TNCC 9th Edition Midterm Exam 2026/2027 |300+ Practice
Questions, Correct Answers & Detailed Rationales
Questions 1–50: Initial Assessment, Primary Survey & Trauma
Priorities
1. A trauma patient arrives after a high-speed motor vehicle collision.
What is the nurse's first priority?
A. Obtain a complete medical history
B. Assess airway while maintaining cervical spine protection
C. Insert a urinary catheter
D. Obtain a complete set of laboratory studies
Answer: B
Rationale: Airway assessment is the first priority in the trauma primary
survey. Cervical spine protection should be maintained because
traumatic injury may involve the cervical spine.
2. Which sequence represents the traditional trauma primary survey?
A. CABDE
B. ABCDE
C. SAMPLE
D. OPQRST
Answer: B
Rationale: The primary survey systematically evaluates Airway,
Breathing, Circulation, Disability, and Exposure/Environmental control.
3. A trauma patient is speaking clearly in complete sentences. What
does this finding primarily suggest?
A. Adequate circulation
,B. An intact airway at that moment
C. Normal neurologic function
D. Absence of internal bleeding
Answer: B
Rationale: Clear speech indicates that air is moving through the upper
airway. It does not rule out other serious trauma.
4. Which finding is most concerning for an impending airway
obstruction?
A. Mild tachycardia
B. Hoarse or altered voice
C. Small superficial abrasion
D. Mild hypertension
Answer: B
Rationale: Hoarseness, stridor, gurgling, or voice changes may indicate
upper-airway compromise and require immediate evaluation.
5. During trauma assessment, which finding requires immediate
intervention?
A. Open femur fracture
B. Airway obstruction
C. Abdominal bruising
D. Closed wrist fracture
Answer: B
Rationale: An obstructed airway can rapidly cause hypoxia and death.
Life-threatening airway problems take priority over less immediately
fatal injuries.
,6. What is the purpose of maintaining manual cervical stabilization
during initial trauma assessment?
A. Prevent blood loss
B. Prevent movement of a potentially injured cervical spine
C. Improve circulation
D. Reduce pain
Answer: B
Rationale: Cervical spine motion can worsen an unstable spinal injury
and potentially cause secondary neurologic damage.
7. Which patient should the trauma nurse assess first?
A. Patient with an isolated ankle fracture
B. Patient with a superficial scalp laceration
C. Patient with severe respiratory distress
D. Patient with mild back pain
Answer: C
Rationale: Severe respiratory distress indicates a potentially life-
threatening breathing problem and requires immediate attention.
8. What is the primary purpose of the primary survey?
A. Identify every injury
B. Identify and treat immediate life threats
C. Complete discharge planning
D. Determine insurance status
Answer: B
Rationale: The primary survey focuses on rapidly identifying and
managing conditions that can immediately threaten life.
, 9. A trauma patient has blood pooling in the mouth and cannot clear it
independently. What is the priority?
A. Give oral fluids
B. Suction the airway
C. Obtain an abdominal CT
D. Apply a splint
Answer: B
Rationale: Blood and secretions can obstruct the airway and impair
ventilation. Suctioning helps restore airway patency.
10. Which assessment is included under "D" in the ABCDE approach?
A. Distal pulses
B. Disability/neurologic status
C. Drainage
D. Dehydration
Answer: B
Rationale: Disability includes rapid neurologic assessment, including
level of consciousness, pupils, and motor function.
11. Which Glasgow Coma Scale component evaluates the patient's
ability to follow commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupil size
Answer: C
Rationale: The motor component assesses responses ranging from
obeying commands to no motor response.
Questions, Correct Answers & Detailed Rationales
Questions 1–50: Initial Assessment, Primary Survey & Trauma
Priorities
1. A trauma patient arrives after a high-speed motor vehicle collision.
What is the nurse's first priority?
A. Obtain a complete medical history
B. Assess airway while maintaining cervical spine protection
C. Insert a urinary catheter
D. Obtain a complete set of laboratory studies
Answer: B
Rationale: Airway assessment is the first priority in the trauma primary
survey. Cervical spine protection should be maintained because
traumatic injury may involve the cervical spine.
2. Which sequence represents the traditional trauma primary survey?
A. CABDE
B. ABCDE
C. SAMPLE
D. OPQRST
Answer: B
Rationale: The primary survey systematically evaluates Airway,
Breathing, Circulation, Disability, and Exposure/Environmental control.
3. A trauma patient is speaking clearly in complete sentences. What
does this finding primarily suggest?
A. Adequate circulation
,B. An intact airway at that moment
C. Normal neurologic function
D. Absence of internal bleeding
Answer: B
Rationale: Clear speech indicates that air is moving through the upper
airway. It does not rule out other serious trauma.
4. Which finding is most concerning for an impending airway
obstruction?
A. Mild tachycardia
B. Hoarse or altered voice
C. Small superficial abrasion
D. Mild hypertension
Answer: B
Rationale: Hoarseness, stridor, gurgling, or voice changes may indicate
upper-airway compromise and require immediate evaluation.
5. During trauma assessment, which finding requires immediate
intervention?
A. Open femur fracture
B. Airway obstruction
C. Abdominal bruising
D. Closed wrist fracture
Answer: B
Rationale: An obstructed airway can rapidly cause hypoxia and death.
Life-threatening airway problems take priority over less immediately
fatal injuries.
,6. What is the purpose of maintaining manual cervical stabilization
during initial trauma assessment?
A. Prevent blood loss
B. Prevent movement of a potentially injured cervical spine
C. Improve circulation
D. Reduce pain
Answer: B
Rationale: Cervical spine motion can worsen an unstable spinal injury
and potentially cause secondary neurologic damage.
7. Which patient should the trauma nurse assess first?
A. Patient with an isolated ankle fracture
B. Patient with a superficial scalp laceration
C. Patient with severe respiratory distress
D. Patient with mild back pain
Answer: C
Rationale: Severe respiratory distress indicates a potentially life-
threatening breathing problem and requires immediate attention.
8. What is the primary purpose of the primary survey?
A. Identify every injury
B. Identify and treat immediate life threats
C. Complete discharge planning
D. Determine insurance status
Answer: B
Rationale: The primary survey focuses on rapidly identifying and
managing conditions that can immediately threaten life.
, 9. A trauma patient has blood pooling in the mouth and cannot clear it
independently. What is the priority?
A. Give oral fluids
B. Suction the airway
C. Obtain an abdominal CT
D. Apply a splint
Answer: B
Rationale: Blood and secretions can obstruct the airway and impair
ventilation. Suctioning helps restore airway patency.
10. Which assessment is included under "D" in the ABCDE approach?
A. Distal pulses
B. Disability/neurologic status
C. Drainage
D. Dehydration
Answer: B
Rationale: Disability includes rapid neurologic assessment, including
level of consciousness, pupils, and motor function.
11. Which Glasgow Coma Scale component evaluates the patient's
ability to follow commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupil size
Answer: C
Rationale: The motor component assesses responses ranging from
obeying commands to no motor response.
