TNCC NOTES FOR WRITTEN EXAM QUESTION
AND ANSWERS 2025
What is kinematics? - CORRECT ANSWER-A branch of mechanics (energy transfer)
that refers to motion and does not consider the concepts of force and mass of the object
or body.
What is Newton's First Law? - CORRECT ANSWER-A body at rest will remain at rest. A
body in motion will remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - CORRECT ANSWER-Energy can neither
be created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? - CORRECT ANSWER-Force equals mass multiplied
by acceleration of deceleration.
What is kinetic energy (KE)? - CORRECT ANSWER-KE equals 1/2 the mass (M)
multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? - CORRECT ANSWER-A = Airway
with simultaneous cervical spine protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient warm)
What is the Mnemonic for the Secondary Assessment? - CORRECT ANSWER-F = Full
set of VS/Focused adjuncts (includes cardiac monitor, urinary catheter, and gastric
tube)/Family presence
G = Give comfort measures (verbal reassurance, touch, and pharmacologic and
nonpharmacologic management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds? - CORRECT ANSWER-Auscultate
the lungs bilaterally at the second intercostal space midclavicular line and at the fifth
intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - CORRECT ANSWER-- Tracheal
deviation
,- JVD
What are signs of ineffective breathing? - CORRECT ANSWER-- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing
effectively? - CORRECT ANSWER-A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? - CORRECT
ANSWER-- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - CORRECT ANSWER-- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - CORRECT ANSWER--
Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
, - IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? - CORRECT ANSWER-DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
What are the interventions for Disability? - CORRECT ANSWER-- If assessment
indicates a decreased LOC, conduct further investigation during secondary focused
assessments
- If pt is not alert or verbal, continue to monitor for any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration, consider
hyperventilation.
What is assessed and intervened for Expose/Environmental Controls? - CORRECT
ANSWER-- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
- Keep clothing for evidence
What is the first thing assessed under the Secondary Assessment? - CORRECT
ANSWER-FULL SET VS / FOCUSED ADJUNCTS / FAMILY PRESENCE
- ABCDE should be completed
- Labs, X-rays, CT, Foley,
- Family Presence
What is the second thing assessed under the Secondary Assessment? - CORRECT
ANSWER-GIVE COMFORT MEASURES
- Talking to pt
- Pharmacologic/Nonpharmacologic pain management
- Observe for physical signs of pain
AND ANSWERS 2025
What is kinematics? - CORRECT ANSWER-A branch of mechanics (energy transfer)
that refers to motion and does not consider the concepts of force and mass of the object
or body.
What is Newton's First Law? - CORRECT ANSWER-A body at rest will remain at rest. A
body in motion will remain in motion until acted on by an outside force.
What is the Law of Conservation of Energy? - CORRECT ANSWER-Energy can neither
be created nor destroyed. It is only changed from one form to another.
What is Newton's Second Law? - CORRECT ANSWER-Force equals mass multiplied
by acceleration of deceleration.
What is kinetic energy (KE)? - CORRECT ANSWER-KE equals 1/2 the mass (M)
multiplied by the velocity squared.
What is the Mnemonic for the Initial Assessment? - CORRECT ANSWER-A = Airway
with simultaneous cervical spine protection
B = Breathing
C = Circulation
D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing and keep the patient warm)
What is the Mnemonic for the Secondary Assessment? - CORRECT ANSWER-F = Full
set of VS/Focused adjuncts (includes cardiac monitor, urinary catheter, and gastric
tube)/Family presence
G = Give comfort measures (verbal reassurance, touch, and pharmacologic and
nonpharmacologic management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Where do you listen to auscultate breath sounds? - CORRECT ANSWER-Auscultate
the lungs bilaterally at the second intercostal space midclavicular line and at the fifth
intercostal space at the anterior axillary line.
What are the late signs of breathing compromise? - CORRECT ANSWER-- Tracheal
deviation
,- JVD
What are signs of ineffective breathing? - CORRECT ANSWER-- AMS
- Cyanosis, especially around the mouth
- Asymmetric expansion of chest wall
- Paradoxical movement of the chest wall during inspiration and expiration
- Use of accessory muscles or abdominal muscles or both or diaphragmatic breathing
- Sucking chest wounds
- Absent or diminished breath sounds
- Administer O2 via NRB or assist ventilations with a bag-mask device, as indicated
- Anticipate definitive airway management to support ventilation.
Upon initial assessment, what type of oxygen should be used for a pt breathing
effectively? - CORRECT ANSWER-A tight-fitting nonrebreather mask at 12-15 lpm.
What intervention should be done if a pt presents with effective circulation? - CORRECT
ANSWER-- Insert 2 large caliber IV's
- Administer warmed isotonic crystalloid solution at an appropriate rate
What are signs of ineffective circulation? - CORRECT ANSWER-- Tachycardia
- AMS
- Uncontrolled external bleeding
- Pale, cool, moist skin
- Distended or abnormally flattened external jugular veins
- Distant heart sounds
What are the interventions for Effective/Ineffective Circulation? - CORRECT ANSWER--
Control any uncontrolled external bleeding by:
- Applying direct pressure over bleeding site
- Elevating bleeding extremity
- Applying pressure over arterial pressure points
- Using tourniquet (last resort).
- Cannulate 2 large-caliber IV's and initiate infusions of an isotonic crystalloid solution
- Use warmed solution
- Use pressure bags to increase speed of IVF infusion
- Use blood administration tubing for possible administration of blood
- Use rapid infusion device based on protocol
- Use NS 0.9% in same tubing as blood product
- IV = surgical cut-down, central line, or both.
- Blood sample to determine ABO and Rh group
, - IO in sternum, legs, arms or pelvis
- Administer blood products
- PASG (without interfering with fluid resuscitation)
How do you assess Mnemonic "D"? - CORRECT ANSWER-DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
- GCS
- PERRL?
- Determine presence of lateralizing signs including:
- Unilateral deterioration in motor movements or unequal pupils
- Symptoms that help to locate area of injury in brain
What are the interventions for Disability? - CORRECT ANSWER-- If assessment
indicates a decreased LOC, conduct further investigation during secondary focused
assessments
- If pt is not alert or verbal, continue to monitor for any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic deterioration, consider
hyperventilation.
What is assessed and intervened for Expose/Environmental Controls? - CORRECT
ANSWER-- Remove clothing
- Ensure appropriate decontamination if exposed to hazardous material
- Keep pt warm
- Keep clothing for evidence
What is the first thing assessed under the Secondary Assessment? - CORRECT
ANSWER-FULL SET VS / FOCUSED ADJUNCTS / FAMILY PRESENCE
- ABCDE should be completed
- Labs, X-rays, CT, Foley,
- Family Presence
What is the second thing assessed under the Secondary Assessment? - CORRECT
ANSWER-GIVE COMFORT MEASURES
- Talking to pt
- Pharmacologic/Nonpharmacologic pain management
- Observe for physical signs of pain
