TNCC 9TH EDITION STUDY GUIDE 2026
PRACTICE QUESTIONS AND ANSWERS
DETAILED REVIEW
◉ What does VIPP stand for? Answer: vital signs, injuries/interventions,
primary survey, pain
◉ During the head-to-toe, where would you find Grey-Turner's sign?
Answer: flank
◉ During the head-to-toe, where would you find Cullen's sign? Answer:
umbilicus
◉ What is sometimes deferred at the end of the head-to-toe? Answer:
inspecting posterior
◉ Antibiotics, consults, head CT, imaging, law enforcement, mandatory
reporting, psychosocial support, social services, splinting, tetanus, and
wound care are all interventions that you do AFTER and before WHAT?
Answer: AFTER head-to-toe, BEFORE J (VIPP)
◉ What three items are obtained during the pertinent history
assessment? Answer: Medical records, prehospital report, SAMPLE
,◉ What are examples of nonpharmacologic measures? (must identify at
least one during testing) Answer: Distraction, family presence, padding
bony prominences, repositioning, splinting, verbal reassurance
◉ For whom is capnography highly recommended? Answer: all patients
◉ In step M of "Get Adjuncts", what else might be indicated besides
cardiac monitor? Answer: EKG
◉ In Step 16 of "Exposure and Environment", you must name at least
one of these interventions: Answer: blankets, room temp increase,
warmed fluids, warming lights
◉ At what point PRIOR TO the head-to-toe is the patient inspected for
obvious injuries? Answer: In Step 15 of "Exposure and Environment"
◉ In Step 13 of "Disability", what is assessed if pt is altered? Answer:
glucose
◉ To assess circulation, you must do these two main tasks: Answer: 1.
inspect AND palpate skin color, temp, moisture and 2. palpate a pulse
◉ What do you do when alterations are identified in any of the steps in
the primary survery? Answer: intervene as appropriate and reassess
, ◉ What three assessments must be done if the patient is intubated?
Answer: 1. attach CO2 detector and assess for evidence of exhaled CO2;
2. observe for rise and fall of the chest w/ assisted ventilations; 3.
auscultate over epigastrium for gurgling AND lungs for bilateral breath
sounds
◉ Four of these must be identified to assess breathing effectiveness:
Answer: Breath sounds, depth/pattern/rate, spontaneous breathing,
subcutaneous emphysema, increased work of breathing, symmetrical
chest rise and fall, tracheal deviation/JVD, open wounds/deformities,
skin color
◉ What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section? Answer:
cardiac monitor
◉ When should 2 IV sites be established? Answer: During "Circulation"
assessment
◉ If the patient is intubated and you've already assessed ETT placement,
what else needs to be done with the ETT? (step 10) Answer: assess ETT
position by noting the number at teeth/gums AND secure ETT
◉ What should you verbalize after completing all ETT assessments?
Answer: moving patient from assisted ventilation to mechanical
PRACTICE QUESTIONS AND ANSWERS
DETAILED REVIEW
◉ What does VIPP stand for? Answer: vital signs, injuries/interventions,
primary survey, pain
◉ During the head-to-toe, where would you find Grey-Turner's sign?
Answer: flank
◉ During the head-to-toe, where would you find Cullen's sign? Answer:
umbilicus
◉ What is sometimes deferred at the end of the head-to-toe? Answer:
inspecting posterior
◉ Antibiotics, consults, head CT, imaging, law enforcement, mandatory
reporting, psychosocial support, social services, splinting, tetanus, and
wound care are all interventions that you do AFTER and before WHAT?
Answer: AFTER head-to-toe, BEFORE J (VIPP)
◉ What three items are obtained during the pertinent history
assessment? Answer: Medical records, prehospital report, SAMPLE
,◉ What are examples of nonpharmacologic measures? (must identify at
least one during testing) Answer: Distraction, family presence, padding
bony prominences, repositioning, splinting, verbal reassurance
◉ For whom is capnography highly recommended? Answer: all patients
◉ In step M of "Get Adjuncts", what else might be indicated besides
cardiac monitor? Answer: EKG
◉ In Step 16 of "Exposure and Environment", you must name at least
one of these interventions: Answer: blankets, room temp increase,
warmed fluids, warming lights
◉ At what point PRIOR TO the head-to-toe is the patient inspected for
obvious injuries? Answer: In Step 15 of "Exposure and Environment"
◉ In Step 13 of "Disability", what is assessed if pt is altered? Answer:
glucose
◉ To assess circulation, you must do these two main tasks: Answer: 1.
inspect AND palpate skin color, temp, moisture and 2. palpate a pulse
◉ What do you do when alterations are identified in any of the steps in
the primary survery? Answer: intervene as appropriate and reassess
, ◉ What three assessments must be done if the patient is intubated?
Answer: 1. attach CO2 detector and assess for evidence of exhaled CO2;
2. observe for rise and fall of the chest w/ assisted ventilations; 3.
auscultate over epigastrium for gurgling AND lungs for bilateral breath
sounds
◉ Four of these must be identified to assess breathing effectiveness:
Answer: Breath sounds, depth/pattern/rate, spontaneous breathing,
subcutaneous emphysema, increased work of breathing, symmetrical
chest rise and fall, tracheal deviation/JVD, open wounds/deformities,
skin color
◉ What can be applied in step 12 of "Circulation and Control of
Hemorrhage" for which credit is given in the LMNOP section? Answer:
cardiac monitor
◉ When should 2 IV sites be established? Answer: During "Circulation"
assessment
◉ If the patient is intubated and you've already assessed ETT placement,
what else needs to be done with the ETT? (step 10) Answer: assess ETT
position by noting the number at teeth/gums AND secure ETT
◉ What should you verbalize after completing all ETT assessments?
Answer: moving patient from assisted ventilation to mechanical
