TNCC Test prep 9th Edition Questions
with Correct Answers | 100% pass
Section 1: Initial Assessment & Triage
1. A trauma patient arrives via EMS. The primary survey reveals a patent airway, breathing at
28 breaths/min, a weak radial pulse, and a GCS of 13. According to the ABCDE approach, what
is the priority intervention?
A. Obtain a full set of vital signs.
B. Apply a cervical collar.
C. Initiate two large-bore IV lines.
D. Prepare for intubation.
Correct Answer: C
Rationale: The patient is showing signs of shock (tachycardia, tachypnea, altered mental
status). The priority after identifying inadequate circulation is to establish IV access for fluid
resuscitation. While B and D are important, C is the immediate circulatory intervention.
2. Which of the following is a contraindication for using a supraglottic airway (SGA) in a
trauma patient?
A. Facial trauma with a wired jaw.
B. Obesity (BMI > 30).
C. Suspected cervical spine injury.
D. Patient with a gag reflex.
Correct Answer: D
Rationale: A supraglottic airway (like an LMA) is contraindicated in patients with a gag reflex
because it can stimulate vomiting and aspiration. A wired jaw (A) is also a relative
contraindication, but D is an absolute physiological contraindication. C is not a contraindication;
SGAs are often used with manual in-line stabilization.
3. A patient with a gunshot wound to the right chest has distended neck veins, tracheal
deviation to the left, and absent breath sounds on the right. What is the immediate priority?
A. Needle decompression.
B. Chest tube insertion.
C. Pericardiocentesis.
D. CT scan of the chest.
, Correct Answer: A
Rationale: These are classic signs of a tension pneumothorax. Needle decompression is the
immediate life-saving intervention. Chest tube (B) follows, but A is the priority.
Pericardiocentesis (C) is for cardiac tamponade, which does not typically cause tracheal
deviation.
4. Select All That Apply: Which of the following are components of the "A" in the ABCDE
primary survey?
A. Assess for stridor.
B. Check for pooled secretions.
C. Palpate the trachea for deviation.
D. Assess for hoarseness.
E. Apply a cervical collar.
F. Suction the oropharynx if needed.
Correct Answer: A, B, D, F
Rationale: The "A" (Airway) assessment includes looking for signs of obstruction (stridor,
hoarseness, pooled secretions) and intervening (suctioning). C (Tracheal deviation) is assessed
during "B" (Breathing) or "D" (Disability) and is a late sign. E (C-collar) is part of "C"
(Circulation/Disability) or the initial C-spine precautions, not the primary airway assessment.
5. A patient is unresponsive with snoring respirations. After manual in-line stabilization, what
is the next immediate action?
A. Insert an oropharyngeal airway (OPA).
B. Perform a jaw-thrust maneuver.
C. Suction the airway.
D. Apply high-flow oxygen.
Correct Answer: B
Rationale: The snoring indicates a partial airway obstruction from the tongue. The jaw-
thrust maneuver (B) is the correct first step to open the airway while maintaining C-spine
stabilization. An OPA (A) can be used after the jaw thrust if needed, but B is the immediate
manual maneuver.
6. Which of the following is the most reliable indicator of adequate perfusion in a trauma
patient?
A. Blood pressure.
B. Heart rate.
C. Urine output.
D. Capillary refill.
, Correct Answer: C
Rationale: Urine output is the most sensitive indicator of end-organ perfusion and overall
volume status. Blood pressure (A) is a late sign of shock. Heart rate (B) can be altered by
medications. Capillary refill (D) is affected by temperature.
7. A patient involved in a motor vehicle crash has a GCS of 14. What does this indicate?
A. Mild head injury.
B. Moderate head injury.
C. Severe head injury.
D. Normal neurological status.
Correct Answer: A
Rationale: A GCS of 13-15 is classified as a mild head injury. 9-12 is moderate, and 3-8 is
severe.
8. During the primary survey, a patient is found to have paradoxical chest wall movement.
This is indicative of:
A. Tension pneumothorax.
B. Flail chest.
C. Cardiac tamponade.
D. Open pneumothorax.
Correct Answer: B
Rationale: Paradoxical movement (the injured section moves inward on inspiration and
outward on expiration) is the hallmark sign of a flail chest.
9. Which of the following is a key component of the "E" (Exposure/Environmental Control) in
the primary survey?
A. Log-rolling the patient.
B. Removing all clothing.
C. Preventing hypothermia.
D. Assessing for priapism.
Correct Answer: C
Rationale: While removing clothing (B) is part of exposure, preventing hypothermia (C) is
the critical "Environmental Control" component to prevent the trauma triad of death
(hypothermia, acidosis, coagulopathy).
10. A patient has a penetrating wound to the left anterior chest. What is the priority nursing
intervention?
A. Apply a sterile occlusive dressing.
, B. Apply a non-occlusive dressing.
C. Prepare for a chest tube.
D. Administer a tetanus shot.
Correct Answer: B
Rationale: For an open pneumothorax (sucking chest wound), a non-occlusive dressing (like
a Vaseline gauze taped on three sides) is used to allow air to escape and prevent tension
pneumothorax. A fully occlusive dressing (A) can convert it to a tension pneumothorax.
11. The "C" in the ABCDE primary survey stands for:
A. Consciousness.
B. Circulation.
C. Cervical spine.
D. Both B and C.
Correct Answer: D
Rationale: The "C" stands for Circulation and includes assessing for pulse, skin color, and
controlling external hemorrhage. Cervical spine stabilization is also a critical component of the
"C" step in trauma.
12. Which of the following patients should be triaged to the highest priority (Red)?
A. Patient with a simple fracture of the radius.
B. Patient with a GCS of 15 and a sprained ankle.
C. Patient with a tension pneumothorax.
D. Patient with a laceration requiring 5 sutures.
Correct Answer: C
Rationale: Tension pneumothorax is an immediate life-threat. The other patients are lower
acuity (Green or Yellow).
13. A trauma patient has a systolic blood pressure of 80 mmHg and a heart rate of 130 bpm.
This is classified as:
A. Class I hemorrhage.
B. Class II hemorrhage.
C. Class III hemorrhage.
D. Class IV hemorrhage.
Correct Answer: C
Rationale: Class III hemorrhage (30-40% blood loss) is characterized by hypotension,
tachycardia, and altered mental status.
with Correct Answers | 100% pass
Section 1: Initial Assessment & Triage
1. A trauma patient arrives via EMS. The primary survey reveals a patent airway, breathing at
28 breaths/min, a weak radial pulse, and a GCS of 13. According to the ABCDE approach, what
is the priority intervention?
A. Obtain a full set of vital signs.
B. Apply a cervical collar.
C. Initiate two large-bore IV lines.
D. Prepare for intubation.
Correct Answer: C
Rationale: The patient is showing signs of shock (tachycardia, tachypnea, altered mental
status). The priority after identifying inadequate circulation is to establish IV access for fluid
resuscitation. While B and D are important, C is the immediate circulatory intervention.
2. Which of the following is a contraindication for using a supraglottic airway (SGA) in a
trauma patient?
A. Facial trauma with a wired jaw.
B. Obesity (BMI > 30).
C. Suspected cervical spine injury.
D. Patient with a gag reflex.
Correct Answer: D
Rationale: A supraglottic airway (like an LMA) is contraindicated in patients with a gag reflex
because it can stimulate vomiting and aspiration. A wired jaw (A) is also a relative
contraindication, but D is an absolute physiological contraindication. C is not a contraindication;
SGAs are often used with manual in-line stabilization.
3. A patient with a gunshot wound to the right chest has distended neck veins, tracheal
deviation to the left, and absent breath sounds on the right. What is the immediate priority?
A. Needle decompression.
B. Chest tube insertion.
C. Pericardiocentesis.
D. CT scan of the chest.
, Correct Answer: A
Rationale: These are classic signs of a tension pneumothorax. Needle decompression is the
immediate life-saving intervention. Chest tube (B) follows, but A is the priority.
Pericardiocentesis (C) is for cardiac tamponade, which does not typically cause tracheal
deviation.
4. Select All That Apply: Which of the following are components of the "A" in the ABCDE
primary survey?
A. Assess for stridor.
B. Check for pooled secretions.
C. Palpate the trachea for deviation.
D. Assess for hoarseness.
E. Apply a cervical collar.
F. Suction the oropharynx if needed.
Correct Answer: A, B, D, F
Rationale: The "A" (Airway) assessment includes looking for signs of obstruction (stridor,
hoarseness, pooled secretions) and intervening (suctioning). C (Tracheal deviation) is assessed
during "B" (Breathing) or "D" (Disability) and is a late sign. E (C-collar) is part of "C"
(Circulation/Disability) or the initial C-spine precautions, not the primary airway assessment.
5. A patient is unresponsive with snoring respirations. After manual in-line stabilization, what
is the next immediate action?
A. Insert an oropharyngeal airway (OPA).
B. Perform a jaw-thrust maneuver.
C. Suction the airway.
D. Apply high-flow oxygen.
Correct Answer: B
Rationale: The snoring indicates a partial airway obstruction from the tongue. The jaw-
thrust maneuver (B) is the correct first step to open the airway while maintaining C-spine
stabilization. An OPA (A) can be used after the jaw thrust if needed, but B is the immediate
manual maneuver.
6. Which of the following is the most reliable indicator of adequate perfusion in a trauma
patient?
A. Blood pressure.
B. Heart rate.
C. Urine output.
D. Capillary refill.
, Correct Answer: C
Rationale: Urine output is the most sensitive indicator of end-organ perfusion and overall
volume status. Blood pressure (A) is a late sign of shock. Heart rate (B) can be altered by
medications. Capillary refill (D) is affected by temperature.
7. A patient involved in a motor vehicle crash has a GCS of 14. What does this indicate?
A. Mild head injury.
B. Moderate head injury.
C. Severe head injury.
D. Normal neurological status.
Correct Answer: A
Rationale: A GCS of 13-15 is classified as a mild head injury. 9-12 is moderate, and 3-8 is
severe.
8. During the primary survey, a patient is found to have paradoxical chest wall movement.
This is indicative of:
A. Tension pneumothorax.
B. Flail chest.
C. Cardiac tamponade.
D. Open pneumothorax.
Correct Answer: B
Rationale: Paradoxical movement (the injured section moves inward on inspiration and
outward on expiration) is the hallmark sign of a flail chest.
9. Which of the following is a key component of the "E" (Exposure/Environmental Control) in
the primary survey?
A. Log-rolling the patient.
B. Removing all clothing.
C. Preventing hypothermia.
D. Assessing for priapism.
Correct Answer: C
Rationale: While removing clothing (B) is part of exposure, preventing hypothermia (C) is
the critical "Environmental Control" component to prevent the trauma triad of death
(hypothermia, acidosis, coagulopathy).
10. A patient has a penetrating wound to the left anterior chest. What is the priority nursing
intervention?
A. Apply a sterile occlusive dressing.
, B. Apply a non-occlusive dressing.
C. Prepare for a chest tube.
D. Administer a tetanus shot.
Correct Answer: B
Rationale: For an open pneumothorax (sucking chest wound), a non-occlusive dressing (like
a Vaseline gauze taped on three sides) is used to allow air to escape and prevent tension
pneumothorax. A fully occlusive dressing (A) can convert it to a tension pneumothorax.
11. The "C" in the ABCDE primary survey stands for:
A. Consciousness.
B. Circulation.
C. Cervical spine.
D. Both B and C.
Correct Answer: D
Rationale: The "C" stands for Circulation and includes assessing for pulse, skin color, and
controlling external hemorrhage. Cervical spine stabilization is also a critical component of the
"C" step in trauma.
12. Which of the following patients should be triaged to the highest priority (Red)?
A. Patient with a simple fracture of the radius.
B. Patient with a GCS of 15 and a sprained ankle.
C. Patient with a tension pneumothorax.
D. Patient with a laceration requiring 5 sutures.
Correct Answer: C
Rationale: Tension pneumothorax is an immediate life-threat. The other patients are lower
acuity (Green or Yellow).
13. A trauma patient has a systolic blood pressure of 80 mmHg and a heart rate of 130 bpm.
This is classified as:
A. Class I hemorrhage.
B. Class II hemorrhage.
C. Class III hemorrhage.
D. Class IV hemorrhage.
Correct Answer: C
Rationale: Class III hemorrhage (30-40% blood loss) is characterized by hypotension,
tachycardia, and altered mental status.
