TNCC 2026/2027 COMPREHENSIVE
TRAUMA NURSING EXAM QUESTIONS
AND ANSWERS
1. During the across-the-room survey, you observe a patient with a spurting wound to the
femoral area. What is the priority intervention?
A. Open the airway and provide oxygen
B. Assess the level of consciousness
C. Start two large-bore IV lines
D. Apply direct pressure or a tourniquet
Answer: D
Conceptual Explanation: The TNCC priority is to identify and control uncontrolled
hemorrhage before addressing the airway, known as the C-ABC approach.
2. When assessing the ‘A’ (Airway) in a trauma patient, which finding indicates the need for
an immediate definitive airway?
A. Snoring respirations
B. Oxygen saturation of 92% on room air
,C. Presence of a small amount of dried blood on the lips
D. GCS score of 7
Answer: D
Conceptual Explanation: A GCS of 8 or less generally indicates the need for a definitive
airway (intubation) to protect the airway and ensure adequate oxygenation/ventilation.
3. In the ‘B’ (Breathing) assessment, a patient presents with tracheal deviation, absent breath
sounds on the right, and hypotension. What is the immediate intervention?
A. Perform a needle thoracostomy
B. Obtain a portable chest X-ray
C. Intubate the patient
D. Insert a chest tube at the 5th intercostal space
Answer: A
Conceptual Explanation: The clinical signs suggest a tension pneumothorax, which is a
life-threatening emergency requiring immediate needle decompression before waiting for
imaging.
4. What is the goal for ETCO2 in a head-injured patient with signs of herniation?
A. 25-30 mmHg
B. 45-50 mmHg
C. 35-45 mmHg
, D. 30-35 mmHg
Answer: D
Conceptual Explanation: Brief, controlled hyperventilation to maintain an ETCO2 of 30-
35 mmHg may be used for patients showing signs of herniation to induce cerebral
vasoconstriction, but should not be done routinely.
5. A patient with a suspected pelvic fracture is hemodynamically unstable. Which
intervention should be prioritized during the ‘C’ (Circulation) phase?
A. Log roll to inspect the back
B. Pelvic X-ray in the trauma bay
C. Immediate Foley catheter insertion
D. Application of a pelvic binder
Answer: D
Conceptual Explanation: Pelvic binders stabilize the fracture and reduce internal pelvic
volume to help control venous bleeding in unstable pelvic fractures.
6. Which component of the Trauma Triad of Death is often exacerbated by rapid
administration of cold IV fluids?
A. Hypothermia
B. Hypercalcemia
C. Coagulopathy
TRAUMA NURSING EXAM QUESTIONS
AND ANSWERS
1. During the across-the-room survey, you observe a patient with a spurting wound to the
femoral area. What is the priority intervention?
A. Open the airway and provide oxygen
B. Assess the level of consciousness
C. Start two large-bore IV lines
D. Apply direct pressure or a tourniquet
Answer: D
Conceptual Explanation: The TNCC priority is to identify and control uncontrolled
hemorrhage before addressing the airway, known as the C-ABC approach.
2. When assessing the ‘A’ (Airway) in a trauma patient, which finding indicates the need for
an immediate definitive airway?
A. Snoring respirations
B. Oxygen saturation of 92% on room air
,C. Presence of a small amount of dried blood on the lips
D. GCS score of 7
Answer: D
Conceptual Explanation: A GCS of 8 or less generally indicates the need for a definitive
airway (intubation) to protect the airway and ensure adequate oxygenation/ventilation.
3. In the ‘B’ (Breathing) assessment, a patient presents with tracheal deviation, absent breath
sounds on the right, and hypotension. What is the immediate intervention?
A. Perform a needle thoracostomy
B. Obtain a portable chest X-ray
C. Intubate the patient
D. Insert a chest tube at the 5th intercostal space
Answer: A
Conceptual Explanation: The clinical signs suggest a tension pneumothorax, which is a
life-threatening emergency requiring immediate needle decompression before waiting for
imaging.
4. What is the goal for ETCO2 in a head-injured patient with signs of herniation?
A. 25-30 mmHg
B. 45-50 mmHg
C. 35-45 mmHg
, D. 30-35 mmHg
Answer: D
Conceptual Explanation: Brief, controlled hyperventilation to maintain an ETCO2 of 30-
35 mmHg may be used for patients showing signs of herniation to induce cerebral
vasoconstriction, but should not be done routinely.
5. A patient with a suspected pelvic fracture is hemodynamically unstable. Which
intervention should be prioritized during the ‘C’ (Circulation) phase?
A. Log roll to inspect the back
B. Pelvic X-ray in the trauma bay
C. Immediate Foley catheter insertion
D. Application of a pelvic binder
Answer: D
Conceptual Explanation: Pelvic binders stabilize the fracture and reduce internal pelvic
volume to help control venous bleeding in unstable pelvic fractures.
6. Which component of the Trauma Triad of Death is often exacerbated by rapid
administration of cold IV fluids?
A. Hypothermia
B. Hypercalcemia
C. Coagulopathy
