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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 exam 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 exam 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 exam 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 exam 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 exam 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 exam committee.



Next- item writers create exam questions and the items are reviewed- revised- and approved by the exam construction and review committee. The items are also repeatedly reviewed throughout the exam 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 their practice exams are created by the same organization designing the actual exams (thats us).
We have a committee of nurses and emergency professionals who build their practice exams with the goal of helping you succeed.
A BCEN practice exam 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.