TNS EXAM / TRAUMA NURSE SPECIALIST
CERTIFICATION (TNS) TEST BANK 2026/2027 PRACTICE
QUESTIONS 100% CORRECT!!
Table of Contents
1. Module 1: Initial Assessment & Airway Management (Questions 1–10)
2. Module 2: Shock, Hemorrhage, and Circulation (Questions 11–20)
3. Module 3: Traumatic Brain and Spinal Cord Injuries (Questions 21–30)
4. Module 4: Thoracic and Abdominal Trauma (Questions 31–40)
5. Module 5: Musculoskeletal, Burn, and Special Populations (Questions 41–50)
Trauma
Module 1: Initial Assessment & Airway Management
Question 1
,During the primary survey of a multi-trauma patient, the trauma nurse notes snoring
respirations and decreased responsiveness. What is the immediate priority action?
● A. Insert a definitive endotracheal tube immediately.
● B. Perform a manual airway maneuver such as the chin-lift or jaw-thrust.
● C. Administer high-flow oxygen via a non-rebreather mask.
● D. Obtain an immediate stat portable chest radiograph.
Correct Answer: B
Rationale: The immediate priority for any airway compromise identified during the
primary survey (Airway and C-spine step) is manual alignment and clearing/opening the
airway using basic maneuvers (jaw-thrust without head-tilt in trauma). While intubation
or oxygenation will follow, opening the obstructed airway structurally comes first.
Question 2
A patient presents following a high-speed motor vehicle collision with massive facial
trauma, bleeding, and distortion of normal anatomic landmarks. Attempts at oral
endotracheal intubation have failed. Which intervention is indicated next?
● A. Nasotracheal intubation with local vasoconstrictors
● B. Insertion of a standard nasopharyngeal airway
● C. Surgical or percutaneous cricothyroidotomy
● D. Insertion of a dual-lumen esophageal airway device
Correct Answer: C
Rationale: In a "cannot intubate, cannot oxygenate" (CICO) scenario with severe facial
destruction precluding safe oral or nasal intubation, a surgical or percutaneous
cricothyroidotomy is the definitive life-saving airway procedure of choice. Nasotracheal
intubation is contraindicated in severe midface/cribriform plate fractures.
Question 3
When performing the Trauma Nursing Process (TNP) primary survey, which of the
following represents the correct sequence of the initial assessment steps?
● A. Airway, Breathing, Circulation, Disability, Exposure
● B. Circulation, Airway, Breathing, Disability, Exposure
● C. Alertness, Chief complaint, Circulation, Decision, Evaluation
● D. Airway, Circulation, Breathing, Exposure, Disability
Correct Answer: A
, Rationale: The universally accepted standard foundational framework for trauma
resuscitation follows the systematic ABCDE sequence: Airway (with cervical spine
stabilization), Breathing and ventilation, Circulation (and hemorrhage control), Disability
(neurologic status), and Exposure/Environment.
Question 4
Which physical finding is most characteristic of an impending tension pneumothorax
during the primary assessment?
● A. Bilateral equal breath sounds with a slow respiratory rate
● B. Tracheal deviation toward the affected side and flat neck veins
● C. Hyperresonance, absent breath sounds, and hypotension on the affected side
● D. Muffled heart tones with clear, equal bilateral lung fields
Correct Answer: C
Rationale:* A tension pneumothorax causes air to trap in the pleural space, collapsing
the lung and shifting mediastinal structures. Hallmark signs include acute respiratory
distress, unilateral absent breath sounds, hyperresonance to percussion, hemodynamic
collapse (hypotension), tracheal deviation away from the affected side, and distended
neck veins.
Question 5
A patient sustains blunt chest trauma. On assessment, paradoxical chest wall
movement is observed during spontaneous breathing. What is the primary
pathophysiology responsible for this finding?
● A. A complete tear of the primary mainstem bronchus
● B. A flail chest resulting from multiple rib fractures in multiple places
● C. Accumulation of chyle within the thoracic cavity
● D. Rapid accumulation of blood in the pericardial sac
Correct Answer: B
Rationale:* A flail chest occurs when two or more adjacent ribs are fractured in two or
more places, creating a freely moving segment of the chest wall that moves
paradoxically inward during inspiration and outward during expiration, severely
impairing ventilation.
Question 6
CERTIFICATION (TNS) TEST BANK 2026/2027 PRACTICE
QUESTIONS 100% CORRECT!!
Table of Contents
1. Module 1: Initial Assessment & Airway Management (Questions 1–10)
2. Module 2: Shock, Hemorrhage, and Circulation (Questions 11–20)
3. Module 3: Traumatic Brain and Spinal Cord Injuries (Questions 21–30)
4. Module 4: Thoracic and Abdominal Trauma (Questions 31–40)
5. Module 5: Musculoskeletal, Burn, and Special Populations (Questions 41–50)
Trauma
Module 1: Initial Assessment & Airway Management
Question 1
,During the primary survey of a multi-trauma patient, the trauma nurse notes snoring
respirations and decreased responsiveness. What is the immediate priority action?
● A. Insert a definitive endotracheal tube immediately.
● B. Perform a manual airway maneuver such as the chin-lift or jaw-thrust.
● C. Administer high-flow oxygen via a non-rebreather mask.
● D. Obtain an immediate stat portable chest radiograph.
Correct Answer: B
Rationale: The immediate priority for any airway compromise identified during the
primary survey (Airway and C-spine step) is manual alignment and clearing/opening the
airway using basic maneuvers (jaw-thrust without head-tilt in trauma). While intubation
or oxygenation will follow, opening the obstructed airway structurally comes first.
Question 2
A patient presents following a high-speed motor vehicle collision with massive facial
trauma, bleeding, and distortion of normal anatomic landmarks. Attempts at oral
endotracheal intubation have failed. Which intervention is indicated next?
● A. Nasotracheal intubation with local vasoconstrictors
● B. Insertion of a standard nasopharyngeal airway
● C. Surgical or percutaneous cricothyroidotomy
● D. Insertion of a dual-lumen esophageal airway device
Correct Answer: C
Rationale: In a "cannot intubate, cannot oxygenate" (CICO) scenario with severe facial
destruction precluding safe oral or nasal intubation, a surgical or percutaneous
cricothyroidotomy is the definitive life-saving airway procedure of choice. Nasotracheal
intubation is contraindicated in severe midface/cribriform plate fractures.
Question 3
When performing the Trauma Nursing Process (TNP) primary survey, which of the
following represents the correct sequence of the initial assessment steps?
● A. Airway, Breathing, Circulation, Disability, Exposure
● B. Circulation, Airway, Breathing, Disability, Exposure
● C. Alertness, Chief complaint, Circulation, Decision, Evaluation
● D. Airway, Circulation, Breathing, Exposure, Disability
Correct Answer: A
, Rationale: The universally accepted standard foundational framework for trauma
resuscitation follows the systematic ABCDE sequence: Airway (with cervical spine
stabilization), Breathing and ventilation, Circulation (and hemorrhage control), Disability
(neurologic status), and Exposure/Environment.
Question 4
Which physical finding is most characteristic of an impending tension pneumothorax
during the primary assessment?
● A. Bilateral equal breath sounds with a slow respiratory rate
● B. Tracheal deviation toward the affected side and flat neck veins
● C. Hyperresonance, absent breath sounds, and hypotension on the affected side
● D. Muffled heart tones with clear, equal bilateral lung fields
Correct Answer: C
Rationale:* A tension pneumothorax causes air to trap in the pleural space, collapsing
the lung and shifting mediastinal structures. Hallmark signs include acute respiratory
distress, unilateral absent breath sounds, hyperresonance to percussion, hemodynamic
collapse (hypotension), tracheal deviation away from the affected side, and distended
neck veins.
Question 5
A patient sustains blunt chest trauma. On assessment, paradoxical chest wall
movement is observed during spontaneous breathing. What is the primary
pathophysiology responsible for this finding?
● A. A complete tear of the primary mainstem bronchus
● B. A flail chest resulting from multiple rib fractures in multiple places
● C. Accumulation of chyle within the thoracic cavity
● D. Rapid accumulation of blood in the pericardial sac
Correct Answer: B
Rationale:* A flail chest occurs when two or more adjacent ribs are fractured in two or
more places, creating a freely moving segment of the chest wall that moves
paradoxically inward during inspiration and outward during expiration, severely
impairing ventilation.
Question 6
