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Trauma Certified Registered Nurse test Practice Test

TCRN test Format | Course Contents | Course Outline | test Syllabus | test Objectives

About the TCRN Exam
Clinical Practice: Head and Neck
A. Neurologic trauma
1. Traumatic brain injuries
2. Spinal injuries
B. Maxillofacial and neck traum
1. Facial fractures
2. Ocular trauma
3. Neck trauma
Clinical Practice: Trunk
A. Thoracic trauma
1. Chest wall injuries
2. Pulmonary injuries
B. Cardiac injuries
1. Great vessel injuries
C. Abdominal trauma
1. Hollow organ injuries
2. Solid organ injuries
3. Diaphragmatic injuries
4. Retroperitoneal injuries
D. Genitourinary trauma
E. Obstetrical trauma (pregnant patients)
Clinical Practice: Extremity and Wound
25 A. Musculoskeletal trauma
1. Vertebral injuries
2. Pelvic injuries
3. Compartment syndrome
4. Amputations
5. Extremity fractures
6. Soft- tissue injuries
B. Surface and burn trauma
1. Chemical burns
2. Electrical burns
3. Thermal burns
4. Inhalation injuries
Clinical Practice: Special Considerations
A. Psychosocial issues related to trauma
B. Shock
1. Hypovolemic
2. Obstructive (e.g., tamponade, tension, pneumothorax)
3. Distributive (e.g., neurogenic, septic)
4. Cardiogenic
C. SIRS and MODS
Continuum of Care
A. Injury prevention
B. Prehospital care
C. Patient safety (e.g., fall prevention)
D. Patient transfer
1. Intrafacility (within a facility, across departments)
2. Interfacility (from one facility to another
E. Forensic issues
1. Evidence collection
2. Chain of custody
F. End- of- life issues
1. Organ/ tissue donation
2. Advance directives
3. Family presence
4. Palliative care
G. Rehabilitation (discharge planning)
Professional Issues 17 A. Trauma quality management
1. Performance improvement
2. Outcomes follow- up and feedback (e.g., referring facilities, EMS)
3. Evidence- based practice
4. Research
5. Mortality/ morbidity reviews
B. Staff safety (e.g., standard precautions, workplace violence)
C. Disaster management (i.e., preparedness, mitigation, response, and recovery)
D. Critical incident stress management
E. Regulations and standards
1. HIPAA
2. EMTALA
3. Designation/ verifi cation (e.g., trauma center/ trauma systems)
F. Education and outreach for interprofessional trauma teams and the public
G. Trauma registry (e.g., data collection)
H. Ethical issues
D. Critical incident stress management
E. Regulations and standards
1. HIPAA
2. EMTALA
3. Designation/ verifi cation (e.g., trauma center/ trauma systems)
F. Education and outreach for interprofessional trauma teams and the public
G. Trauma registry (e.g., data collection)
H. Ethical issues

I. Assessment
A. Establish mechanism of injury
B. Assess, intervene, and stabilize patients with immediate life- threatening conditions
C. Assess pain
D. Assess for adverse drug and blood reactions
E. Obtain complete patient history
F. Obtain a complete physical evaluation
G. Use Glasgow Coma Scale (GCS) to evaluate patient status
H. Assist with focused abdominal sonography for trauma (FAST) examination
I. Calculate burn surface area
J. Assessment not otherwise specified
II. Analysis
A. Provide appropriate response to diagnostic test results
B. Prepare equipment that might be needed by the team
C. Identify the need for diagnostic tests
D. Determine the plan of care
E. Identify desired patient outcomes
F. Determine the need to transfer to a higher level of care
G. Determine the need for emotional or psychosocial support
H. Analysis not otherwise specified
III. Implementation
A. Incorporate age- specific needs for the patient population served
B. Respond with decisiveness and clarity to unexpected events
C. Demonstrate knowledge of pharmacology
D. Assist with or perform the following procedures:
1. Chest tube insertion
2. Arterial line insertion
3. Central line insertion
4. Compartment syndrome monitoring devices:
a. Abdominal
b. Extremity
5. Doppler
6. End- tidal CO 2
7. Temperature- control devices (e.g., warming and cooling)
8. Pelvic stabilizer
9. Immobilization devices
10. Tourniquets
11. Surgical airway insertion
12. Intraosseous needles
13. Intracranial pressure (ICP) monitoring devices
14. Infusers:
a. Autotransfusion
b. Fluid
c. Blood and blood products
15. Needle decompression
16. Fluid resuscitation:
a. Burn fluid resuscitation
b. Hypertonic solution
c. Permissive hypotension
d. Massive transfusion protocol (MTP)
17. Pericardiocentesis
18. Bedside open thoracotomy
E. Manage patients who have had the following procedures:
1. Chest tube insertion
2. Arterial line insertion
3. Central line insertion
4. Compartment syndrome monitoring devices:
a. Abdominal
b. Extremity
5. End- tidal CO 2
6. Temperature control devices (e.g., warming and cooling)
7. Pelvic stabilizer
8. Immobilization devices
9. Tourniquets
10. Surgical airway
11. Intraosseous needles
12. ICP monitoring devices
13. Infusers:
a. Fluid
b. Blood and blood products
14. Needle decompression
15. Fluid resuscitation:
a. Burn fluid resuscitation
b. Hypertonic solution
c. Permissive hypotension
d. MTP
16. Pericardiocentesis
F. Manage patients pain relief by providing:
1. Pharmacologic interventions
2. Non pharmacologic interventions
G. Manage patient sedation and analgesia
H. Manage tension pneumothorax
I. Manage burn resuscitation
J. Manage increased abdominal pressure
K. Provide complex wound management (e.g., ostomies, drains, wound vacuumassisted closure [VAC], open abdomen)
L. Implementation not otherwise specified
IV. Evaluation
A. Evaluate patients response to interventions
B. Monitor patient status and report findings to the team
C. Adapt the plan of care as indicated
D. Evaluation not otherwise specified
V. Continuum of care
A. Monitor or evaluate for opportunities for program or system improvement
B. Ensure proper placement of patients
C. Restore patient to optimal health
D. Collect, analyze, and use data:
1. To Excellerate patient outcomes
2. For benchmarking
3. To decrease incidence of trauma
E. Coordinate the multidisciplinary plan of care
F. Continuum of care not otherwise specified
VI. Professional issues
A. Adhere to regulatory requirements related to:
1. Infectious diseases
2. Hazardous materials
3. Verification/ designation
4. Confidentiality
B. Follow standards of practice
C. Involve family in:
1. Patient care
2. Teaching/ discharging planning
D. Recognize need for social/ protective service consults
E. Provide information to patient and family regarding community resources
F. Address language and cultural barriers
G. Participate in and promote lifelong learning related to new developments and clinical advances
H. Act as an advocate (e.g., for patients, families, and colleagues) related to ethical, legal, and psychosocial issues
I. Provide trauma patients and their families with psychosocial support
J. Assess methods continuously to Excellerate patient outcomes
K. Assist in maintaining the performance improvement programs
L. Participate in multidisciplinary rounds
M. Professional issues not otherwise specified

The TCRN test is for nurses practicing across the continuum of trauma care who want to demonstrate their expertise and knowledge in trauma nursing. BCEN is the only source for trauma care nurses and their employers to gain recognized certification for greater knowledge and performance. Advance your trauma nursing care and career at every critical point in the continuum.

BCENs certification exams are developed by an test committee of nurses who practice in the specific exams specialty area and represent diverse geography. BCEN partners with a test development company to ensure the test is psychometrically sound and questions are written in best practice format. Earning a BCEN certification is a national recognition and allows the holder to display the credential as part of their signature.

BCEN exams are based on specialty nursing role delineation studies (RDS). These research studies also known as a practice analysis or job analysis are conducted by test committees of subject matter experts.

As part of the RDS, survey instruments are distributed to nurses practicing in each specialty area throughout the United States. The survey responses guide the test committee in determining knowledge relevant to practice. The integrated concepts, cognitive level distribution, and the number of items (questions) specified within each content area are developed by an iterative process resulting in unanimous agreement from the test committee.

Next, item writers create test questions and the items are reviewed, revised, and approved by the test construction and review committee. The items are also repeatedly reviewed throughout the test development process.

Finally, examinations are delivered by computer at Pearson VUE testing centers. The examinations are administered daily Monday through Friday at the test takers convenience.

Only our practice exams are created by the same organization designing the genuine exams (thats us).
We have a committee of nurses and emergency professionals who build our practice exams with the goal of helping you succeed.
A BCEN practice test will help you familiarize yourself with the computer-based format of the real exam.
You will be able to answer questions, then have immediate access to the correct answers, backed up with rationale and references.

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Nursing
TCRN
Trauma Certified Registered Nurse Exam
https://killexams.com/pass4sure/exam-detail/TCRN
Question: 511
The nurse assesses the patient and discovers that the patient has apraxia confabulation. Which consultorder is most appropriate for this patient?
1. Speech therapy
2. Occupational therapy (OT)
3. Physical therapy (PT)
4. Psychologist
Answer: A Explanation:
Speech therapy aids motor speech disorders, such as problems saying sounds, syllables, and words. This speech abnormality occurs not because of muscle weakness or paralysis. The brain has problems in planning to move body parts, such as the lips, jaw, and tongue, needed for speech. The patient knows what he or she wants to say, but his or her brain has difficulty coordinating the muscle movements necessary to say those words; so the patient fabricates in order to achieve desired outcomes. Occupational therapy (OT), physical therapy (PT), and a psychologist are not the specialists needed to Excellerate this speech apraxia.
Question: 512
the shaft of her radius. Which of the following injuries is least associated with radial fractures?
1. Wrist fracture
2. Clavicle fracture
3. Elbow fracture
4. Shoulder fracture
5. Ms. Carrington slipped and fell while at homShe attempted to brace herself for the fall and fractured
Answer: B Explanation:
When the shaft of the radius and ulna is fractured this means that enough force was applied to fracture the shaft, and the force could be transmitted to the affiliated joints such as the wrist, elbow, and shoulder. The clavicle could be fractured in this type of injury; however, it would not be from the impact of the initial injury to the shaft.
Question: 513
A 23-year-old male patient comes in after a nuclear explosion. He is unresponsive and agonal breathing.What would be the caregiver�s first priority be in the care of this particular situation?
1. Decontaminate the patient to limit exposure to others and then initiate resuscitation efforts.
2. The health care provider should initiate resuscitation efforts.
3. The health care provider should rapidly place all contaminated objects, including clothing, into a
4. Place a waterproof drape over the patient and immediately begin resuscitation efforts.
Answer: B Explanation:
It is rare that an irradiated patient would infect a health care provider and spread the contamination to other patients, so all resuscitation and lifesaving efforts should be initiated before any decontamination begins. Wounds can be covered with waterproof drapes before decontamination to prevent further contamination
Question: 514
A patient comes to the emergency room with burns to bilateral lower extremities, groin, and the anteriorchest and abdominal walls. Using the rule of nines, what is the appropriate calculation of the percentageof total body surface area burned?
1. 55% of the body
2. 31% of the body
3. 28% of the body
4. 45% of the body
Answer: A Explanation:
The rule of nines is calculated with each body part totaling a value of nine. The head = 9%, chest (anterior) = 9%, abdomen (anterior) = 9%, upper/mid/low back and buttocks = 18%, each arm = 9%, each palm = 1%, groin = 1%, each leg = 18% total (front = 9%, back = 9%). In this scenario, the bilateral lower extremities wound accounts for 36% (18% � 2), the groin 1%, the anterior chest 9%, and abdomen 9%. This adds up to 55% of the total body surface area burned.
Question: 515
Proper medical management of a traumatic brain injury patient includes all except:
1. Administering analgesics
2. Administering 3% saline infusion
3. Maintaining cerebral perfusion pressure (CPP) greater than 60
4. Administering steroids
Answer: D Explanation:
Administering steroids has not been revealed to Excellerate outcomes and is currently not recommended in traumatic brain injury (TBI) treatment. Analgesics decrease intracranial pressure (ICP) by decreasing pain, agitation, and metabolic demands. Administration of 3% saline infusion decreases cerebral edema, aiding in decreasing ICP. This hypertonic solution increases vascular osmolality and increases perfusion to vital organs. Maintaining CPP greater than 60 increases cerebral blood flow
Question: 516
nursing intervention for this patient?
1. Obtain intravenous access to start fluid resuscitation
2. Place a sterile dressing on the burn site
3. Prepare for intubation
4. Obtain a history of comorbidities and home medications
5. The nurse receives a patient with third-degree burns to the facWhich of the following is the priority
Answer: C Explanation:
Burn patients are treated just like any other trauma patient; the priority is the airway. Patients who suffer from burns to the face, neck, or have obvious inhalation injury should have their airway assessed first and will mostly likely require intubation. This should be assessed before history is obtained, intravenous catheters are placed for fluid resuscitation, or wound care is provided.
Question: 517
There are many complications from cardiac contusions. Which of the following is not considered one ofthem?
1. Cardiogenic shock
2. Congestive heart failure
3. Hypovolemic shock
4. Thrombus formation
Answer: C Explanation:
Complications of cardiac contusions include arrhythmias, cardiogenic shock, depressed ventricular wall motion, congestive heart failure, and thrombus formation/embolism. Hypovolemic shock is not a complication of a cardiac contusion. Hypovolemic shock occurs with large blood loss.
Question: 518
What is the data-collection system that is composed of uniform data elements that describe the injuryevent, demographics, prehospital information, diagnosis, care and outcomes of injured patients?
1. National Trauma Data Bank
2. Trauma registry
3. ACTION Registry
4. IMPACT Registry
Answer: B Explanation:
The purpose of the trauma registry is to obtain, code, and sort information on trauma events for analysis, and reporting individual and aggregate results. Registry data is used for performance improvement, medical research, statistical analysis, critical pathways, care coordination, epidemiology, and injury prevention. Registry data then goes to the National Trauma Data Bank and is compiled annually and disseminated in the form of hospital benchmark reports, data-quality reports, and research data sets. Action Registry is a quality-improvement program that focuses on high-risk STEMI (ST-elevation myocardial infarction)/NSTEMI (non-ST segment elevation myocardial infarction) patients for clinical guideline recommendations. Impact Registry assesses the prevalence, demographics, management and outcomes of pediatric and adult congenital heart disease patients who undergo diagnostic catheterizations and catheter-based interventions.
Question: 519
Which type of incomplete cord syndrome is the most common and usually occurs as a result ofhyperextension injuries or interrupted blood supply to the cord?
1. Central cord
2. Anterior cord
3. Posterior cord
4. Brown�Sequard
Answer: A Explanation:
Central cord syndrome is caused by injuries that result in swelling at the center of the cord. The mechanism includes hyperextension injuries and interruption of blood supply to the spinal cord. Anterior cord syndrome is usually from anterior cord compression or disruption of the anterior spinal artery. Posterior cord syndrome also occurs with hyperextension but this is the rarest of the syndromes. Brown� Sequard syndrome occurs with transverse hemisection of the cord and usually is caused by a penetrating injury
Question: 520
Abdominal compartment syndrome (ACS) includes all of the following except:
1. Metabolic acidosis
2. Decreased cardiac output
3. Metabolic alkalosis
4. Decreased urinary output
Answer: C
Explanation:
Abdominal compartment compression results in altered cellular oxygenation and initiates cellular injury leading to hypoperfusion and cellular death. Abdominal compartment syndrome (ACS) is recognized with growing frequency as the cause of increased morbidity related to metabolic acidosis, decreased urine output, respiratory failure, and decreased cardiac output. The cause of these events might easily be mistaken for other pathologic events, such as hypovolemia, if the clinician is not alert to the morbidity associated with ACS.
Question: 521
A pregnant patient presents to the emergency room after being involved in a fender bender. Upon vaginalsituation?
1. Attempt to push the cord back in
2. Position to relieve cord pressure
3. Place the patient in Trendelenburg position
4. Cover the cord in moist sterile gauze
5. examination, the nurse notes umbilical cord prolapsWhat is the most important intervention for this
Answer: B Explanation:
The fetal presenting part should be elevated to relieve pressure off the cord because cord compression cuts off the oxygen supply to the fetus. Arrangements should be made for urgent cesarean delivery. Never attempt to push the cord back in or cover with sterile gauze. Placing the patient in the Trendelenburg position is not completely contraindicated but relieving the direct pressure off of the cord is most effective.
Question: 522
The nurse is assessing a burn patient. After the nurses inspects and auscultates, the nurse moves onto apalpation assessment. Which of the following palpation assessments is abnormal for a burn patient?
1. Palpation of the burned extremity detected decreased sensation
2. Does not feel pain when palpated around the full thickness burn
3. Burn tissue feels cold
4. Peripheral pulse in circumferential burn is decreased
Answer: D Explanation:
A patient with a full-thickness burn will usually not feel pain on the genuine site because of damage to the nerve endings, but the patient will feel pain in the surrounding tissue in first-and second-degree burns. Temperature assessment of the skin is important because burn tissue may feel cold as a result of hypoperfusion and fluid loss. Palpation for pulses on circumferential burn is important because there may be direct injury to vessels and vascular compromise. A decreased or loss of pulse is an abnormal finding.

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