Trauma Nursing Core Course (TNCC) Proctored Exam with NGN – 250
Practice Questions & Verified Answers with Rationales (2026 Latest
Update)
Questions 1–250
1. A trauma patient arrives after a motor vehicle collision with an
open airway, tachypnea, and an SpO₂ of 88% on room air. What is
the priority intervention?
A) Establish IV access
B) Administer high-flow oxygen and assess breathing
C) Apply cervical collar
D) Perform FAST exam
Answer B: Administer high-flow oxygen and assess breathing
,Rationale: Hypoxemia requires immediate oxygen administration and
breathing assessment per the A (Airway) and B (Breathing) steps of
the Initial Assessment.
2. During the primary survey, which statement best describes the
purpose of the "A" (Airway) assessment?
A) To identify life-threatening injuries
B) To confirm airway patency and protect the cervical spine
C) To assess for tension pneumothorax
D) To evaluate for spinal cord injury
Answer B: To confirm airway patency and protect the cervical spine
Rationale: Airway assessment ensures the airway is patent and the
cervical spine is motion-restricted.
3. An unconscious trauma patient has an OPA in place and is being
ventilated. The provider notes absent breath sounds on the right
side and tracheal deviation to the left. Which immediate action is
indicated?
A) Administer a 1-L normal saline bolus
,B) Perform needle decompression at the 2nd intercostal space on the
right mid-clavicular line
C) Apply a three-sided occlusive dressing to the right chest
D) Obtain a chest x-ray
Answer B: Perform needle decompression at the 2nd intercostal
space on the right mid-clavicular line
Rationale: Absent breath sounds and tracheal deviation suggest
tension pneumothorax; immediate needle decompression is
indicated.
4. A 22-year-old male sustained a gunshot wound to the abdomen.
He is pale, diaphoretic, has a heart rate of 130, systolic BP of 85.
Which type of shock is this patient most likely experiencing?
A) Neurogenic shock
B) Hemorrhagic shock
C) Cardiogenic shock
D) Obstructive shock
Answer B: Hemorrhagic shock
Rationale: Tachycardia and hypotension from penetrating trauma
with visible or suspected bleeding indicate hemorrhagic shock.
, 5. A trauma patient is being evaluated with a GCS score of 7. Which
of the following is the most appropriate airway management?
A) Insert an OPA and continue with supplemental oxygen
B) Rapid sequence intubation (RSI)
C) Place a nasal trumpet and monitor
D) Surgical airway immediately
Answer B: Rapid sequence intubation (RSI)
Rationale: GCS ≤8 indicates a compromised airway/neurologic status;
RSI is the standard of care.
6. A patient is placed in cervical spine motion restriction (CSMR).
Which finding would allow for cervical spine clearance?
A) Midline cervical tenderness
B) Patient is alert, oriented, and has no midline tenderness
C) Distracting injury present
D) Focal neurologic deficit
Answer B: Patient is alert, oriented, and has no midline tenderness
Practice Questions & Verified Answers with Rationales (2026 Latest
Update)
Questions 1–250
1. A trauma patient arrives after a motor vehicle collision with an
open airway, tachypnea, and an SpO₂ of 88% on room air. What is
the priority intervention?
A) Establish IV access
B) Administer high-flow oxygen and assess breathing
C) Apply cervical collar
D) Perform FAST exam
Answer B: Administer high-flow oxygen and assess breathing
,Rationale: Hypoxemia requires immediate oxygen administration and
breathing assessment per the A (Airway) and B (Breathing) steps of
the Initial Assessment.
2. During the primary survey, which statement best describes the
purpose of the "A" (Airway) assessment?
A) To identify life-threatening injuries
B) To confirm airway patency and protect the cervical spine
C) To assess for tension pneumothorax
D) To evaluate for spinal cord injury
Answer B: To confirm airway patency and protect the cervical spine
Rationale: Airway assessment ensures the airway is patent and the
cervical spine is motion-restricted.
3. An unconscious trauma patient has an OPA in place and is being
ventilated. The provider notes absent breath sounds on the right
side and tracheal deviation to the left. Which immediate action is
indicated?
A) Administer a 1-L normal saline bolus
,B) Perform needle decompression at the 2nd intercostal space on the
right mid-clavicular line
C) Apply a three-sided occlusive dressing to the right chest
D) Obtain a chest x-ray
Answer B: Perform needle decompression at the 2nd intercostal
space on the right mid-clavicular line
Rationale: Absent breath sounds and tracheal deviation suggest
tension pneumothorax; immediate needle decompression is
indicated.
4. A 22-year-old male sustained a gunshot wound to the abdomen.
He is pale, diaphoretic, has a heart rate of 130, systolic BP of 85.
Which type of shock is this patient most likely experiencing?
A) Neurogenic shock
B) Hemorrhagic shock
C) Cardiogenic shock
D) Obstructive shock
Answer B: Hemorrhagic shock
Rationale: Tachycardia and hypotension from penetrating trauma
with visible or suspected bleeding indicate hemorrhagic shock.
, 5. A trauma patient is being evaluated with a GCS score of 7. Which
of the following is the most appropriate airway management?
A) Insert an OPA and continue with supplemental oxygen
B) Rapid sequence intubation (RSI)
C) Place a nasal trumpet and monitor
D) Surgical airway immediately
Answer B: Rapid sequence intubation (RSI)
Rationale: GCS ≤8 indicates a compromised airway/neurologic status;
RSI is the standard of care.
6. A patient is placed in cervical spine motion restriction (CSMR).
Which finding would allow for cervical spine clearance?
A) Midline cervical tenderness
B) Patient is alert, oriented, and has no midline tenderness
C) Distracting injury present
D) Focal neurologic deficit
Answer B: Patient is alert, oriented, and has no midline tenderness
