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TNCC Study Guide 2026 | 600+ Questions | Trauma Assessment, Shock, Airway & Emergency Care | Nursing

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This document is a comprehensive and in-depth study guide for the TNCC (Trauma Nursing Core Course) Exam (2026), containing over 600 verified questions and correct answers covering the full spectrum of trauma nursing and emergency care. It includes essential topics such as primary and secondary survey (ABCDE approach), shock classifications (hypovolemic, cardiogenic, obstructive, distributive), airway management and rapid sequence intubation, traumatic brain injuries, spinal cord injuries, chest trauma, and burn management. Based on the full content (157 pages), the material provides extensive, scenario-based and concept-based learning aligned with real TNCC exam standards. Early sections (pages 1–10) focus on priority interventions such as rapid transfer to trauma centers and recognizing compensated shock, while later sections deliver detailed theoretical explanations including trauma physiology, ICP management, head injuries (epidural vs subdural hematoma), thoracic injuries (pneumothorax, hemothorax, cardiac tamponade), and advanced airway techniques. The document also integrates key frameworks such as MARCH, DOPE, AVPU, and rapid sequence intubation steps, making it highly valuable for both exam success and real clinical application. This resource is ideal for students and professionals enrolled in nursing (BSN, ADN), emergency nursing, paramedic, and critical care programs. It is particularly beneficial for TNCC certification candidates, NCLEX-RN preparation, emergency department nurses, trauma team members, and paramedics. Suitable users include undergraduate and graduate nursing students, ER and ICU nurses, physician assistant students, and healthcare professionals seeking to strengthen trauma assessment, decision-making, and emergency response skills. The document aligns closely with the TNCC (Trauma Nursing Core Course) 9th Edition Manual by the Emergency Nurses Association (ENA), reinforcing evidence-based trauma care guidelines, systematic assessment approaches, and life-saving interventions required in emergency nursing practice. Keywords: tncc study guide, trauma nursing exam, emergency nursing questions, shock types nursing, airway management tncc, rapid sequence intubation steps, traumatic brain injury nursing, spinal cord injury assessment, chest trauma management, pneumothorax signs, icp management nursing, march algorithm trauma, dope mnemonic airway, avpu scale nursing, critical care exam prep

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TNCC Study Guide 2026 Exam
Questions and Correct Answers |
New Update


A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a

rural critical access facility. He complains of neck pain, SOB, and diffuse

abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on

high-flow O2 via NRB mask. Which of the following is the priority

intervention for this patient? - 🧠 ANSWER ✔✔Expedite transfer to the

closest trauma center

,Which of the following considerations is the most important when caring for

a geriatric trauma pt? - 🧠 ANSWER ✔✔a pertinent medical hx is crucial


Following a review of recent drills and a real disaster event, a hospital has

identified deficiencies and is taking steps to minimize the impact of a future

disaster . Which phase of the disaster life cycle does this describe? - 🧠

ANSWER ✔✔Mitigation


EMS brings a pt who fell while riding his bicycle. Using the American

College of Surgeobs screening guidelines, which assessment finding would

prompt the RN to prepare the pt for a radiologic spine clearance? - 🧠

ANSWER ✔✔Multiple requests for water


What is the effect of hypothermia on the oxyhemoglobin dissociation

curve? - 🧠 ANSWER ✔✔hemoglobin does not readily release O2 for use by

the tissues

Which of the following is a component of the trauma triad of death? - 🧠

ANSWER ✔✔acidosis


EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2

C). The pt exhibits urinary incontinence and priapism. These assessment

,findings are most consistent with which of the following types of spinal cord

injury? - 🧠 ANSWER ✔✔Complete


Which of the following is an expected finding in a pt with a tube

thoracstomy connected to a chest drainage system? - 🧠 ANSWER

✔✔flucuation in the water seal chamber


During the primary survey of an unconscious pt with multi-system trauma,

the nurse notes snoring respirations. What priority nursing interventions

should be preformed next? - 🧠 ANSWER ✔✔insert an oropharyngeal

airway if there is no gag reflex

A 35 y/o M presents with facial trauma after being struck in the face with a

baseball. A teardrop-shaped left pupil is noted on exam. What type of injury

is suspected? - 🧠 ANSWER ✔✔globe rupture


A trauma pt is restless and repeatedly asking "where am i?" VS upon

arrival: BP 110/60, HR96, RR 24. Her skin is cool and dry. Current VS are

BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which stage of

shock? - 🧠 ANSWER ✔✔compensated


An unresponsive trauma pt has an oropharygeal airway in place, shallow

and labored respirations, and dusky skin. The trauma team has


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, administered medications for drug-assisted intubation and attempted

intubation but was unsuccessful. What is the most appropriate immediate

next step? - 🧠 ANSWER ✔✔ventilate with a bag mask device


When is the tertiary survey completed fora trauma pt? - 🧠 ANSWER

✔✔within 24 hrs of trauma


An intubated and sedated pt in the ED has multiple extremity injuries with

the potential for causing compartment syndrome. What is the most reliable

indication of compartment syndrome in a patient who is unconscious? - 🧠

ANSWER ✔✔pressure


Which of the following is possible complication of positive-pressure

ventilation? - 🧠 ANSWER ✔✔worsening pneumothorax


the most reassuring finding for a male pt with hip pain after a fall is which of

the following? - 🧠 ANSWER ✔✔pelvic stability


Which of the following pulse pressures indicate early hypovolemic shock? -

🧠 ANSWER ✔✔narrowed


Patients with a crush injury should be monitored for which of the following

conditions? - 🧠 ANSWER ✔✔dysrhythmias

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