TNCC FINAL EXAM TEST 2026 -
ADVANCED LEVEL EXAM QUESTIONS
AND ANSWERS
1. During the primary survey, a patient with a suspected C-spine injury requires airway
management. Which maneuver is most appropriate?
A. Head-tilt, chin-lift
B. Jaw-thrust maneuver
C. Hyper-extension of the neck
D. Lateral positioning
Answer: B
Conceptual Explanation: The jaw-thrust maneuver is the preferred method for opening
the airway in trauma patients with suspected cervical spine injuries to minimize movement
of the vertebrae.
2. A patient presents with muffled heart sounds, jugular venous distention, and hypotension.
Which condition should be suspected?
A. Tension pneumothorax
,B. Massive hemothorax
C. Hypovolemic shock
D. Cardiac tamponade
Answer: D
Conceptual Explanation: Beck’s triad (muffled heart sounds, JVD, and hypotension) is a
classic indicator of cardiac tamponade.
3. Which assessment finding is a late sign of tension pneumothorax?
A. Decreased breath sounds
B. Tracheal deviation
C. Hyperresonance on percussion
D. Tachycardia
Answer: B
Conceptual Explanation: Tracheal deviation is a late and often rare sign of tension
pneumothorax; clinical diagnosis should be based on respiratory distress and
hemodynamic instability.
4. In the ‘Disability’ phase of the primary survey, what is the most important assessment to
include?
A. Range of motion of all limbs
B. Deep tendon reflexes
, C. Pain scale assessment
D. Glasgow Coma Scale and pupil response
Answer: D
Conceptual Explanation: The Disability (D) phase focuses on neurological status using
GCS and pupillary assessment to identify life-threatening brain injuries.
5. A trauma patient has a suspected pelvic fracture and is hemodynamically unstable. Where
should a pelvic binder be placed?
A. Over the iliac crests
B. Over the lower abdomen
C. Over the greater trochanters
D. Over the mid-thighs
Answer: C
Conceptual Explanation: Pelvic binders should be centered over the greater trochanters
to provide optimal stabilization and compression of the pelvic ring.
6. Which physiological change in pregnancy may mask early signs of shock?
A. Increased heart rate by 15-20 bpm
B. Increased systemic vascular resistance
C. Decreased cardiac output
ADVANCED LEVEL EXAM QUESTIONS
AND ANSWERS
1. During the primary survey, a patient with a suspected C-spine injury requires airway
management. Which maneuver is most appropriate?
A. Head-tilt, chin-lift
B. Jaw-thrust maneuver
C. Hyper-extension of the neck
D. Lateral positioning
Answer: B
Conceptual Explanation: The jaw-thrust maneuver is the preferred method for opening
the airway in trauma patients with suspected cervical spine injuries to minimize movement
of the vertebrae.
2. A patient presents with muffled heart sounds, jugular venous distention, and hypotension.
Which condition should be suspected?
A. Tension pneumothorax
,B. Massive hemothorax
C. Hypovolemic shock
D. Cardiac tamponade
Answer: D
Conceptual Explanation: Beck’s triad (muffled heart sounds, JVD, and hypotension) is a
classic indicator of cardiac tamponade.
3. Which assessment finding is a late sign of tension pneumothorax?
A. Decreased breath sounds
B. Tracheal deviation
C. Hyperresonance on percussion
D. Tachycardia
Answer: B
Conceptual Explanation: Tracheal deviation is a late and often rare sign of tension
pneumothorax; clinical diagnosis should be based on respiratory distress and
hemodynamic instability.
4. In the ‘Disability’ phase of the primary survey, what is the most important assessment to
include?
A. Range of motion of all limbs
B. Deep tendon reflexes
, C. Pain scale assessment
D. Glasgow Coma Scale and pupil response
Answer: D
Conceptual Explanation: The Disability (D) phase focuses on neurological status using
GCS and pupillary assessment to identify life-threatening brain injuries.
5. A trauma patient has a suspected pelvic fracture and is hemodynamically unstable. Where
should a pelvic binder be placed?
A. Over the iliac crests
B. Over the lower abdomen
C. Over the greater trochanters
D. Over the mid-thighs
Answer: C
Conceptual Explanation: Pelvic binders should be centered over the greater trochanters
to provide optimal stabilization and compression of the pelvic ring.
6. Which physiological change in pregnancy may mask early signs of shock?
A. Increased heart rate by 15-20 bpm
B. Increased systemic vascular resistance
C. Decreased cardiac output
