TNCC 2026 EXAM 400 QUESTIONS AND CORRECT ANSWERS
WITH RATIONALE LATEST UPDATE ALREADY GRADED A+
This comprehensive question bank contains 400 multiple-choice questions
covering the Trauma Nursing Core Course (TNCC) 2026 curriculum. It
systematically addresses all components of trauma care including the primary
survey (ABCDE), secondary survey, airway management, breathing and
ventilation, circulation and hemorrhage control, disability and neurologic
assessment, and exposure with hypothermia prevention. Key topics include
shock classification, trauma resuscitation, injury mechanisms, spinal cord
injury management, burn care, pediatric and geriatric trauma considerations,
and trauma team dynamics. Each question includes the correct answer and
detailed rationale explaining the clinical reasoning. The progression from
foundational concepts to complex trauma scenarios supports effective exam
preparation for TNCC certification.
1. A trauma patient arrives after a motor vehicle collision. Which assessment
should the nurse perform first?
A) Obtain a full health history
B) Assess airway patency
C) Check pupil response
D) Inspect for external bleeding
Answer: B
Rationale: TNCC follows the ABCDE primary survey. Airway is always assessed
first because an obstructed airway is immediately life-threatening .
2. What is the primary goal of a trauma system?
A) To reduce hospital costs
B) To provide optimal care from injury to discharge
C) To ensure all patients go to Level I centers
D) To train paramedics
,Answer: B
Rationale: A trauma system coordinates care from the scene to rehabilitation to
ensure optimal outcomes. This includes prevention, acute care, and rehabilitation .
3. Which triage criterion automatically qualifies a patient for highest priority?
A) Closed femur fracture
B) Respiratory rate of 24
C) Penetrating injury to head, neck, or torso
D) Systolic BP of 110
Answer: C
Rationale: Penetrating injuries to the head, neck, and torso are high-priority triage
criteria per CDC guidelines and indicate potential for life-threatening injury .
4. What Glasgow Coma Scale score indicates severe brain injury requiring highest
priority triage?
A) 13 or less
B) 12 or less
C) 10 or less
D) 8 or less
Answer: D
Rationale: A GCS of 8 or less is a criterion for highest priority triage and indicates
severe traumatic brain injury with potential for airway compromise .
5. Which vital sign abnormality meets criteria for highest priority triage in adults?
A) Respiratory rate of 22
B) Heart rate of 110
C) Systolic BP of 85 mmHg
D) Temperature of 36.0 degrees Celsius
Answer: C
Rationale: Systolic blood pressure less than 90 mmHg is a physiologic criterion for
highest priority trauma triage, indicating potential shock .
6. What is the defining characteristic of a Level I trauma center?
A) Provides definitive care for most injured patients
B) Has 24/7 coverage by all surgical subspecialties and research
C) Stabilizes patients before transfer to a higher level
D) Only handles pediatric trauma
Answer: B
Rationale: Level I centers provide comprehensive care, have all subspecialties
available 24/7, and lead in research and education .
,7. What is the first step in the primary survey?
A) Breathing
B) Circulation
C) Disability
D) Airway maintenance with c-spine restriction
Answer: D
Rationale: The primary survey follows the ABCDE sequence, starting with Airway
maintenance while simultaneously restricting cervical spine movement .
8. Which maneuver is preferred to open the airway in a trauma patient?
A) Head tilt-chin lift
B) Jaw thrust
C) Neck hyperextension
D) Cricoid pressure
Answer: B
Rationale: The jaw thrust minimizes cervical spine movement while opening the
airway, making it the preferred maneuver in trauma patients with potential c-spine
injury .
9. A trauma patient arrives unresponsive with gurgling respirations. What is the
nurse's priority action?
A) Insert an oropharyngeal airway
B) Suction the airway
C) Apply oxygen via nonrebreather
D) Assess breath sounds
Answer: B
Rationale: Airway obstruction from secretions must be cleared immediately.
Suctioning restores airway patency before adjuncts or oxygen are applied .
10. What is the primary indication for an oropharyngeal airway (OPA)?
A) Conscious patient with gag reflex
B) Unconscious patient without a gag reflex
C) Patient with facial trauma
D) Patient with a cervical spine injury
Answer: B
Rationale: An OPA is used in unconscious patients lacking a gag reflex to prevent
airway obstruction by the tongue .
11. When is a nasopharyngeal airway (NPA) contraindicated?
, A) Patient has a gag reflex
B) Patient has suspected basilar skull fracture
C) Patient is conscious
D) Patient has a cervical spine injury
Answer: B
Rationale: NPA insertion is contraindicated in suspected basilar skull fractures due
to the risk of intracranial placement of the airway .
12. What is the definitive airway of choice in a trauma patient?
A) Laryngeal mask airway
B) Endotracheal intubation with c-spine control
C) Esophageal tracheal device
D) Nasotracheal intubation
Answer: B
Rationale: A cuffed tube in the trachea with cervical spine restriction is the
definitive airway, providing protection against aspiration and allowing mechanical
ventilation .
13. An unresponsive trauma patient has an oropharyngeal airway in place, shallow
and labored respirations, and dusky skin. The trauma team has administered
medications for drug-assisted intubation and attempted intubation but was
unsuccessful. What is the most appropriate immediate next step?
A) Attempt intubation again immediately
B) Ventilate with a bag-mask device
C) Perform a cricothyroidotomy
D) Insert a laryngeal mask airway
Answer: B
Rationale: After an unsuccessful intubation attempt, the priority is to ventilate the
patient with a bag-mask device to maintain oxygenation while preparing for the
next intervention .
14. What is the surgical airway of choice in an emergency?
A) Tracheostomy
B) Cricothyroidotomy
C) Bronchoscopy
D) Laryngotomy
Answer: B
Rationale: Cricothyroidotomy is the preferred surgical airway in emergencies due
to its superficial location and ease of access .
WITH RATIONALE LATEST UPDATE ALREADY GRADED A+
This comprehensive question bank contains 400 multiple-choice questions
covering the Trauma Nursing Core Course (TNCC) 2026 curriculum. It
systematically addresses all components of trauma care including the primary
survey (ABCDE), secondary survey, airway management, breathing and
ventilation, circulation and hemorrhage control, disability and neurologic
assessment, and exposure with hypothermia prevention. Key topics include
shock classification, trauma resuscitation, injury mechanisms, spinal cord
injury management, burn care, pediatric and geriatric trauma considerations,
and trauma team dynamics. Each question includes the correct answer and
detailed rationale explaining the clinical reasoning. The progression from
foundational concepts to complex trauma scenarios supports effective exam
preparation for TNCC certification.
1. A trauma patient arrives after a motor vehicle collision. Which assessment
should the nurse perform first?
A) Obtain a full health history
B) Assess airway patency
C) Check pupil response
D) Inspect for external bleeding
Answer: B
Rationale: TNCC follows the ABCDE primary survey. Airway is always assessed
first because an obstructed airway is immediately life-threatening .
2. What is the primary goal of a trauma system?
A) To reduce hospital costs
B) To provide optimal care from injury to discharge
C) To ensure all patients go to Level I centers
D) To train paramedics
,Answer: B
Rationale: A trauma system coordinates care from the scene to rehabilitation to
ensure optimal outcomes. This includes prevention, acute care, and rehabilitation .
3. Which triage criterion automatically qualifies a patient for highest priority?
A) Closed femur fracture
B) Respiratory rate of 24
C) Penetrating injury to head, neck, or torso
D) Systolic BP of 110
Answer: C
Rationale: Penetrating injuries to the head, neck, and torso are high-priority triage
criteria per CDC guidelines and indicate potential for life-threatening injury .
4. What Glasgow Coma Scale score indicates severe brain injury requiring highest
priority triage?
A) 13 or less
B) 12 or less
C) 10 or less
D) 8 or less
Answer: D
Rationale: A GCS of 8 or less is a criterion for highest priority triage and indicates
severe traumatic brain injury with potential for airway compromise .
5. Which vital sign abnormality meets criteria for highest priority triage in adults?
A) Respiratory rate of 22
B) Heart rate of 110
C) Systolic BP of 85 mmHg
D) Temperature of 36.0 degrees Celsius
Answer: C
Rationale: Systolic blood pressure less than 90 mmHg is a physiologic criterion for
highest priority trauma triage, indicating potential shock .
6. What is the defining characteristic of a Level I trauma center?
A) Provides definitive care for most injured patients
B) Has 24/7 coverage by all surgical subspecialties and research
C) Stabilizes patients before transfer to a higher level
D) Only handles pediatric trauma
Answer: B
Rationale: Level I centers provide comprehensive care, have all subspecialties
available 24/7, and lead in research and education .
,7. What is the first step in the primary survey?
A) Breathing
B) Circulation
C) Disability
D) Airway maintenance with c-spine restriction
Answer: D
Rationale: The primary survey follows the ABCDE sequence, starting with Airway
maintenance while simultaneously restricting cervical spine movement .
8. Which maneuver is preferred to open the airway in a trauma patient?
A) Head tilt-chin lift
B) Jaw thrust
C) Neck hyperextension
D) Cricoid pressure
Answer: B
Rationale: The jaw thrust minimizes cervical spine movement while opening the
airway, making it the preferred maneuver in trauma patients with potential c-spine
injury .
9. A trauma patient arrives unresponsive with gurgling respirations. What is the
nurse's priority action?
A) Insert an oropharyngeal airway
B) Suction the airway
C) Apply oxygen via nonrebreather
D) Assess breath sounds
Answer: B
Rationale: Airway obstruction from secretions must be cleared immediately.
Suctioning restores airway patency before adjuncts or oxygen are applied .
10. What is the primary indication for an oropharyngeal airway (OPA)?
A) Conscious patient with gag reflex
B) Unconscious patient without a gag reflex
C) Patient with facial trauma
D) Patient with a cervical spine injury
Answer: B
Rationale: An OPA is used in unconscious patients lacking a gag reflex to prevent
airway obstruction by the tongue .
11. When is a nasopharyngeal airway (NPA) contraindicated?
, A) Patient has a gag reflex
B) Patient has suspected basilar skull fracture
C) Patient is conscious
D) Patient has a cervical spine injury
Answer: B
Rationale: NPA insertion is contraindicated in suspected basilar skull fractures due
to the risk of intracranial placement of the airway .
12. What is the definitive airway of choice in a trauma patient?
A) Laryngeal mask airway
B) Endotracheal intubation with c-spine control
C) Esophageal tracheal device
D) Nasotracheal intubation
Answer: B
Rationale: A cuffed tube in the trachea with cervical spine restriction is the
definitive airway, providing protection against aspiration and allowing mechanical
ventilation .
13. An unresponsive trauma patient has an oropharyngeal airway in place, shallow
and labored respirations, and dusky skin. The trauma team has administered
medications for drug-assisted intubation and attempted intubation but was
unsuccessful. What is the most appropriate immediate next step?
A) Attempt intubation again immediately
B) Ventilate with a bag-mask device
C) Perform a cricothyroidotomy
D) Insert a laryngeal mask airway
Answer: B
Rationale: After an unsuccessful intubation attempt, the priority is to ventilate the
patient with a bag-mask device to maintain oxygenation while preparing for the
next intervention .
14. What is the surgical airway of choice in an emergency?
A) Tracheostomy
B) Cricothyroidotomy
C) Bronchoscopy
D) Laryngotomy
Answer: B
Rationale: Cricothyroidotomy is the preferred surgical airway in emergencies due
to its superficial location and ease of access .
