TRAUMA NURSING EXCELLENCE: TNCC
2025–2026 FULL EXAM REVIEW | VERIFIED
Q&A + HIGH-LEVEL CRITICAL THINKING
RATIONALES
1. What is the first priority in the primary
trauma survey?
Answer: Airway with cervical spine protection.
Rationale: Airway compromise is
lifethreatening, and spinal stabilization prevents
secondary injury.
2. Why is rapid control of external bleeding
essential in trauma?
Answer: To prevent hemorrhagic shock.
Rationale: Uncontrolled bleeding is the most
common cause of preventable trauma death.
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3. What is the purpose of performing a
jawthrust maneuver instead of a head-tilt-
chin-lift in trauma?
Answer: To open the airway while protecting
the cervical spine.
Rationale: The jaw-thrust avoids neck
movement that could worsen spinal injury.
4. Why is high-flow oxygen administered to
trauma patients?
Answer: To improve oxygen delivery to vital
organs.
Rationale: Trauma often causes hypoxia due to
shock, airway obstruction, or chest injury.
5. What is the significance of unequal breath
sounds after chest trauma?
Answer: Possible pneumothorax or
hemothorax.
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Rationale: Trauma can cause lung collapse or
bleeding, reducing ventilation on one side.
6. Why is the AVPU scale used during
neurological assessment?
Answer: To quickly evaluate level of
consciousness.
Rationale: AVPU provides rapid identification of
neurological deterioration.
7. What does a deviated trachea typically
indicate in chest trauma?
Answer: Tension pneumothorax.
Rationale: Air trapped under pressure shifts
mediastinal structures.
8. Why must a trauma patient be fully
exposed during assessment?
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Answer: To identify hidden injuries. Rationale:
Clothing can conceal bleeding, deformities, or
open wounds.
9. Why is warming the trauma patient
important?
Answer: To prevent hypothermia. Rationale:
Trauma patients rapidly lose temperature,
worsening coagulopathy.
10. Why is capillary refill assessed in trauma?
Answer: To evaluate peripheral perfusion.
Rationale: Delayed refill suggests shock and
inadequate circulation.
11. What condition is suspected when a
trauma patient shows muffled heart
sounds?
Answer: Cardiac tamponade.