TNCC 10th Edition Certification Exam Actual 2026/2027 –
Complete Practice Test with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Trauma Nursing Fundamentals & Initial Assessment —
Primary & Secondary Survey (Questions 1–12)
Q1: A trauma patient arrives in the ED after a motor vehicle collision. The trauma team
leader performs the primary survey. Which sequence correctly follows the TNCC
Trauma Nursing Process (TNP) A-B-C-D-E framework?
A. Airway with cervical spine protection → Breathing/ventilation → Circulation with
hemorrhage control → Disability/neurological assessment → Exposure/environmental
control
B. Airway without cervical spine protection → Breathing → Circulation → Disability →
Exposure → then apply cervical collar
C. Circulation → Airway → Breathing → Disability → Exposure
D. Exposure → Disability → Circulation → Breathing → Airway
Correct Answer: A
Rationale: The TNCC A-B-C-D-E sequence is: Airway (with simultaneous cervical spine
protection), Breathing/ventilation, Circulation (with hemorrhage control), Disability
(neurological assessment including GCS, AVPU, pupils), and Exposure/environmental
control. Option B delays cervical spine protection, which violates TNCC
standards—c-spine protection is initiated simultaneously with airway assessment.
Option C is incorrect unless uncontrolled external hemorrhage is identified during
across-the-room observation, which may reprioritize circulation. Option D reverses the
entire sequence.
,Q2: During the across-the-room observation of a trauma patient who sustained a stab
wound to the thigh, the nurse notes bright red blood spurting from the wound and
pooling rapidly on the floor. The patient is alert and talking. Which action is the priority?
A. Open the airway using a jaw-thrust maneuver
B. Apply direct pressure to the wound and prepare for tourniquet application
C. Assess breath sounds bilaterally
D. Perform a full neurological examination
Correct Answer: B
Rationale: Uncontrolled external hemorrhage is the leading cause of preventable death
in trauma. The across-the-room observation may reprioritize circulation before
airway/breathing when uncontrolled external hemorrhage is identified. The patient is
talking (patent airway), so airway is not the immediate priority. Direct pressure followed
by tourniquet application is the priority intervention per TNCC hemorrhage control
principles. Options A, C, and D follow the standard A-B-C-D-E sequence but are
secondary to life-threatening hemorrhage.
Q3: A trauma patient arrives with snoring respirations, gurgling sounds, and visible
blood in the oropharynx. The patient is unresponsive. Which intervention is the priority?
A. Insert an oropharyngeal airway and begin bag-mask ventilation
B. Perform a jaw-thrust maneuver to open the airway, suction the oropharynx, and
reassess
C. Immediately intubate with an endotracheal tube
D. Place the patient in the recovery position
Correct Answer: B
Rationale: Snoring respirations indicate partial airway obstruction, often from the
tongue or secretions. The priority is to open the airway using a jaw-thrust maneuver
, (with cervical spine protection), suction secretions/blood, and reassess. Option A may
be needed but does not address the immediate obstruction. Option C is premature
without first attempting basic airway maneuvers. Option D is contraindicated in trauma
with potential spinal injury.
Q4: A patient is talking clearly in full sentences, answering questions appropriately, and
denies difficulty breathing. Which assessment finding confirms the patient's airway
status?
A. The airway is potentially compromised and requires immediate intubation
B. The airway is patent but may become obstructed; prepare for cricothyrotomy
C. A patient talking clearly has a patent airway
D. The airway cannot be assessed until the cervical spine is cleared radiographically
Correct Answer: C
Rationale: A patient who is talking clearly in full sentences has a patent airway. This is a
fundamental TNCC assessment principle—if the patient can speak, the airway is open.
Options A and B overstate the concern. Option D is incorrect—airway assessment does
not require radiographic c-spine clearance; cervical spine protection is maintained
manually or with a collar during assessment.
Q5: The trauma nurse is assessing disability during the primary survey. Which
components are included in the standard neurological assessment?
A. Glasgow Coma Scale (GCS), pupillary assessment, and AVPU scale
B. Glasgow Coma Scale only
C. Pupillary assessment only
D. AVPU scale and reflex testing only
Correct Answer: A
Complete Practice Test with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section A: Trauma Nursing Fundamentals & Initial Assessment —
Primary & Secondary Survey (Questions 1–12)
Q1: A trauma patient arrives in the ED after a motor vehicle collision. The trauma team
leader performs the primary survey. Which sequence correctly follows the TNCC
Trauma Nursing Process (TNP) A-B-C-D-E framework?
A. Airway with cervical spine protection → Breathing/ventilation → Circulation with
hemorrhage control → Disability/neurological assessment → Exposure/environmental
control
B. Airway without cervical spine protection → Breathing → Circulation → Disability →
Exposure → then apply cervical collar
C. Circulation → Airway → Breathing → Disability → Exposure
D. Exposure → Disability → Circulation → Breathing → Airway
Correct Answer: A
Rationale: The TNCC A-B-C-D-E sequence is: Airway (with simultaneous cervical spine
protection), Breathing/ventilation, Circulation (with hemorrhage control), Disability
(neurological assessment including GCS, AVPU, pupils), and Exposure/environmental
control. Option B delays cervical spine protection, which violates TNCC
standards—c-spine protection is initiated simultaneously with airway assessment.
Option C is incorrect unless uncontrolled external hemorrhage is identified during
across-the-room observation, which may reprioritize circulation. Option D reverses the
entire sequence.
,Q2: During the across-the-room observation of a trauma patient who sustained a stab
wound to the thigh, the nurse notes bright red blood spurting from the wound and
pooling rapidly on the floor. The patient is alert and talking. Which action is the priority?
A. Open the airway using a jaw-thrust maneuver
B. Apply direct pressure to the wound and prepare for tourniquet application
C. Assess breath sounds bilaterally
D. Perform a full neurological examination
Correct Answer: B
Rationale: Uncontrolled external hemorrhage is the leading cause of preventable death
in trauma. The across-the-room observation may reprioritize circulation before
airway/breathing when uncontrolled external hemorrhage is identified. The patient is
talking (patent airway), so airway is not the immediate priority. Direct pressure followed
by tourniquet application is the priority intervention per TNCC hemorrhage control
principles. Options A, C, and D follow the standard A-B-C-D-E sequence but are
secondary to life-threatening hemorrhage.
Q3: A trauma patient arrives with snoring respirations, gurgling sounds, and visible
blood in the oropharynx. The patient is unresponsive. Which intervention is the priority?
A. Insert an oropharyngeal airway and begin bag-mask ventilation
B. Perform a jaw-thrust maneuver to open the airway, suction the oropharynx, and
reassess
C. Immediately intubate with an endotracheal tube
D. Place the patient in the recovery position
Correct Answer: B
Rationale: Snoring respirations indicate partial airway obstruction, often from the
tongue or secretions. The priority is to open the airway using a jaw-thrust maneuver
, (with cervical spine protection), suction secretions/blood, and reassess. Option A may
be needed but does not address the immediate obstruction. Option C is premature
without first attempting basic airway maneuvers. Option D is contraindicated in trauma
with potential spinal injury.
Q4: A patient is talking clearly in full sentences, answering questions appropriately, and
denies difficulty breathing. Which assessment finding confirms the patient's airway
status?
A. The airway is potentially compromised and requires immediate intubation
B. The airway is patent but may become obstructed; prepare for cricothyrotomy
C. A patient talking clearly has a patent airway
D. The airway cannot be assessed until the cervical spine is cleared radiographically
Correct Answer: C
Rationale: A patient who is talking clearly in full sentences has a patent airway. This is a
fundamental TNCC assessment principle—if the patient can speak, the airway is open.
Options A and B overstate the concern. Option D is incorrect—airway assessment does
not require radiographic c-spine clearance; cervical spine protection is maintained
manually or with a collar during assessment.
Q5: The trauma nurse is assessing disability during the primary survey. Which
components are included in the standard neurological assessment?
A. Glasgow Coma Scale (GCS), pupillary assessment, and AVPU scale
B. Glasgow Coma Scale only
C. Pupillary assessment only
D. AVPU scale and reflex testing only
Correct Answer: A
