted relative to the other end, and hyperextension injury is caused when the head is thrown back too far.
TCRN Trauma Nurse Practice 202 The nurse is assessing a trauma patient for the development of abdominal compartment syndrome. At what intra-abdominal pressure is medical intervention typically indicated to prevent this condition?
A. 12 mm Hg
B. 20 mm Hg ✓
C. 2 mm Hg
D. 7 mm Hg
Correct — B. Answer: 20 mm Hg Medical intervention is typically indicated when intra-abdominal pressure reaches 20 mm Hg to prevent abdominal compartment syndrome. Intra-abdominal pressures in the range of 2 to 7 mm Hg are considered normal, while pressures of 12 mm Hg indicate the onset of intra-abdominal hypertension.
TCRN Trauma Nurse Practice 202 Which of the following findings is most indicative of severe abdominal trauma?
A. Rebound tenderness
B. Periumbilical ecchymosis (Cullen's sign) ✓
C. Absent bowel sounds
D. Hematuria
Correct — B. Answer: Periumbilical ecchymosis (Cullen's sign) Cullen's sign is characterized by periumbilical ecchymosis, which typically indicates retroperitoneal or intra-abdominal bleeding due to high-force trauma. While absent bowel sounds can be related to abdominal trauma, they are nonspecific. Hematuria may be present with trauma but does not specifically indicate the severity, and rebound tenderness indicates peritoneal irritation but is not as specific as Cullen's sign for severe injury.
TCRN Trauma Nurse Practice 202 What is the correct formula to calculate the estimated bladder pressure (EBP) using intraperitoneal pressure (IPP) and abdominal wall compliance (AWC)?
A. $$\frac{IPP + (2 \times AWC)}{3}$$ ✓
B. $$\frac{2 \times IPP + AWC}{3}$$
C. $$2 \times \frac{IPP + AWC}{3}$$
D. $$\frac{3 \times IPP + AWC}{2}$$
Correct — A. Answer: $$\frac{IPP + (2 \times AWC)}{3}$$ The correct calculation for EBP is $$\frac{IPP + (2 \times AWC)}{3}$$. EBP estimation takes into account the intraperitoneal pressure and the compliance of the abdominal wall, and provides a better estimate of the actual bladder pressure.
TCRN Trauma Nurse Practice 202 Which of the following findings is most unlikely in a patient with a ruptured spleen?
A. Left upper quadrant pain
B. Hypotension
C. Referred pain to the left shoulder (Kehr's sign)
D. Muffled heart sounds ✓
Correct — D. Answer: Muffled heart sounds Muffled heart sounds are commonly associated with cardiac tamponade, not with a ruptured spleen. Findings consistent with a ruptured spleen include left upper quadrant pain, hypotension, and referred pain to the left shoulder (Kehr's sign).
TCRN Trauma Nurse Practice 202 A trauma nurse is assisting a patient who is an expectant mother and has just experienced a miscarriage. The patient's spouse requests that a religious ritual be performed for the lost fetus. The nurse understands that contacting a clergy to perform this ritual will help to alleviate which of the following forms of psychological stress injury?
A. Fatigue injury
B. Moral injury ✓
C. Grief injury
D. Trauma injury
Correct — B. Answer: Moral injury Moral injury is caused by inner conflict due to behaviors or witnessing behaviors that violate moral values. The patient's spouse may experience moral injury if the religious ritual is not performed. Grief injury is caused by the loss of cherished people, things, or parts of one's self. Grief injury is likely to occur due to the loss of the fetus, regardless of whether the religious ritual is performed or not. Fatigue injury describes a psychological stress injury caused by the accumulation of stress over time without sufficient rest and recovery. Trauma injury is caused by the experience of death, provoking terror, horror, or helplessness.
TCRN Trauma Nurse Practice 202 A trauma nurse observes a colleague documenting a patient's vital signs inaccurately in an extremely busy emergency department. Which ethical principle should prompt the trauma nurse to address this documentation error?
A. Justice
B. Veracity ✓
C. Autonomy
D. Beneficence
Correct — B. Answer: Veracity The principle of veracity involves truth-telling and honesty. The trauma nurse should correct the documentation error to ensure that the patient's medical records are accurate and truthful. Autonomy refers to allowing individuals to make their own decisions. Beneficence involves doing good and promoting the well-being of others. Justice involves treating others fairly and equitably.
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You will be tested on
- Safe and effective care environment
- Health promotion and maintenance
- Psychosocial and physiological integrity
- Pharmacology, infection control and patient safety
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Topics in this question bank
Safe and effective care environment
Health promotion and maintenance
Psychosocial and physiological integrity
Pharmacology, infection control and patient safety
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