Trauma Nursing Core Course (TNCC) Exam Practice | 100 Original
Questions with Answers and Rationales 2026/2027
Initial assessment and priorities
Identify and treat immediate threats as they are found. Severe external bleeding,
airway obstruction, impaired ventilation, and poor perfusion require prompt action
and repeated assessment.
1. An injured client has spurting leg bleeding and an obstructed airway. What
is appropriate?
A. Wait for imaging
B. Call for help and coordinate immediate hemorrhage control and airway support
C. Address only the less visible injuries
D. Complete the history first
Answer: B
Rationale: Concurrent life threats require coordinated urgent treatment rather
than a delayed linear assessment.
2. A trauma client speaks clearly. What does this establish?
A. Cervical injury is excluded
B. Ventilation is certainly adequate
C. No future airway risk exists
D. The airway is patent at that moment
Answer: D
Rationale: Speech suggests current patency but does not rule out evolving
obstruction or other injuries.
3. Which client needs the fastest escalation?
A. A client with stable ankle swelling
B. A client with new stridor after neck trauma
C. A client asking for water
D. A client with a healed scar
Answer: B
Rationale: Stridor can indicate narrowing of a vulnerable airway.
,4. After an emergency intervention, what comes next?
A. Begin discharge without reassessment
B. Stop monitoring
C. Assume treatment was successful
D. Reassess the response and continue the survey
Answer: D
Rationale: Repeated assessment detects persistent threats and treatment failure.
Airway obstruction and protection
Airway care combines protection from aspiration, removal of visible obstruction
when appropriate, basic maneuvers, and skilled escalation. Protect the spine
without allowing hypoxia.
5. An unconscious trauma client has gurgling respirations. What is the
immediate concern?
A. Fluid or secretions interfering with the airway
B. Isolated hypertension
C. Normal sleep sounds
D. An uncomplicated limb injury
Answer: A
Rationale: Gurgling suggests liquid obstruction that may require suction and
airway support.
6. Which maneuver is generally preferred initially when cervical injury is
possible?
A. Jaw thrust with spinal protection
B. Forceful neck hyperextension
C. Repeated neck rotation
D. Unassisted sitting
Answer: A
Rationale: Jaw thrust can open the airway while limiting cervical movement.
, 7. A responsive client has an intact gag reflex. Which adjunct may provoke
vomiting?
A. An oropharyngeal airway
B. An oxygen mask
C. A pulse oximeter
D. A nasal cannula
Answer: A
Rationale: Oropharyngeal adjuncts are generally unsuitable when protective
reflexes remain intact.
8. Severe facial trauma prevents effective basic airway management. What
should the nurse do?
A. Summon skilled airway help and prepare rescue equipment
B. Delay until the full examination ends
C. Persist indefinitely with a failing technique
D. Give oral fluids
Answer: A
Rationale: Failure to oxygenate or ventilate requires rapid escalation and backup
planning.
Ventilation and intubation monitoring
Oxygenation and ventilation are different. Assess chest movement, respiratory
effort, auscultation, and capnography when available; an oxygen saturation value
alone does not confirm ventilation.
9. After intubation, which tool helps confirm tracheal placement and ongoing
ventilation?
A. Tube color alone
B. Auscultation of the stomach alone
C. Continuous waveform capnography with clinical assessment
D. A normal skin tone alone
Answer: C
Rationale: A sustained carbon dioxide waveform supports placement assessment
and ongoing monitoring.
Questions with Answers and Rationales 2026/2027
Initial assessment and priorities
Identify and treat immediate threats as they are found. Severe external bleeding,
airway obstruction, impaired ventilation, and poor perfusion require prompt action
and repeated assessment.
1. An injured client has spurting leg bleeding and an obstructed airway. What
is appropriate?
A. Wait for imaging
B. Call for help and coordinate immediate hemorrhage control and airway support
C. Address only the less visible injuries
D. Complete the history first
Answer: B
Rationale: Concurrent life threats require coordinated urgent treatment rather
than a delayed linear assessment.
2. A trauma client speaks clearly. What does this establish?
A. Cervical injury is excluded
B. Ventilation is certainly adequate
C. No future airway risk exists
D. The airway is patent at that moment
Answer: D
Rationale: Speech suggests current patency but does not rule out evolving
obstruction or other injuries.
3. Which client needs the fastest escalation?
A. A client with stable ankle swelling
B. A client with new stridor after neck trauma
C. A client asking for water
D. A client with a healed scar
Answer: B
Rationale: Stridor can indicate narrowing of a vulnerable airway.
,4. After an emergency intervention, what comes next?
A. Begin discharge without reassessment
B. Stop monitoring
C. Assume treatment was successful
D. Reassess the response and continue the survey
Answer: D
Rationale: Repeated assessment detects persistent threats and treatment failure.
Airway obstruction and protection
Airway care combines protection from aspiration, removal of visible obstruction
when appropriate, basic maneuvers, and skilled escalation. Protect the spine
without allowing hypoxia.
5. An unconscious trauma client has gurgling respirations. What is the
immediate concern?
A. Fluid or secretions interfering with the airway
B. Isolated hypertension
C. Normal sleep sounds
D. An uncomplicated limb injury
Answer: A
Rationale: Gurgling suggests liquid obstruction that may require suction and
airway support.
6. Which maneuver is generally preferred initially when cervical injury is
possible?
A. Jaw thrust with spinal protection
B. Forceful neck hyperextension
C. Repeated neck rotation
D. Unassisted sitting
Answer: A
Rationale: Jaw thrust can open the airway while limiting cervical movement.
, 7. A responsive client has an intact gag reflex. Which adjunct may provoke
vomiting?
A. An oropharyngeal airway
B. An oxygen mask
C. A pulse oximeter
D. A nasal cannula
Answer: A
Rationale: Oropharyngeal adjuncts are generally unsuitable when protective
reflexes remain intact.
8. Severe facial trauma prevents effective basic airway management. What
should the nurse do?
A. Summon skilled airway help and prepare rescue equipment
B. Delay until the full examination ends
C. Persist indefinitely with a failing technique
D. Give oral fluids
Answer: A
Rationale: Failure to oxygenate or ventilate requires rapid escalation and backup
planning.
Ventilation and intubation monitoring
Oxygenation and ventilation are different. Assess chest movement, respiratory
effort, auscultation, and capnography when available; an oxygen saturation value
alone does not confirm ventilation.
9. After intubation, which tool helps confirm tracheal placement and ongoing
ventilation?
A. Tube color alone
B. Auscultation of the stomach alone
C. Continuous waveform capnography with clinical assessment
D. A normal skin tone alone
Answer: C
Rationale: A sustained carbon dioxide waveform supports placement assessment
and ongoing monitoring.
