TNCC FINAL PAPER 2026 QUESTIONS AND
ANSWERS
✅✅1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema - ✔✔✅✅Inspect the mouth for:
✅✅1. Check the presence of adequate rise and fall of the chest with assisted
ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ✔✔✅✅If the
pt has a definitive airway in what should you do?
✅✅1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method -
✔✔✅✅If Airway is not patent
✅✅1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ✔✔✅✅Following conditions might require a
definitive airway
✅✅Breathing: To assess breathing expose the chest:
1. Inspect for
a. spontaneous breathing
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
d. signs of difficulty breathing such as accessory muscle use
e. skin color (normal, pale, flushed, cyanotic)
, f. contusions, abrasions, deformities (flail chest)
g. open pneumothoraces (sucking chest wounds)
h. JVD
i. signs of inhalation injury (singed nasal hairs, carbonaceous sputum) - ✔✔✅✅B
✅✅tracheal deviation and jvd - ✔✔✅✅Late signs of tension pneumo:
✅✅1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ✔✔✅✅Auscultate the chest
for:
✅✅1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ✔✔✅✅Palpate the chest for
✅✅1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ✔✔✅✅If breathing is absent..
✅✅trauma its need early supplemental oxygen, start with 15 mL O2 and titrate oxygen
delivery. - ✔✔✅✅Oxygen on trauma patients
✅✅Circulation and Control of Hemorrhage
Inspect first for any uncontrolled bleeding
Skin color
palpate for central pulses - carotid and femoral - rate, rhythm, and strength
Skin temp: cool, diaphoretic, or warm and dry - ✔✔✅✅C
✅✅apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
ANSWERS
✅✅1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema - ✔✔✅✅Inspect the mouth for:
✅✅1. Check the presence of adequate rise and fall of the chest with assisted
ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor - ✔✔✅✅If the
pt has a definitive airway in what should you do?
✅✅1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method -
✔✔✅✅If Airway is not patent
✅✅1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation - ✔✔✅✅Following conditions might require a
definitive airway
✅✅Breathing: To assess breathing expose the chest:
1. Inspect for
a. spontaneous breathing
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
d. signs of difficulty breathing such as accessory muscle use
e. skin color (normal, pale, flushed, cyanotic)
, f. contusions, abrasions, deformities (flail chest)
g. open pneumothoraces (sucking chest wounds)
h. JVD
i. signs of inhalation injury (singed nasal hairs, carbonaceous sputum) - ✔✔✅✅B
✅✅tracheal deviation and jvd - ✔✔✅✅Late signs of tension pneumo:
✅✅1. equal breath sounds bilaterally at the second intercostal space midclavicular line
and the bases for fifth intercostal space at the axillary line - ✔✔✅✅Auscultate the chest
for:
✅✅1. bony fractures and possible rib fractures, which may impact ventilation
2. palpate for crepitus
3. subcutaneous emphysema which may be a sign for a pneumothorax
4. soft tissue injury - ✔✔✅✅Palpate the chest for
✅✅1. open the airway, use jaw thrust
2. insert an oral airway
3. assist ventilations with a bag mask
4. prepare for definitive airway - ✔✔✅✅If breathing is absent..
✅✅trauma its need early supplemental oxygen, start with 15 mL O2 and titrate oxygen
delivery. - ✔✔✅✅Oxygen on trauma patients
✅✅Circulation and Control of Hemorrhage
Inspect first for any uncontrolled bleeding
Skin color
palpate for central pulses - carotid and femoral - rate, rhythm, and strength
Skin temp: cool, diaphoretic, or warm and dry - ✔✔✅✅C
✅✅apply direct pressure to bleeding
elevate extremity
apply pressure over arterial sites
Consider a pelvic binder for pelvic fractures
consider a tourniquet
cannulate two veins with large caliber IV - if unable to gain assess consider IO
a. obtain labs, type and cross
