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TNCC 9th Edition Test Bank — Complete Questions and Answers with Rationales, Graded A+ (Solved 2025/2026)

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This is a TNCC (Trauma Nursing Core Course) 9th Edition test bank containing questions and answers with detailed rationales, marked as graded A+ and 100% complete for the 2023/2024 exam cycle. The document is organized into two main parts: a question-and-answer section with verified answers and supporting rationale, and a comprehensive course-content section that breaks down the TNCC primary survey framework step by step. The question section covers trauma nursing scenarios including a knife injury to the neck with difficulty swallowing and speaking requiring cervical spine assessment, a saw injury with a gaping thigh wound managed first with direct pressure, an elderly patient on anticoagulants with delayed subdural hematoma symptoms later identified as alcohol withdrawal, a second rib fracture associated with brachial plexus injury, and a C5 spinal cord injury prioritizing respiratory status. It also addresses post-incident nurse coping after caring for a child with devastating burns, blast injury phases with fragmentation injuries classified as secondary, hypercapnia and hypocapnia effects on cerebral vasoconstriction, the general impression step allowing reprioritization of circulation before airway or breathing, and sexual assault history obtained using direct quotes. Additional content includes pregnant trauma patients at 30 weeks with normal vital signs in pregnancy, frostbite treatment with tissue plasminogen activator, kinematic concepts used to anticipate injury types, palpation of the pelvis with gentle pressure downward and medially, base deficit as the best measure of cellular perfusion predicting resuscitation outcome, reverse Trendelenburg positioning for airway maintenance in obese patients, uncontrolled external hemorrhage as the leading cause of preventable prehospital death, bag-mask ventilation at one breath every six seconds, effective communication as a cornerstone of high-performance trauma teams, and a 13-month-old cooperating with assessment as a sign of possible altered mental status. The course-content section details the full primary survey, including Alertness and Airway with Simultaneous Cervical Spinal Stabilization with inspection, auscultation, and palpation findings and interventions such as suctioning, jaw thrust, nasopharyngeal and oropharyngeal airways, and definitive airway consideration; Breathing and Ventilation with inspection, auscultation, and palpation plus life-threatening pulmonary injuries including open pneumothorax, tension pneumothorax, flail chest, and hemothorax; Circulation and Control of Hemorrhage with external bleeding control, two large-bore IVs, warmed isotonic crystalloid, and component therapy; Disability with GCS and PERRL assessment; Exposure and Environmental Control with heat loss prevention; Full Set of VS and Family Presence; and Get Resuscitation Adjuncts using the LMNOP mnemonic. It also covers the AVPU alertness scale, GCS scoring for eyes, verbal, and motor, shock classifications including hypovolemic, obstructive, cardiogenic, and distributive with anaphylactic, septic, and neurogenic subtypes and their treatments, thoracic and abdominal organ injury content for the liver and spleen including grading, Cullen sign, and asplenic vaccination needs, ocular trauma including corneal abrasion, foreign body, laceration, intraocular foreign body, and cycloplegic agents, the secondary survey using MIST and SAMPLE history and head-to-toe soft tissue and bony deformity assessment, and the initial assessment sequence from preparation and triage through definitive care or transport. Students can use this test bank for TNCC exam preparation, trauma nursing certification review, and self-testing by working through the questions and checking responses against the verified answers and rationales.

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TNCC 9TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE (SOLVED 2023/2024)
TEST BANK

A adult patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. They complain of difficulty swallowing and speaking. In the
primary survey, further assessment is indicated next for which of the following
conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ansa. Damage to the cervical spine

A patient arrives at the emergency department by private vehicle after sustaining an
injury to the right lower extremity while using a saw. There is a large gaping wound to
the right thigh area with significant bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure

A patient fell two weeks ago, striking their head. Today, the patient presented with a
persistent headache and nausea and was diagnosed with a small subdural hematoma.
The patient has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports the patient has been anxious, restless, shaky, and vomited twice during
the night. The patient states they couldn't sleep because a young child kept coming into
the room. What is the most likely cause for these signs and symptoms?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus - ansb. alcohol withdrawal

A patient involved in a MVC has sustained a fracture to the second rib of the anterior left
chest. Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - ansb. Brachial plexus injury

A patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management for this patient?
a. maintain adequate respiratory status.
b. administer balanced resuscitation fluid

,TNCC 9TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE (SOLVED 2023/2024)
TEST BANK

c. perform serial assessments of neurologic function
d. maintain core temperature - ansa. maintain adequate respiratory status

A trauma nurse cared for a child with devastating burns two weeks ago. The nurse
called in sick for a couple of days and is now back working on the team. Which of the
following behaviors would indicate this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
d. They are thinking about transferring out of the emergency department. - ansa. They
are talking about taking the emergency nursing certification examination.

Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
d. quaternary - ansb. secondary

In a patient with severe traumatic brain injury, hypocapnia causes which condition?
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction

The general impression step in the initial assessment provides the opportunity to do
which of the following?
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.

The nurse is obtaining a history for a patient who presents following sexual assault. This
history is completed using which of the following techniques?
a. Bring the family in to the interview room.
b. Use direct quotes to record information.
c. Obtain information specific only to the assault.
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record
information.

,TNCC 9TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE (SOLVED 2023/2024)
TEST BANK

The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of
94/62 mm Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124
beats/minute. The emergency nurse interprets the patient's hemodynamic findings as
an indication of which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy

Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c. administer tissue plasminogen activator
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator

Understanding the kinematic concepts associated with the mechanism of injury and
energy transfer can initially assist the trauma care provider in which of the following?
a. Anticipating the types of injuries that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries
that may be present

What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests, downward and laterally.
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply gentle
pressure over the iliac crests, downward and medially.

What is the best measure of the adequacy of cellular perfusion and can help to predict
the outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hematocrit level
c. Base deficit
d. Oxygen saturation - ansc. Base deficit

What is the best position for maintaining an open airway in the obese patient?
a. Prone
b. Supine

, TNCC 9TH EDITION – QUESTIONS AND ANSWERS
GRADED A+ 100% COMPLETE (SOLVED 2023/2024)
TEST BANK

c. Reverse Trendelenburg
d. Right lateral recumbent - ansc. Reverse Trendelenburg

What is the leading cause of preventable death for the trauma patient in the prehospital
environment?
a. Airway compromise
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled external hemorrhage - ansd. Uncontrolled external hemorrhage

Which of the following accurately describes ventilation principles associated with use of
a bag-mask device for an adult?
a. Compress the bag-mask device at a rate of one breath every 6 seconds.
b. Delivers 100% oxygen.
c. Squeeze the bag-mask device completely for each breath.
d. Maintain the oxygen saturation levels between 92% and 94%. - ansa. Compress the
bag-mask device at a rate of one breath every 6 seconds.

Which of the following is considered a cornerstone of a high-performance trauma team?
a. Individual goals
b. Use of TeamSTEPPS
c. Identification of a single decision maker
d. Effective communication - ansd. Effective communication

While performing an assessment on a 13-month-old involved in a motor vehicle
collision, the nurse identifies which of the following findings from the patient as a sign of
possible altered mental status?
a. Sunken fontanel
b. Crying, but consolable
c. Spontaneous movement of arms and legs
d. Cooperation with the assessment - ansd. Cooperation with the assessment

A (AVPU) - ansAlert. Will be able to maintain airway once clear.

A (Primary Survey) - ansAirway and alertness with simultaneous cervical spinal
stabilization.

Airway Assessment - ansInspect: tongue obstruction, loose/missing teeth, foreign
objects, blood, vomitus, secretions, edema, burns or evidence of inhalation injury

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