Free TCRN exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the TCRN exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1For an adult with severe traumatic brain injury, which intracranial pressure exceeds the treatment threshold in the Brain Trauma Foundation guideline?

   1. A. 18 mm Hg
   2. B. 20 mm Hg
   3. C. 23 mm Hg
   4. D. 22 mm Hg

   Answer: C

   Explanation: The guideline states "Treating ICP above 22 mm Hg is recommended because values above this level are associated with increased mortality." Thus 23 mm Hg exceeds the threshold; 22 does not, and 18 and 20 are lower.

   Reference: Guidelines for the Management of Severe TBI, 4th Edition — 16. Intracranial Pressure Thresholds

2. 2Why can a pulmonary contusion impair oxygenation after blunt chest trauma?

   1. A. Hemorrhage and edema produce ventilation-perfusion mismatch
   2. B. Pleural blood directly compresses the vena cava
   3. C. Pericardial blood prevents cardiac filling
   4. D. A fractured rib blocks the main bronchus

   Answer: A

   Explanation: The manual states "Pulmonary contusion creates a ventilation and perfusion mismatch because of lung hemorrhage and edema." The other mechanisms describe different chest injuries or an unsupported mechanism.

   Reference: Overview of Thoracic Trauma — Pathophysiology of Thoracic Trauma

3. 3A vertebral subluxation after trauma may occur without visible bony injury. Rupture of which spinal structure can permit this?

   1. A. Spinal ligaments
   2. B. The spinal cord alone
   3. C. The vertebral body cortex alone
   4. D. Epidural veins alone

   Answer: A

   Explanation: The manual states "Subluxations, which may involve ligament rupture without bony injury". The other structures do not stabilize vertebral alignment.

   Reference: Spinal Trauma — Vertebral injury

4. 4For an older adult seen after a fall, which history feature most strongly predicts another fall?

   1. A. A previous fall
   2. B. A single normal blood pressure reading
   3. C. Use of reading glasses alone
   4. D. No prior mobility concerns

   Answer: A

   Explanation: The manual states "The most consistent predictor of falling is a previous fall." Reviewing prior falls is therefore pertinent to risk assessment after acute care.

   Reference: Falls in Older Adults — Etiology of Falls

5. 5During the initial trauma evaluation, what does the primary survey systematically assess and stabilize?

   1. A. Airway, breathing, circulation, disability, and exposure.
   2. B. Allergies, medications, prior surgery, diet, and exercise.
   3. C. Head-to-toe findings only after imaging.
   4. D. Rehabilitation needs and discharge readiness.

   Answer: A

   Explanation: MSD Manual Professional Edition: Approach to the Trauma Patient states: "Primary survey: Evaluation and stabilization using the mnemonic A, B, C, D, E, (Airway, Breathing, Circulation, Disability [neurologic status], and Exposure/Environmental control)" This establishes airway, breathing, circulation, disability, and exposure. as the answer under the stated conditions.

   Reference: MSD Manual Professional Edition: Approach to the Trauma Patient — Evaluation and Treatment of Trauma Patient

6. 6During a mass casualty incident, several patients are still and appear to have obvious life threats. Under the SALT global sort, when should they be individually assessed?

   1. A. First.
   2. B. Second, after patients who wave.
   3. C. Third, after patients who walk.
   4. D. Only after all transport is complete.

   Answer: A

   Explanation: Federal Interagency Committee on EMS: Model Uniform Core Criteria for Mass Casualty Incident Triage states: "Still / Obvious Life Threat Assess 1st" This supports first. for the stated question.

   Reference: Federal Interagency Committee on EMS: Model Uniform Core Criteria for Mass Casualty Incident Triage — Appendix A, SALT diagram, page 15

7. 7Which cerebral perfusion pressure range is the recommended target for survival and favorable outcomes after severe traumatic brain injury?

   1. A. 50–60 mm Hg
   2. B. 60–70 mm Hg
   3. C. 70–80 mm Hg
   4. D. 80–90 mm Hg

   Answer: B

   Explanation: The guideline specifies "The recommended target cerebral perfusion pressure (CPP) value for survival and favorable outcomes is between 60 and 70 mm Hg." The other ranges shift the target lower or higher.

   Reference: Guidelines for the Management of Severe TBI, 4th Edition — 17. Cerebral Perfusion Pressure Thresholds

8. 8In tension pneumothorax, what circulatory mechanism can produce hypotension?

   1. A. Increased intrathoracic pressure reduces venous return
   2. B. Reduced pericardial pressure limits ventricular filling
   3. C. Alveolar hemorrhage directly stops blood flow
   4. D. Rib pain directly lowers cardiac contractility

   Answer: A

   Explanation: The manual states "Decreased venous return can occur due to increased intrathoracic pressure in tension pneumothorax". The distractors confuse this obstructive mechanism with pericardial or pulmonary processes.

   Reference: Overview of Thoracic Trauma — Pathophysiology of Thoracic Trauma

9. 9What makes an unstable vertebral injury particularly dangerous during a change in patient position?

   1. A. Movement may compress the spinal cord or its blood supply
   2. B. Movement always restores normal alignment
   3. C. Position change prevents all secondary injury
   4. D. The vertebra cannot move after ligament disruption

   Answer: A

   Explanation: The manual states that free movement may occur, "potentially compressing the spinal cord or its vascular supply". This distinguishes unstable injury from stable fracture.

   Reference: Spinal Trauma — Vertebral injury

10. 10Why can a low-energy fall cause a fracture in an older adult?

    1. A. Osteoporosis and poorer bone quality increase fragility
    2. B. Age makes bones resistant to all low-energy trauma
    3. C. Low-energy falls cannot produce fractures
    4. D. Only head injury can cause fracture after a fall

    Answer: A

    Explanation: The manual says "Osteoporosis and age-related changes in bone quality, which increase bone fragility" increase the risk of a traumatic fall resulting in fracture.

    Reference: Falls in Older Adults — Etiology of Falls