TNCC 9th Edition Exam 2026/2027 | Complete Practice
Questions, Correct Answers & Detailed Rationales
Questions 1–50: Initial Assessment, Primary Survey & Trauma
Priorities
1. A trauma patient arrives after a motor-vehicle collision. Which
assessment should the trauma nurse perform first?
A. Obtain a detailed medical history
B. Assess airway while maintaining cervical-spine protection
C. Obtain a complete medication list
D. Assess urine output
Answer: B
Rationale: The primary survey begins with airway assessment while
protecting the cervical spine. Immediate threats to life are addressed
before obtaining a detailed history.
2. During the primary survey, which finding requires immediate
intervention?
A. Blood pressure of 138/82 mmHg
B. Respiratory rate of 18/min
C. Absent breath sounds on one side with severe respiratory distress
D. Small superficial forearm abrasion
Answer: C
Rationale: Unilateral absent breath sounds with respiratory distress can
indicate tension pneumothorax, a rapidly life-threatening condition
requiring immediate treatment.
,3. The trauma primary survey is primarily designed to:
A. Identify all injuries
B. Establish a complete diagnosis
C. Identify and treat immediate life threats
D. Determine discharge readiness
Answer: C
Rationale: The primary survey focuses on rapidly identifying and
managing conditions that threaten life.
4. Which sequence best represents the traditional trauma primary
survey?
A. History, examination, laboratory testing, imaging
B. Airway, breathing, circulation, disability, exposure
C. Circulation, airway, exposure, disability, breathing
D. Neurologic examination, airway, circulation, imaging
Answer: B
Rationale: The ABCDE approach provides a systematic method for
rapidly evaluating life-threatening trauma conditions.
5. A patient has facial trauma and blood pooling in the mouth. What is
the nurse's priority?
A. Obtain a temperature
B. Clear the airway
C. Apply a urinary catheter
D. Obtain a detailed history
Answer: B
Rationale: Blood and secretions can obstruct the airway. Suction and
airway management take priority.
,6. Which finding most strongly suggests an airway obstruction?
A. Clear speech
B. Snoring respirations
C. Normal oxygen saturation
D. Warm skin
Answer: B
Rationale: Snoring often occurs when soft tissues partially obstruct the
upper airway, particularly in an unconscious patient.
7. A trauma patient is unconscious and has no obvious airway
obstruction. Which maneuver is generally preferred when cervical-spine
injury is suspected?
A. Head-tilt/chin-lift
B. Jaw-thrust maneuver
C. Neck hyperextension
D. Rotating the head laterally
Answer: B
Rationale: The jaw-thrust can open the airway while minimizing
cervical-spine movement.
8. Which patient should receive the highest priority?
A. Stable patient with an isolated ankle fracture
B. Patient with controlled scalp bleeding
C. Patient with airway obstruction
D. Patient with a minor laceration
Answer: C
Rationale: Airway compromise is an immediate threat to life and takes
priority.
, 9. What is the purpose of the exposure component of the primary
survey?
A. Prevent hypothermia by leaving the patient uncovered
B. Completely inspect the patient for injuries
C. Obtain insurance information
D. Assess only the extremities
Answer: B
Rationale: Exposure allows identification of injuries that may otherwise
be hidden by clothing.
10. After exposing a trauma patient, the nurse should:
A. Leave the patient uncovered for continued observation
B. Cover the patient to prevent heat loss
C. Apply ice to the entire body
D. Delay temperature management
Answer: B
Rationale: Trauma patients are particularly vulnerable to hypothermia,
which can worsen coagulopathy and shock.
11. Which assessment is most useful for evaluating circulation during
the primary survey?
A. Skin color and peripheral pulses
B. Bowel sounds
C. Visual acuity
D. Hearing
Answer: A
Rationale: Circulation assessment includes pulse quality, skin findings,
bleeding, and overall perfusion.
Questions, Correct Answers & Detailed Rationales
Questions 1–50: Initial Assessment, Primary Survey & Trauma
Priorities
1. A trauma patient arrives after a motor-vehicle collision. Which
assessment should the trauma nurse perform first?
A. Obtain a detailed medical history
B. Assess airway while maintaining cervical-spine protection
C. Obtain a complete medication list
D. Assess urine output
Answer: B
Rationale: The primary survey begins with airway assessment while
protecting the cervical spine. Immediate threats to life are addressed
before obtaining a detailed history.
2. During the primary survey, which finding requires immediate
intervention?
A. Blood pressure of 138/82 mmHg
B. Respiratory rate of 18/min
C. Absent breath sounds on one side with severe respiratory distress
D. Small superficial forearm abrasion
Answer: C
Rationale: Unilateral absent breath sounds with respiratory distress can
indicate tension pneumothorax, a rapidly life-threatening condition
requiring immediate treatment.
,3. The trauma primary survey is primarily designed to:
A. Identify all injuries
B. Establish a complete diagnosis
C. Identify and treat immediate life threats
D. Determine discharge readiness
Answer: C
Rationale: The primary survey focuses on rapidly identifying and
managing conditions that threaten life.
4. Which sequence best represents the traditional trauma primary
survey?
A. History, examination, laboratory testing, imaging
B. Airway, breathing, circulation, disability, exposure
C. Circulation, airway, exposure, disability, breathing
D. Neurologic examination, airway, circulation, imaging
Answer: B
Rationale: The ABCDE approach provides a systematic method for
rapidly evaluating life-threatening trauma conditions.
5. A patient has facial trauma and blood pooling in the mouth. What is
the nurse's priority?
A. Obtain a temperature
B. Clear the airway
C. Apply a urinary catheter
D. Obtain a detailed history
Answer: B
Rationale: Blood and secretions can obstruct the airway. Suction and
airway management take priority.
,6. Which finding most strongly suggests an airway obstruction?
A. Clear speech
B. Snoring respirations
C. Normal oxygen saturation
D. Warm skin
Answer: B
Rationale: Snoring often occurs when soft tissues partially obstruct the
upper airway, particularly in an unconscious patient.
7. A trauma patient is unconscious and has no obvious airway
obstruction. Which maneuver is generally preferred when cervical-spine
injury is suspected?
A. Head-tilt/chin-lift
B. Jaw-thrust maneuver
C. Neck hyperextension
D. Rotating the head laterally
Answer: B
Rationale: The jaw-thrust can open the airway while minimizing
cervical-spine movement.
8. Which patient should receive the highest priority?
A. Stable patient with an isolated ankle fracture
B. Patient with controlled scalp bleeding
C. Patient with airway obstruction
D. Patient with a minor laceration
Answer: C
Rationale: Airway compromise is an immediate threat to life and takes
priority.
, 9. What is the purpose of the exposure component of the primary
survey?
A. Prevent hypothermia by leaving the patient uncovered
B. Completely inspect the patient for injuries
C. Obtain insurance information
D. Assess only the extremities
Answer: B
Rationale: Exposure allows identification of injuries that may otherwise
be hidden by clothing.
10. After exposing a trauma patient, the nurse should:
A. Leave the patient uncovered for continued observation
B. Cover the patient to prevent heat loss
C. Apply ice to the entire body
D. Delay temperature management
Answer: B
Rationale: Trauma patients are particularly vulnerable to hypothermia,
which can worsen coagulopathy and shock.
11. Which assessment is most useful for evaluating circulation during
the primary survey?
A. Skin color and peripheral pulses
B. Bowel sounds
C. Visual acuity
D. Hearing
Answer: A
Rationale: Circulation assessment includes pulse quality, skin findings,
bleeding, and overall perfusion.
