Want to test your diagnostics knowledge before the TCRN exam? Below are free sample flashcards from the 80-card diagnostics section of our 1050-card TCRN (Trauma Certified Registered Nurse) deck, which covers MTP, Base Deficit, Following Massive Transfusion Protocol and more.
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An ICP waveform shows the P2 peak (tidal wave) higher than the P1 peak (percussion wave). What is the clinical significance of this finding in a patient with a traumatic brain injury?
Show answer →This indicates decreased intracranial compliance. In a healthy brain, P1 > P2 > P3. When P2 exceeds P1, it signifies that the brain's compensatory mechanisms (displacing CSF and venous blood) are exhausted. Small increases in volume will now cause significant ICP spikes. BCEN Tip: Recognize this as an early warning sign of impending herniation, even if the absolute ICP value remains within the normal range (<20 mmHg).
A 19y/o athlete is struck in the chest by a baseball and collapses into cardiac arrest. What is the most likely diagnosis, and how does it differ diagnostically from BCI?
Show answer →Commotio Cordis. Unlike BCI (which involves structural damage/contusion), Commotio Cordis is a purely electrical event caused by a blow during the vulnerable repolarization phase (R-on-T phenomenon), leading to Ventricular Fibrillation. Diagnostics: ECG shows VF; post-resuscitation Echo is typically normal because there is no structural contusion. BCI involves actual tissue damage.
A polytrauma patient's TEG reveals an LY30 of 18%. What is the pathophysiological state occurring, and what is the standard pharmacological treatment to be initiated immediately?
Show answer →An LY30 >3% (percentage of clot lysis 30 minutes after MA) indicates hyperfibrinolysis, a hallmark of severe Trauma-Induced Coagulopathy (TIC). This represents the premature breakdown of stable clots. Intervention: Tranexamic Acid (TXA) 1g IV bolus, followed by a 1g infusion over 8 hours. Clinical Pearl: Hyperfibrinolysis is part of the lethal triad (acidosis, hypothermia, coagulopathy). Exam Tip: BCEN emphasizes the CRASH-2 and PATCH trial findings—TXA is most effective when given within 3 hours of injury.
A patient in hemorrhagic shock has a Base Deficit of -18. Following Massive Transfusion Protocol (MTP), the BD improves to -4, but the lactate remains 5.5. Which marker is a better predictor of 24-hour mortality in this scenario?
Show answer →Persistent elevation of lactate (failure to clear) is generally a stronger predictor of mortality than the base deficit. While BD reflects the immediate state of buffering and volume status, lactate reflects global tissue oxygen debt and cellular function. Exam Strategy: BCEN looks for your ability to prioritize trends. If the BD improves but lactate stays high, the patient is still at high risk for MODS and death. This is known as lagging lactate and indicates that cellular-level resuscitation is not yet complete.
A trauma patient received vecuronium for intubation 2 hours ago. How must the nurse verify the absence of neuromuscular blockade before brain death testing?
Show answer →Perform a Train-of-Four (TOF) stimulation. The patient MUST have 4/4 twitches. Rationale: Residual paralytics mimic brain death by abolishing reflexes and respiratory effort. Strategy: BCEN often tests the order of operations. Always confirm the clearance of CNS depressants and paralytics before proceeding to the clinical brainstem exam.
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Try 30 free TCRN cards firstThe full TCRN deck contains 1050 flashcards, and 80 of them focus on diagnostics. This page shows 5 free samples.
Our TCRN deck dedicates 80 of 1050 cards (8%) to diagnostics — always cross-check the official BCEN exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the TCRN preview page has 30 more free cards. Full access to all 1050 cards is a one-time $7.
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