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TNCC 9TH EDITION TRAUMA NURSING CERTIFICATION
2026/2027 | Complete Test Bank Validation | Pass
Guaranteed - A+ Graded
Section 1: Trauma Nursing Process & Primary Survey (Q1-12)
Q1. A trauma patient arrives via EMS after a motor vehicle collision. The nurse is
performing the primary survey. According to the TNCC Trauma Nursing Process,
which assessment step should be completed FIRST?
A. Assess breathing effectiveness and auscultate breath sounds
B. Assess level of consciousness using AVPU
C. Assess for obvious uncontrolled external hemorrhage or unresponsiveness/apnea
D. Remove all clothing to inspect for injuries
C. Assess for obvious uncontrolled external hemorrhage or
unresponsiveness/apnea [CORRECT]
Rationale: The TNCC Trauma Nursing Process emphasizes that before proceeding
with the standard A-B-C-D-E sequence, the nurse must first assess for obvious
uncontrolled external hemorrhage or apnea/unresponsiveness, which may require
immediate C-ABC reprioritization. Option A is step B, option B is part of step 5
(AVPU), and option D is step E.
Correct Answer: C
Q2. During the primary survey of a trauma patient, the nurse notes the patient is
responsive but has gurgling airway sounds and facial trauma. Which intervention is
the PRIORITY?
A. Insert an oropharyngeal airway (OPA)
B. Perform a jaw-thrust maneuver while maintaining cervical spine precautions
,2
C. Administer high-flow oxygen via non-rebreather mask
D. Suction the oropharynx and nasopharynx
B. Perform a jaw-thrust maneuver while maintaining cervical spine precautions
[CORRECT]
Rationale: In a trauma patient with suspected cervical spine injury, the jaw-thrust
maneuver is the preferred method to open the airway without extending the neck.
An OPA (A) may be inserted after the airway is opened but is not the first step.
Suctioning (D) should follow airway opening. Oxygen (C) is important but secondary
to establishing a patent airway.
Correct Answer: B
Q3. A 28-year-old male was ejected from a motorcycle and arrives with a GCS of 8.
During the primary survey, which finding would require the nurse to immediately
reprioritize to C-ABC?
A. Stridor heard on auscultation
B. Absent radial pulse with active bleeding from a femoral wound
C. Asymmetrical chest rise and absent breath sounds on the left
D. Fixed and dilated right pupil
B. Absent radial pulse with active bleeding from a femoral wound [CORRECT]
Rationale: C-ABC reprioritization is required when there is obvious uncontrolled
external hemorrhage or unresponsiveness/apnea. Active, life-threatening bleeding
with absent radial pulse indicates massive hemorrhage that must be controlled
before airway and breathing interventions. Options A, C, and D are addressed within
the standard A-B-D sequence.
Correct Answer: B
Q4. Which component of the TNCC Trauma Nursing Process occurs AFTER the
primary survey but BEFORE the secondary survey?
,3
A. Obtain a full set of vital signs and weight in kilograms
B. Facilitate family presence
C. Resuscitation with interventions and reassessments
D. Apply the LMNOP mnemonic for adjunctive assessments
C. Resuscitation with interventions and reassessments [CORRECT]
Rationale: The TNCC Trauma Nursing Process sequence is: 1) Activation/Preparation,
2) Primary Survey, 3) Resuscitation, 4) Secondary Survey, 5) Ongoing Monitoring, 6)
Transfer/Disposition. Resuscitation occurs between the primary and secondary
surveys. Options A, B, and D are components of the secondary survey or ongoing
care.
Correct Answer: C
Q5. The nurse is applying the LMNOP mnemonic during the secondary survey of a
trauma patient. What does the "P" stand for?
A. Perform a focused abdominal sonography for trauma (FAST) exam
B. Assess pain using an appropriate pain scale
C. Place a pelvic binder for suspected pelvic fracture
D. Prepare the patient for possible procedural sedation
B. Assess pain using an appropriate pain scale [CORRECT]
Rationale: The LMNOP mnemonic in TNCC stands for: L = Labs (trauma panel), M =
Monitor (cardiac, EKG), N = NG/OG tube consideration, O = O2 and end-tidal
capnography assessment, P = Pain assessment using an appropriate scale. Pain
assessment is a critical component of comprehensive trauma care and is often
under-addressed in the acute phase.
Correct Answer: B
Q6. A trauma patient has been stabilized in the ED. According to the TNCC Trauma
Nursing Process, what is the FINAL question the nurse should ask before disposition?
, 4
A. "Has the family been notified and updated?"
B. "Does this patient need to be transferred to another hospital, to surgery, or to
critical care?"
C. "Have all wounds been dressed and documented?"
D. "Is the patient pain-free and comfortable?"
B. "Does this patient need to be transferred to another hospital, to surgery, or to
critical care?" [CORRECT]
Rationale: The final step of the TNCC Trauma Nursing Process requires the nurse to
evaluate whether the patient needs transfer to a higher level of care, surgical
intervention, or critical care admission. This disposition decision is the culmination of
the systematic assessment and intervention process.
Correct Answer: B
Q7. Which vital sign finding in a trauma patient is MOST consistent with Class III
hemorrhagic shock?
A. HR 88, BP 128/82, RR 16, slightly anxious
B. HR 110, BP 118/76, RR 22, mildly anxious
C. HR 135, BP 88/60, RR 32, confused and anxious
D. HR 155, BP 68/40, RR 44, lethargic and unresponsive
C. HR 135, BP 88/60, RR 32, confused and anxious [CORRECT]
Rationale: Class III hemorrhagic shock involves 30-40% blood loss (1500-2000 mL in
a 70 kg adult), characterized by HR >120, low BP, narrow pulse pressure, RR >30,
urine output <15 mL/hr, and altered mental status (confused, anxious). Option A
describes Class I, B describes Class II, and D describes Class IV shock.
Correct Answer: C
Q8. The prehospital report indicates a patient was involved in a high-speed MVC with
significant intrusion into the passenger compartment. The patient is alert, talking,
TNCC 9TH EDITION TRAUMA NURSING CERTIFICATION
2026/2027 | Complete Test Bank Validation | Pass
Guaranteed - A+ Graded
Section 1: Trauma Nursing Process & Primary Survey (Q1-12)
Q1. A trauma patient arrives via EMS after a motor vehicle collision. The nurse is
performing the primary survey. According to the TNCC Trauma Nursing Process,
which assessment step should be completed FIRST?
A. Assess breathing effectiveness and auscultate breath sounds
B. Assess level of consciousness using AVPU
C. Assess for obvious uncontrolled external hemorrhage or unresponsiveness/apnea
D. Remove all clothing to inspect for injuries
C. Assess for obvious uncontrolled external hemorrhage or
unresponsiveness/apnea [CORRECT]
Rationale: The TNCC Trauma Nursing Process emphasizes that before proceeding
with the standard A-B-C-D-E sequence, the nurse must first assess for obvious
uncontrolled external hemorrhage or apnea/unresponsiveness, which may require
immediate C-ABC reprioritization. Option A is step B, option B is part of step 5
(AVPU), and option D is step E.
Correct Answer: C
Q2. During the primary survey of a trauma patient, the nurse notes the patient is
responsive but has gurgling airway sounds and facial trauma. Which intervention is
the PRIORITY?
A. Insert an oropharyngeal airway (OPA)
B. Perform a jaw-thrust maneuver while maintaining cervical spine precautions
,2
C. Administer high-flow oxygen via non-rebreather mask
D. Suction the oropharynx and nasopharynx
B. Perform a jaw-thrust maneuver while maintaining cervical spine precautions
[CORRECT]
Rationale: In a trauma patient with suspected cervical spine injury, the jaw-thrust
maneuver is the preferred method to open the airway without extending the neck.
An OPA (A) may be inserted after the airway is opened but is not the first step.
Suctioning (D) should follow airway opening. Oxygen (C) is important but secondary
to establishing a patent airway.
Correct Answer: B
Q3. A 28-year-old male was ejected from a motorcycle and arrives with a GCS of 8.
During the primary survey, which finding would require the nurse to immediately
reprioritize to C-ABC?
A. Stridor heard on auscultation
B. Absent radial pulse with active bleeding from a femoral wound
C. Asymmetrical chest rise and absent breath sounds on the left
D. Fixed and dilated right pupil
B. Absent radial pulse with active bleeding from a femoral wound [CORRECT]
Rationale: C-ABC reprioritization is required when there is obvious uncontrolled
external hemorrhage or unresponsiveness/apnea. Active, life-threatening bleeding
with absent radial pulse indicates massive hemorrhage that must be controlled
before airway and breathing interventions. Options A, C, and D are addressed within
the standard A-B-D sequence.
Correct Answer: B
Q4. Which component of the TNCC Trauma Nursing Process occurs AFTER the
primary survey but BEFORE the secondary survey?
,3
A. Obtain a full set of vital signs and weight in kilograms
B. Facilitate family presence
C. Resuscitation with interventions and reassessments
D. Apply the LMNOP mnemonic for adjunctive assessments
C. Resuscitation with interventions and reassessments [CORRECT]
Rationale: The TNCC Trauma Nursing Process sequence is: 1) Activation/Preparation,
2) Primary Survey, 3) Resuscitation, 4) Secondary Survey, 5) Ongoing Monitoring, 6)
Transfer/Disposition. Resuscitation occurs between the primary and secondary
surveys. Options A, B, and D are components of the secondary survey or ongoing
care.
Correct Answer: C
Q5. The nurse is applying the LMNOP mnemonic during the secondary survey of a
trauma patient. What does the "P" stand for?
A. Perform a focused abdominal sonography for trauma (FAST) exam
B. Assess pain using an appropriate pain scale
C. Place a pelvic binder for suspected pelvic fracture
D. Prepare the patient for possible procedural sedation
B. Assess pain using an appropriate pain scale [CORRECT]
Rationale: The LMNOP mnemonic in TNCC stands for: L = Labs (trauma panel), M =
Monitor (cardiac, EKG), N = NG/OG tube consideration, O = O2 and end-tidal
capnography assessment, P = Pain assessment using an appropriate scale. Pain
assessment is a critical component of comprehensive trauma care and is often
under-addressed in the acute phase.
Correct Answer: B
Q6. A trauma patient has been stabilized in the ED. According to the TNCC Trauma
Nursing Process, what is the FINAL question the nurse should ask before disposition?
, 4
A. "Has the family been notified and updated?"
B. "Does this patient need to be transferred to another hospital, to surgery, or to
critical care?"
C. "Have all wounds been dressed and documented?"
D. "Is the patient pain-free and comfortable?"
B. "Does this patient need to be transferred to another hospital, to surgery, or to
critical care?" [CORRECT]
Rationale: The final step of the TNCC Trauma Nursing Process requires the nurse to
evaluate whether the patient needs transfer to a higher level of care, surgical
intervention, or critical care admission. This disposition decision is the culmination of
the systematic assessment and intervention process.
Correct Answer: B
Q7. Which vital sign finding in a trauma patient is MOST consistent with Class III
hemorrhagic shock?
A. HR 88, BP 128/82, RR 16, slightly anxious
B. HR 110, BP 118/76, RR 22, mildly anxious
C. HR 135, BP 88/60, RR 32, confused and anxious
D. HR 155, BP 68/40, RR 44, lethargic and unresponsive
C. HR 135, BP 88/60, RR 32, confused and anxious [CORRECT]
Rationale: Class III hemorrhagic shock involves 30-40% blood loss (1500-2000 mL in
a 70 kg adult), characterized by HR >120, low BP, narrow pulse pressure, RR >30,
urine output <15 mL/hr, and altered mental status (confused, anxious). Option A
describes Class I, B describes Class II, and D describes Class IV shock.
Correct Answer: C
Q8. The prehospital report indicates a patient was involved in a high-speed MVC with
significant intrusion into the passenger compartment. The patient is alert, talking,
