TNCC Notes for Written Exam 2025 COMPLETE
EXAM QUESTIONS AND VERIFIED ANSWERS
|RECENTLY TESTING REAL EXAM QUESTIONS|
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A branch of mechanics (energy transfer) that refers to
What is kinematics? motion and does not consider the concepts of force
and mass of the object or body.
What is Newton's First A body at rest will remain at rest. A body in motion will
Law? remain in motion until acted on by an outside force.
What is the Law of Energy can neither be created nor destroyed. It is
Conservation of Energy? only changed from one form to another.
What is Newton's Second Force equals mass multiplied by acceleration of
Law? deceleration.
What is kinetic energy KE equals 1/2 the mass (M) multiplied by the velocity
(KE)? squared.
A = Airway with simultaneous cervical spine protection
B = Breathing
What is the Mnemonic for C = Circulation
the Initial Assessment? D = Disability (neurologic status)
E = Expose/Environmental controls (remove clothing
and keep the patient warm)
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F = Full set of VS/Focused adjuncts (includes cardiac
monitor, urinary catheter, and gastric tube)/Family
presence
What is the Mnemonic for
G = Give comfort measures (verbal reassurance,
the Secondary
touch, and pharmacologic and nonpharmacologic
Assessment?
management of pain).
H = Hx and Head-to-toe assessment
I = Inspect posterior surfaces
Auscultate the lungs bilaterally at the second
Where do you listen to
intercostal space midclavicular line and at the fifth
auscultate breath sounds?
intercostal space at the anterior axillary line.
What are the late signs of - Tracheal deviation
breathing compromise? - JVD
- 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
What are signs of
both or diaphragmatic breathing
ineffective 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, A tight-fitting nonrebreather mask at 12-15 lpm.
what type of oxygen
should be used for a pt
breathing effectively?
What intervention should - Insert 2 large caliber IV's
be done if a pt presents - Administer warmed isotonic crystalloid solution at
with effective circulation? an appropriate rate
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- Tachycardia
- AMS
- Uncontrolled external bleeding
What are signs of
- Pale, cool, moist skin
ineffective circulation?
- Distended or abnormally flattened external jugular
veins
- Distant heart sounds
- 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
What are the interventions
- Use pressure bags to increase speed of IVF infusion
for Effective/Ineffective
- Use blood administration tubing for possible
Circulation?
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)
DISABILITY
A = Alert
V = Verbal
P = Pain
U = Unresponsive
How do you assess
- GCS
Mnemonic "D"?
- 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
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- If assessment indicates a decreased LOC, conduct
further investigation during secondary focused
assessments
What are the interventions
- If pt is not alert or verbal, continue to monitor for
for Disability?
any compromise to ABC's
- If pt demonstrates signs of herniation or neurologic
deterioration, consider hyperventilation.
- Remove clothing
What is assessed and
- Ensure appropriate decontamination if exposed to
intervened for
hazardous material
Expose/Environmental
- Keep pt warm
Controls?
- Keep clothing for evidence
FULL SET VS / FOCUSED ADJUNCTS / FAMILY
What is the first thing PRESENCE
assessed under the - ABCDE should be completed
Secondary Assessment? - Labs, X-rays, CT, Foley,
- Family Presence
GIVE COMFORT MEASURES
What is the second thing - Talking to pt
assessed under the - Pharmacologic/Nonpharmacologic pain
Secondary Assessment? management
- Observe for physical signs of pain
HISTORY / HEAD-TO-TOE ASSESSMENT
- MIVT
- M = Mechanism of injury
- I = Injuries sustained
What is assessed under
- V = Vital Signs
the Mnemonic "H"?
- T = Treatment
- Pt generated information
- PMH
- Head-to-toe assessment
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