TNCC Skills Demonstration Exam
Questions and Answers
Preparation and Triage - Answer-
Student Skill Steps
1 States the need to activate the trauma team - Answer-Instructor Responses
"The trauma team is activated"
Student Skill Steps
2 States the need to prepare the trauma room
Get the Rapid Infuser, Chest Trauma Equipment. - Answer-Instructor Responses
"Preparation is complete"
Student Skill Steps
3 States the need to don personal protective equipment (PPE) - Answer-Instructor
Responses
"PPE has been donned by the team"
Across-the-room Observation - Answer-
Student Skill Steps
4 Assesses for obvious uncontrolled external hemorrhage - Answer-Instructor
Responses
"There is no uncontrolled external hemorrhage and no need to consider reprioritizing to
C-ABC."
Primary Survey - Answer-Airway and Alertness with Simultaneous Cervical Spine
Stabilization
Student Skill Steps
5 Assess level of consciousness using AVPU (awake, verbal stim, painful stim,
unresponsive) - Answer-Instructor Responses
,"The patient responds to verbal stimuli by opening eyes but is unable to follow
commands."
Student Skill Steps
6 States the need for a second person to provide manual cervical spinal stabilization
AND demonstrates manual opening of the airway using the jaw thrust maneuver -
Answer-Instructor Responses
"Manual cervical spinal stabilization is being provided. Please demonstrate your
opening of the airway."
Student Skill Steps
7 Demonstrates and describes techniques for determining the patency and protection of
the airway, using inspection, auscultation, and palpation (identify at least 5/6). - Answer-
Instructor Responses
"1. There is no tongue obstruction
2. There are no loose or missing teeth
3. No foreign objects are noted
4. There is no bleeding, vomitus or other secretions.
5. There is no edema
6. Snoring is heard when jaw thrust is released.
7. No gurgling or stridor is heard."
Student Skill Steps
8 States the need for an oropharyngeal airway (OPA) - Answer-Instructor Responses
"The OPA has been placed."
Student Skill Steps
9 States the need for a definitive airway. - Answer-Instructor Responses
"The team is gathering equipment to begin intubation. Please continue your
assessment."
Student Skill Steps
10 Reassess the airway after insertion of OPA - Answer-Instructor Responses
"No snoring is heard. The airway is now patent."
Breathing and Ventilation - Answer-
, Student Skill Steps
11 Demonstrates and describes techniques for determining breathing effectiveness,
using components of inspection, auscultation, and palpation. (Identifies at least 4/8). -
Answer-Instructor Responses
"1. Breathing in spontaneous.
2. Chest rise is symmetrical and shallow.
3. Respirations are very slow and shallow.
4. There are no signs of increased work of breathing.
5. The skin is pale.
6. No wounds are noted. There is no subcutaneous emphysema. The chest wall is
intact.
7. There is no tracheal deviation or jugular venous distension.
8. Breath sounds are diminished."
Student Skill Steps
12 States the need for assisted ventilation with bag valve mask. - Answer-Instructor
Responses
"Ventilations are being assisted."
Instructor Response:
"The patient has just been intubated using rapid sequence intubation. What is your next
step?" - Answer-
Student Skill Steps
13 Assesses endotracheal tube placement (uses correct sequence below):
1. Attaches CO2 Detector
2. Observes for the rise and fall of chest. Auscultates over epigastrum AND then
bilateral breath sounds.
3. After 5 or 6 breaths, observes the CO2 detector for evidence of CO2 in exhaled air.
4. Assess for improvement in skin color. - Answer-Instructor Responses
"1. A CO2 detector is attached.
2. Chest rises and falls with ventilation. No gurgling is heard over the epigastrum.
Breath sounds are equal bilaterally.
3. After 5 or 6 breaths, there is positive evidence for CO2 indicating the tube is correctly
in the trachea.
4. The skin color improves."
Student Skill Steps
Questions and Answers
Preparation and Triage - Answer-
Student Skill Steps
1 States the need to activate the trauma team - Answer-Instructor Responses
"The trauma team is activated"
Student Skill Steps
2 States the need to prepare the trauma room
Get the Rapid Infuser, Chest Trauma Equipment. - Answer-Instructor Responses
"Preparation is complete"
Student Skill Steps
3 States the need to don personal protective equipment (PPE) - Answer-Instructor
Responses
"PPE has been donned by the team"
Across-the-room Observation - Answer-
Student Skill Steps
4 Assesses for obvious uncontrolled external hemorrhage - Answer-Instructor
Responses
"There is no uncontrolled external hemorrhage and no need to consider reprioritizing to
C-ABC."
Primary Survey - Answer-Airway and Alertness with Simultaneous Cervical Spine
Stabilization
Student Skill Steps
5 Assess level of consciousness using AVPU (awake, verbal stim, painful stim,
unresponsive) - Answer-Instructor Responses
,"The patient responds to verbal stimuli by opening eyes but is unable to follow
commands."
Student Skill Steps
6 States the need for a second person to provide manual cervical spinal stabilization
AND demonstrates manual opening of the airway using the jaw thrust maneuver -
Answer-Instructor Responses
"Manual cervical spinal stabilization is being provided. Please demonstrate your
opening of the airway."
Student Skill Steps
7 Demonstrates and describes techniques for determining the patency and protection of
the airway, using inspection, auscultation, and palpation (identify at least 5/6). - Answer-
Instructor Responses
"1. There is no tongue obstruction
2. There are no loose or missing teeth
3. No foreign objects are noted
4. There is no bleeding, vomitus or other secretions.
5. There is no edema
6. Snoring is heard when jaw thrust is released.
7. No gurgling or stridor is heard."
Student Skill Steps
8 States the need for an oropharyngeal airway (OPA) - Answer-Instructor Responses
"The OPA has been placed."
Student Skill Steps
9 States the need for a definitive airway. - Answer-Instructor Responses
"The team is gathering equipment to begin intubation. Please continue your
assessment."
Student Skill Steps
10 Reassess the airway after insertion of OPA - Answer-Instructor Responses
"No snoring is heard. The airway is now patent."
Breathing and Ventilation - Answer-
, Student Skill Steps
11 Demonstrates and describes techniques for determining breathing effectiveness,
using components of inspection, auscultation, and palpation. (Identifies at least 4/8). -
Answer-Instructor Responses
"1. Breathing in spontaneous.
2. Chest rise is symmetrical and shallow.
3. Respirations are very slow and shallow.
4. There are no signs of increased work of breathing.
5. The skin is pale.
6. No wounds are noted. There is no subcutaneous emphysema. The chest wall is
intact.
7. There is no tracheal deviation or jugular venous distension.
8. Breath sounds are diminished."
Student Skill Steps
12 States the need for assisted ventilation with bag valve mask. - Answer-Instructor
Responses
"Ventilations are being assisted."
Instructor Response:
"The patient has just been intubated using rapid sequence intubation. What is your next
step?" - Answer-
Student Skill Steps
13 Assesses endotracheal tube placement (uses correct sequence below):
1. Attaches CO2 Detector
2. Observes for the rise and fall of chest. Auscultates over epigastrum AND then
bilateral breath sounds.
3. After 5 or 6 breaths, observes the CO2 detector for evidence of CO2 in exhaled air.
4. Assess for improvement in skin color. - Answer-Instructor Responses
"1. A CO2 detector is attached.
2. Chest rises and falls with ventilation. No gurgling is heard over the epigastrum.
Breath sounds are equal bilaterally.
3. After 5 or 6 breaths, there is positive evidence for CO2 indicating the tube is correctly
in the trachea.
4. The skin color improves."
Student Skill Steps
