TNCC 9th Edition Exam Practice
Questions Verified Answers with
Detailed Rationales
Based on the Trauma Nursing Core Course (TNCC) 9th Edition curriculum
and ENA guidelines, here is a comprehensive set of exam-style questions
with verified answers and rationales. All hyperlinks and reference links have
been removed.
SECTION 1: PRIMARY SURVEY & TRAUMA
ASSESSMENT (Questions 1-25)
Question 1
The first step in the primary survey of a trauma patient is:
A) Assess circulation
B) Assess airway with cervical spine protection
C) Assess disability (GCS)
D) Expose the patient
Answer: B
Rationale: The ABCDE approach begins with airway assessment while
maintaining cervical spine immobilization. A compromised airway is the
most immediate threat to life. The jaw-thrust maneuver is preferred over
head-tilt/chin-lift in trauma patients to protect the cervical spine.
,Question 2
Which of the following is the most reliable indicator of a patent airway in an
unresponsive trauma patient?
A) Ability to speak
B) Presence of breath sounds
C) Chest rise with bag-valve-mask ventilation
D) Absence of stridor
Answer: A
Rationale: A patient who can speak clearly has a patent airway. For
unresponsive patients, look for foreign bodies, vomitus, or edema. Speech
requires air movement through the vocal cords.
Question 3
The "Jaw-thrust" maneuver is preferred over head-tilt/chin-lift in trauma
patients because:
A) It is easier to perform
B) It provides better airway visualization
C) It minimizes cervical spine movement
D) It requires fewer personnel
Answer: C
Rationale: The jaw-thrust maneuver is preferred because it minimizes
cervical spine movement while opening the airway. All trauma patients are
presumed to have a cervical spine injury until proven otherwise.
Question 4
A 4-person log-roll is performed to:
,A) Assess the anterior chest
B) Maintain spinal alignment while examining the back
C) Rapidly transport the patient
D) Apply a cervical collar
Answer: B
Rationale: A 4-person log-roll (one at head, one at shoulders/chest, one at
hips/pelvis, one at legs) maintains spinal alignment while allowing
examination of the back and placement of a backboard.
Question 5
During the primary survey, life-threatening conditions are identified and
treated:
A) In order of severity
B) Simultaneously as they are found
C) After completing the entire primary survey
D) After the secondary survey
Answer: B
Rationale: Life-threatening conditions (e.g., airway obstruction, tension
pneumothorax, massive hemorrhage) are treated immediately as they are
identified during the primary survey.
Question 6
True or False: A patient with a GCS of 14 who is combative and attempting
to remove cervical collar should be sedated immediately.
Answer: False
, Rationale: Sedation may compromise airway and neurologic assessment.
First, attempt to redirect the patient. If necessary, use chemical restraint
only after ensuring airway protection.
Question 7
The "L" in the mnemonic "ABCDEFGHI" for trauma assessment stands for:
A) Lab work
B) Log-roll
C) Laryngeal assessment
D) Left lateral position
Answer: B
Rationale: In the extended primary survey, "L" stands for Log-roll, which is
performed to assess the posterior aspect of the patient and apply a
backboard while maintaining spinal precautions.
Question 8
Stridor in a trauma patient indicates:
A) Normal breathing
B) Mild respiratory distress
C) Impending airway obstruction
D) Bronchospasm
Answer: C
Rationale: Stridor indicates impending airway obstruction from laryngeal
edema or foreign body. This is a critical airway finding requiring immediate
intervention.
Questions Verified Answers with
Detailed Rationales
Based on the Trauma Nursing Core Course (TNCC) 9th Edition curriculum
and ENA guidelines, here is a comprehensive set of exam-style questions
with verified answers and rationales. All hyperlinks and reference links have
been removed.
SECTION 1: PRIMARY SURVEY & TRAUMA
ASSESSMENT (Questions 1-25)
Question 1
The first step in the primary survey of a trauma patient is:
A) Assess circulation
B) Assess airway with cervical spine protection
C) Assess disability (GCS)
D) Expose the patient
Answer: B
Rationale: The ABCDE approach begins with airway assessment while
maintaining cervical spine immobilization. A compromised airway is the
most immediate threat to life. The jaw-thrust maneuver is preferred over
head-tilt/chin-lift in trauma patients to protect the cervical spine.
,Question 2
Which of the following is the most reliable indicator of a patent airway in an
unresponsive trauma patient?
A) Ability to speak
B) Presence of breath sounds
C) Chest rise with bag-valve-mask ventilation
D) Absence of stridor
Answer: A
Rationale: A patient who can speak clearly has a patent airway. For
unresponsive patients, look for foreign bodies, vomitus, or edema. Speech
requires air movement through the vocal cords.
Question 3
The "Jaw-thrust" maneuver is preferred over head-tilt/chin-lift in trauma
patients because:
A) It is easier to perform
B) It provides better airway visualization
C) It minimizes cervical spine movement
D) It requires fewer personnel
Answer: C
Rationale: The jaw-thrust maneuver is preferred because it minimizes
cervical spine movement while opening the airway. All trauma patients are
presumed to have a cervical spine injury until proven otherwise.
Question 4
A 4-person log-roll is performed to:
,A) Assess the anterior chest
B) Maintain spinal alignment while examining the back
C) Rapidly transport the patient
D) Apply a cervical collar
Answer: B
Rationale: A 4-person log-roll (one at head, one at shoulders/chest, one at
hips/pelvis, one at legs) maintains spinal alignment while allowing
examination of the back and placement of a backboard.
Question 5
During the primary survey, life-threatening conditions are identified and
treated:
A) In order of severity
B) Simultaneously as they are found
C) After completing the entire primary survey
D) After the secondary survey
Answer: B
Rationale: Life-threatening conditions (e.g., airway obstruction, tension
pneumothorax, massive hemorrhage) are treated immediately as they are
identified during the primary survey.
Question 6
True or False: A patient with a GCS of 14 who is combative and attempting
to remove cervical collar should be sedated immediately.
Answer: False
, Rationale: Sedation may compromise airway and neurologic assessment.
First, attempt to redirect the patient. If necessary, use chemical restraint
only after ensuring airway protection.
Question 7
The "L" in the mnemonic "ABCDEFGHI" for trauma assessment stands for:
A) Lab work
B) Log-roll
C) Laryngeal assessment
D) Left lateral position
Answer: B
Rationale: In the extended primary survey, "L" stands for Log-roll, which is
performed to assess the posterior aspect of the patient and apply a
backboard while maintaining spinal precautions.
Question 8
Stridor in a trauma patient indicates:
A) Normal breathing
B) Mild respiratory distress
C) Impending airway obstruction
D) Bronchospasm
Answer: C
Rationale: Stridor indicates impending airway obstruction from laryngeal
edema or foreign body. This is a critical airway finding requiring immediate
intervention.
