TRAUMA NURSING CORE COURSE
(TNCC) ADVANCED EXAM QUESTIONS
AND ANSWERS
1. A patient arrives with a sucking chest wound. What is the immediate priority intervention
during the primary survey?
A. Application of a non-porous dressing taped on three sides
B. Endotracheal intubation
C. Insertion of a large-bore chest tube
D. Needle decompression in the second intercostal space
Answer: A
Conceptual Explanation: An open pneumothorax (sucking chest wound) requires
immediate occlusion with a vented dressing (taped on three sides) to prevent a tension
pneumothorax while allowing air to escape.
2. Which component of the Trauma Nursing Process (TNP) is addressed during the ‘F’ step of
the primary survey?
A. Functional neurological assessment
,B. Focused assessment with sonography for trauma
C. Full set of vitals and Family presence
D. Fluid resuscitation initiation
Answer: C
Conceptual Explanation: In the TNP, ‘F’ stands for Full set of vital signs and Family
presence, which transitions the nurse from the primary survey to adjuncts.
3. In a mass casualty incident, a patient who is awake, breathing at 24 breaths/min, and has a
palpable radial pulse but cannot follow simple commands should be tagged as:
A. Red (Immediate)
B. Yellow (Delayed)
C. Green (Minor)
D. Black (Deceased)
Answer: A
Conceptual Explanation: According to START triage, if a patient cannot follow simple
commands (mental status deficit), they are categorized as Red (Immediate).
4. A patient with a suspected pelvic fracture is hypotensive. Which intervention is most
appropriate to stabilize the pelvis?
A. Internal rotation of the hips and taping the feet together
B. Application of a pelvic binder at the level of the greater trochanters
, C. Placement of a pelvic binder at the level of the iliac crests
D. Log-rolling the patient every 2 hours to prevent pressure ulcers
Answer: B
Conceptual Explanation: A pelvic binder should be centered over the greater trochanters
to effectively stabilize the pelvic ring and decrease internal bleeding.
5. What is the hallmark sign of neurogenic shock that differentiates it from hypovolemic
shock?
A. Tachycardia and cool, clammy skin
B. Hypotension and decreased urine output
C. Narrow pulse pressure and tachypnea
D. Bradycardia and warm, dry skin
Answer: D
Conceptual Explanation: Neurogenic shock involves loss of sympathetic tone, leading to
vasodilation and bradycardia, whereas hypovolemic shock typically presents with
tachycardia.
6. Which lab value is most indicative of the adequacy of tissue perfusion and the success of
resuscitation in trauma?
A. Hemoglobin
B. Serum Lactate
(TNCC) ADVANCED EXAM QUESTIONS
AND ANSWERS
1. A patient arrives with a sucking chest wound. What is the immediate priority intervention
during the primary survey?
A. Application of a non-porous dressing taped on three sides
B. Endotracheal intubation
C. Insertion of a large-bore chest tube
D. Needle decompression in the second intercostal space
Answer: A
Conceptual Explanation: An open pneumothorax (sucking chest wound) requires
immediate occlusion with a vented dressing (taped on three sides) to prevent a tension
pneumothorax while allowing air to escape.
2. Which component of the Trauma Nursing Process (TNP) is addressed during the ‘F’ step of
the primary survey?
A. Functional neurological assessment
,B. Focused assessment with sonography for trauma
C. Full set of vitals and Family presence
D. Fluid resuscitation initiation
Answer: C
Conceptual Explanation: In the TNP, ‘F’ stands for Full set of vital signs and Family
presence, which transitions the nurse from the primary survey to adjuncts.
3. In a mass casualty incident, a patient who is awake, breathing at 24 breaths/min, and has a
palpable radial pulse but cannot follow simple commands should be tagged as:
A. Red (Immediate)
B. Yellow (Delayed)
C. Green (Minor)
D. Black (Deceased)
Answer: A
Conceptual Explanation: According to START triage, if a patient cannot follow simple
commands (mental status deficit), they are categorized as Red (Immediate).
4. A patient with a suspected pelvic fracture is hypotensive. Which intervention is most
appropriate to stabilize the pelvis?
A. Internal rotation of the hips and taping the feet together
B. Application of a pelvic binder at the level of the greater trochanters
, C. Placement of a pelvic binder at the level of the iliac crests
D. Log-rolling the patient every 2 hours to prevent pressure ulcers
Answer: B
Conceptual Explanation: A pelvic binder should be centered over the greater trochanters
to effectively stabilize the pelvic ring and decrease internal bleeding.
5. What is the hallmark sign of neurogenic shock that differentiates it from hypovolemic
shock?
A. Tachycardia and cool, clammy skin
B. Hypotension and decreased urine output
C. Narrow pulse pressure and tachypnea
D. Bradycardia and warm, dry skin
Answer: D
Conceptual Explanation: Neurogenic shock involves loss of sympathetic tone, leading to
vasodilation and bradycardia, whereas hypovolemic shock typically presents with
tachycardia.
6. Which lab value is most indicative of the adequacy of tissue perfusion and the success of
resuscitation in trauma?
A. Hemoglobin
B. Serum Lactate
