TNCC 9TH EDITION
TNP Latest 2025 Exam
Complete 75 Questions & Correct Answers | Graded A+ Pass
Trauma Nursing Core Course | Trauma Nursing Professional
75 Questions • 7 Sections • Multiple Choice (A-D)
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 1
,TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
Aligned with ENA TNCC 9th Edition Provider Manual and 2025-2026 TNP Examination Objectives
EXAMINATION OVERVIEW
This comprehensive examination evaluates mastery of the Emergency Nurses Association (ENA) Trauma Nursing Core
Course (TNCC) 9th Edition and Trauma Nursing Professional (TNP) certification objectives for the 2025-2026 testing
cycle. The exam comprises 75 multiple-choice questions distributed across seven core trauma nursing domains, reflecting
the A-IPI (Airway with c-spine protection, Breathing, Circulation, Disability, Exposure) primary survey framework and
evidence-based trauma care principles. Questions are calibrated to three cognitive levels: approximately 25% test direct
recall of trauma assessment concepts, 55% require application of trauma nursing principles to clinical scenarios, and 20%
demand analysis of complex multi-system trauma situations. Each question includes a verified correct answer and a
detailed rationale with TNCC 9th Edition and ENA guideline citations.
Sectio
Content Domain Questions Count
n
Trauma Systems and Initial Assessment
1 Q1-Q12 12
Trauma Continuum of Care, Triage, Primary Survey, ABCDE, & Team Dynamics
Airway, Breathing, and Thoracic Trauma
2 Q13-Q22 10
Airway Management, Oxygenation/Ventilation, & Thoracic Injuries
Circulation, Hemorrhage, and Shock Management
3 Q23-Q32 10
Hemorrhage Control, Fluid Resuscitation, Shock Recognition, & Vascular Access
Neurological and Spinal Trauma
4 Traumatic Brain Injury, Increased ICP, Spinal Cord Injury, & Neurological Q33-Q42 10
Assessment
Abdominal, Musculoskeletal, and Soft Tissue Trauma
5 Q43-Q52 10
Abdominal Injuries, Fractures, Compartment Syndrome, & Wound Management
Special Populations and Burns
6 Q53-Q62 10
Pediatric, Geriatric, Obstetric, Bariatric Trauma, & Burn Injuries
Resuscitation Procedures and Psychosocial Considerations
7 Q63-Q75 13
RSI, Chest Tubes, FAST, Family Presence, & End-of-Life Care
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 2
,TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
TOTAL Q1-Q75 75
EXAM INSTRUCTIONS
1. This exam contains 75 multiple-choice questions. Each question has four options (A, B, C, D) with exactly ONE
correct answer.
2. Read each question stem carefully. Note whether the question asks for recall, application of TNCC principles, or
analysis of a trauma scenario.
3. Select the BEST answer among the four options. Distractors represent common TNCC/TNP exam pitfalls
(primary survey sequencing errors, airway management mistakes, shock recognition failure, ICP management
errors).
4. After each question, review the rationale to understand the TNCC 9th Edition and ENA evidence-based reasoning
supporting the correct answer.
5. All rationale citations reference the TNCC 9th Edition Provider Manual and current ENA Trauma Nursing
Guidelines.
6. Suggested completion time: 90 minutes. Passing threshold for A+ grade: 90% (68 of 75 correct).
Quality Assurance: All questions, answers, and rationales have been reviewed for alignment with the ENA TNCC 9th Edition Provider Manual
and 2025-2026 TNP examination objectives. Clinical references follow the A-IPI primary survey framework, Brain Trauma Foundation
Guidelines, ACS Committee on Trauma recommendations, and current trauma resuscitation evidence. Candidates should consult the official
ENA TNCC Provider Manual and institutional protocols for complete clinical guidance.
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 3
, TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
SECTION 1: TRAUMA SYSTEMS AND INITIAL ASSESSMENT
Trauma Continuum of Care, Triage, Primary Survey, ABCDE, & Team Dynamics | Q1-Q12 | 12
Questions
This section evaluates foundational knowledge of trauma systems, triage principles, the primary survey (ABCDE), trauma team
roles, and the secondary assessment using AMPLE history. Questions emphasize the A-IPI framework, START triage, and
evidence-based team dynamics per TNCC 9th Edition.
Q1: A 24-year-old male is brought to the ED after a high-speed MVC. He is unconscious, has a GCS of 8, and
exhibits labored breathing with stridor. Manual in-line stabilization is being maintained. Which intervention
should the trauma team prioritize FIRST according to the primary survey?
A. Obtain a STAT head CT to evaluate for intracranial hemorrhage
B. Establish two large-bore IVs and initiate warmed crystalloid infusion
C. Perform a jaw-thrust maneuver and prepare for definitive airway management [CORRECT]
D. Assess pupils for size, equality, and reactivity
Correct Answer: C
Rationale:
The primary survey follows the ABCDE sequence: Airway with c-spine protection, Breathing, Circulation, Disability, Exposure. A
GCS of 8 indicates the patient cannot protect his airway, and stridor signals impending airway obstruction. Per TNCC 9th Edition,
the jaw-thrust maneuver (without head tilt) is the preferred technique for opening the airway when c-spine injury is suspected,
followed by definitive airway management (e.g., RSI with in-line stabilization). Options A (CT) and D (pupils) are Disability
phase interventions and cannot proceed until ABC is secured. Option B (circulation) is the next priority after airway (TNCC 9th
Edition, Primary Survey chapter; A-IPI principle).
Q2: A Level II trauma center receives a patient involved in a fall from 25 feet. The patient is hypotensive (BP
78/40), tachycardic (HR 132), and has a palpable pulse only. Under the CDC Field Triage Decision Scheme,
which guideline BEST supports direct transport to a Level I trauma center rather than the closest Level II
facility?
A. Step One: Physiologic criteria — Glasgow Coma Scale <14 or systolic BP <90 mmHg [CORRECT]
B. Step Two: Anatomic criteria — flail chest, two or more proximal long-bone fractures, or pelvic fracture
C. Step Three: Mechanism of Injury criteria — fall >20 feet or high-speed MVC with death of another occupant
D. Step Four: Special considerations — age >55, anticoagulation, or burns
Correct Answer: A
Rationale:
The CDC Field Triage Decision Scheme uses four sequential steps: physiologic, anatomic, mechanism of injury, and special
considerations. This patient meets Step One physiologic criteria (systolic BP <90 mmHg), which is the highest-acuity triage tier
and mandates transport to the highest-level trauma center available. Step Two (anatomic) and Step Three (MOI) are considered
only if Step One is not met. Step Four applies to special populations. Per TNCC 9th Edition, physiologic derangement always
supersedes mechanism in determining transport destination (CDC Guidelines for Field Triage of Injured Patients; TNCC 9th
Edition, Trauma Systems chapter).
Q3: During a mass casualty incident, EMS uses START (Simple Triage and Rapid Treatment) triage. A
victim is breathing spontaneously at 36 breaths/min after repositioning the airway, has a radial pulse, and can
follow commands. Under what triage category should this patient be classified?
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 4
TNP Latest 2025 Exam
Complete 75 Questions & Correct Answers | Graded A+ Pass
Trauma Nursing Core Course | Trauma Nursing Professional
75 Questions • 7 Sections • Multiple Choice (A-D)
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 1
,TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
Aligned with ENA TNCC 9th Edition Provider Manual and 2025-2026 TNP Examination Objectives
EXAMINATION OVERVIEW
This comprehensive examination evaluates mastery of the Emergency Nurses Association (ENA) Trauma Nursing Core
Course (TNCC) 9th Edition and Trauma Nursing Professional (TNP) certification objectives for the 2025-2026 testing
cycle. The exam comprises 75 multiple-choice questions distributed across seven core trauma nursing domains, reflecting
the A-IPI (Airway with c-spine protection, Breathing, Circulation, Disability, Exposure) primary survey framework and
evidence-based trauma care principles. Questions are calibrated to three cognitive levels: approximately 25% test direct
recall of trauma assessment concepts, 55% require application of trauma nursing principles to clinical scenarios, and 20%
demand analysis of complex multi-system trauma situations. Each question includes a verified correct answer and a
detailed rationale with TNCC 9th Edition and ENA guideline citations.
Sectio
Content Domain Questions Count
n
Trauma Systems and Initial Assessment
1 Q1-Q12 12
Trauma Continuum of Care, Triage, Primary Survey, ABCDE, & Team Dynamics
Airway, Breathing, and Thoracic Trauma
2 Q13-Q22 10
Airway Management, Oxygenation/Ventilation, & Thoracic Injuries
Circulation, Hemorrhage, and Shock Management
3 Q23-Q32 10
Hemorrhage Control, Fluid Resuscitation, Shock Recognition, & Vascular Access
Neurological and Spinal Trauma
4 Traumatic Brain Injury, Increased ICP, Spinal Cord Injury, & Neurological Q33-Q42 10
Assessment
Abdominal, Musculoskeletal, and Soft Tissue Trauma
5 Q43-Q52 10
Abdominal Injuries, Fractures, Compartment Syndrome, & Wound Management
Special Populations and Burns
6 Q53-Q62 10
Pediatric, Geriatric, Obstetric, Bariatric Trauma, & Burn Injuries
Resuscitation Procedures and Psychosocial Considerations
7 Q63-Q75 13
RSI, Chest Tubes, FAST, Family Presence, & End-of-Life Care
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 2
,TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
TOTAL Q1-Q75 75
EXAM INSTRUCTIONS
1. This exam contains 75 multiple-choice questions. Each question has four options (A, B, C, D) with exactly ONE
correct answer.
2. Read each question stem carefully. Note whether the question asks for recall, application of TNCC principles, or
analysis of a trauma scenario.
3. Select the BEST answer among the four options. Distractors represent common TNCC/TNP exam pitfalls
(primary survey sequencing errors, airway management mistakes, shock recognition failure, ICP management
errors).
4. After each question, review the rationale to understand the TNCC 9th Edition and ENA evidence-based reasoning
supporting the correct answer.
5. All rationale citations reference the TNCC 9th Edition Provider Manual and current ENA Trauma Nursing
Guidelines.
6. Suggested completion time: 90 minutes. Passing threshold for A+ grade: 90% (68 of 75 correct).
Quality Assurance: All questions, answers, and rationales have been reviewed for alignment with the ENA TNCC 9th Edition Provider Manual
and 2025-2026 TNP examination objectives. Clinical references follow the A-IPI primary survey framework, Brain Trauma Foundation
Guidelines, ACS Committee on Trauma recommendations, and current trauma resuscitation evidence. Candidates should consult the official
ENA TNCC Provider Manual and institutional protocols for complete clinical guidance.
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 3
, TNCC 9th Edition | TNP 2025 Exam Graded A+ Pass
SECTION 1: TRAUMA SYSTEMS AND INITIAL ASSESSMENT
Trauma Continuum of Care, Triage, Primary Survey, ABCDE, & Team Dynamics | Q1-Q12 | 12
Questions
This section evaluates foundational knowledge of trauma systems, triage principles, the primary survey (ABCDE), trauma team
roles, and the secondary assessment using AMPLE history. Questions emphasize the A-IPI framework, START triage, and
evidence-based team dynamics per TNCC 9th Edition.
Q1: A 24-year-old male is brought to the ED after a high-speed MVC. He is unconscious, has a GCS of 8, and
exhibits labored breathing with stridor. Manual in-line stabilization is being maintained. Which intervention
should the trauma team prioritize FIRST according to the primary survey?
A. Obtain a STAT head CT to evaluate for intracranial hemorrhage
B. Establish two large-bore IVs and initiate warmed crystalloid infusion
C. Perform a jaw-thrust maneuver and prepare for definitive airway management [CORRECT]
D. Assess pupils for size, equality, and reactivity
Correct Answer: C
Rationale:
The primary survey follows the ABCDE sequence: Airway with c-spine protection, Breathing, Circulation, Disability, Exposure. A
GCS of 8 indicates the patient cannot protect his airway, and stridor signals impending airway obstruction. Per TNCC 9th Edition,
the jaw-thrust maneuver (without head tilt) is the preferred technique for opening the airway when c-spine injury is suspected,
followed by definitive airway management (e.g., RSI with in-line stabilization). Options A (CT) and D (pupils) are Disability
phase interventions and cannot proceed until ABC is secured. Option B (circulation) is the next priority after airway (TNCC 9th
Edition, Primary Survey chapter; A-IPI principle).
Q2: A Level II trauma center receives a patient involved in a fall from 25 feet. The patient is hypotensive (BP
78/40), tachycardic (HR 132), and has a palpable pulse only. Under the CDC Field Triage Decision Scheme,
which guideline BEST supports direct transport to a Level I trauma center rather than the closest Level II
facility?
A. Step One: Physiologic criteria — Glasgow Coma Scale <14 or systolic BP <90 mmHg [CORRECT]
B. Step Two: Anatomic criteria — flail chest, two or more proximal long-bone fractures, or pelvic fracture
C. Step Three: Mechanism of Injury criteria — fall >20 feet or high-speed MVC with death of another occupant
D. Step Four: Special considerations — age >55, anticoagulation, or burns
Correct Answer: A
Rationale:
The CDC Field Triage Decision Scheme uses four sequential steps: physiologic, anatomic, mechanism of injury, and special
considerations. This patient meets Step One physiologic criteria (systolic BP <90 mmHg), which is the highest-acuity triage tier
and mandates transport to the highest-level trauma center available. Step Two (anatomic) and Step Three (MOI) are considered
only if Step One is not met. Step Four applies to special populations. Per TNCC 9th Edition, physiologic derangement always
supersedes mechanism in determining transport destination (CDC Guidelines for Field Triage of Injured Patients; TNCC 9th
Edition, Trauma Systems chapter).
Q3: During a mass casualty incident, EMS uses START (Simple Triage and Rapid Treatment) triage. A
victim is breathing spontaneously at 36 breaths/min after repositioning the airway, has a radial pulse, and can
follow commands. Under what triage category should this patient be classified?
TNCC 9th Edition & TNP | Trauma Nursing Certification Page 4
