TNCC (Trauma Nursing Core Course) Exam 2025–
2026 enhance trauma care Accurate Real Exam
Questions a
THIS DOCUMENT CONTAINS THE COMPLETE SET OF REAL EXAM QUESTIONS WITH VERIFIED CORRECT ANSWERS
FOR THE TNCC (T RAUMA N URSING C ORE C OURSE ) EXAM FOR THE 2025–2026 CYCLE. IT COVERS CRITICAL
TOPICS SUCH AS THE INITIAL ASSESSMENT , AIRWAY AND BREATHING MANAGEMENT , SHOCK AND
HEMORRHAGE CONTROL , NEUROLOGIC ASSESSMENT , MUSCULOSKELETAL TRAUMA , DISASTER RESPONSE , AND
TRAUMA NURSING PROCESS ACCORDING TO THE EMERGENCY NURSES A SSOCIATION (ENA) GUIDELINES .
PERFECT FOR NURSES PREPARING FOR TNCC CERTIFICATION OR SEEKING TO ENHANCE TRAUMA CARE SKILLS
The standard approach to treating hypotension in trauma patients has been to
infuse large volumes of IV fluids. Recent studies now recommend a different
approach and note that an elevated BP may dislodge the body's formation of clots
and promote further bleeding. In addition, large volumes of fluid lead to... -
answerDilutional coagulopathy which worsens metabolic acidosis and may cause
hypothermia
ch. 5, p. 45
_________ therapy is now suggested for fluid resuscitation to replace patient
losses, including administering PRBCs, plasma, and platelets. -
answerCOMPONENT THERAPY
ch. 5, p. 45
Assess pupils for... - answerEquality, shape, and reactivity (PERRL)
ch. 5, p. 45
Consider ABGs. A decreased level of consciousness may be an indicator of... -
answerDecreased cerebral perfusion, hypoventilation, or acid-base imbalance.
,ch. 5, p. 46
Hypothermia combined with ______ and ______ is a potentially lethal
combination. - answerHYPOTENSION and ACIDOSIS
ch. 5, p. 46
Explain the LMNOP mnemonic - answerUsed to remember resuscitation adjuncts
L - Lab studies (ABGs, blood type and crossmatch)
- Lactic acid is an excellent reflection of tissue
perfusion
M - Monitor cardiac rate and rhythm: compare patient's pulse to the monitor's
rhythm
- Dysrhythmias (PVCs, a fib, or ST segment changes)
may indicate blunt cardiac trauma
- PEA may point to cardiac tamponade, tension
pneumothorax, or profound hypovolemia
N - Naso- or orogastric tube consideration: insertion provides stomach content
evacuation and relief of gastric distention
O - Oxygenation and ventilation assessment
- Pulse ox may only be accurate if there is adequate
peripheral perfusion
- ETCO2 monitoring (capnography) provides instantaneous information about the
ventilation, perfusion, and metabolism of carbon dioxide (35-45 is normal)
ch. 5, p. 47
ABGs provide values of oxygen, CO2 and base excess, which are... -
answerReflective endpoint measurements of the effectiveness of cellular
perfusion, adequacy of ventilation, and the success of the resuscitation.
An abnormal base deficit may indicate poor perfusion and tissue hypoxia, which
results in the generation of hydrogen ions and metabolic acidosis.
ch. 5, p. 46
When does the secondary survey (HI) begin? - answerAfter the completion of the
primary survey (ABCDE), after the initiation of resuscitation efforts, once vital
,functions have been stabilized and after consideration for resuscitation adjuncts
(FG).
ch. 5, p. 47
Additional history includes the following (MIST mnemonic) prehospital report: -
answer- MOI
- Injuries sustained
- Signs and Symptoms (in the field)
- Treatment (in the field)
ch. 5, p. 47
SAMPLE mnemonic regarding patient's history - answerS - Symptoms associated
with injury
A - Allergies and tetanus status
M - Medications currently used, including anticoagulant therapy
P - Past medical history (hospitalizations/surgeries)
L - Last oral intake
E - Events and Environmental factors related to injury
ch. 5, p. 48
What are odors you want to be sure to document? - answerAlcohol, gasoline, other
chemicals
ch. 5, p. 48
Explain the B2-Transferrin test - answerGold standard for identifying CSF
otorrhea or rhinorrhea
ch. 5, p. 48
What are some circumstances that may lead to unreliable pulse ox readings? -
answer- Poor peripheral perfusion
- BP cuff inflated above sensor
- CO poisoning (carboxyhemoglobin)
- Methemoglobinemia
- Severe dehydration
, Pulse ox provides evidence of SaO2 but not PaO2. The non-liner relationship
between the two measurements is reflected in the oxyhemoglobin-dissociation
curve.
ch. 6, p. 65
Oxyhemoglobin-dissociation curve indicates the correlation of tissue oxygneation
(PaO2) as it saturates the hemoglobin molecule (SO2). P50 describes the oxygen
pressure when the hemoglobin molecule is 50% saturated. Normal P50 is 26.7 mm
Hg. A shift in the curve notes changes in the relationship: - answerShift to the
RIGHT occurs in an environment of HIGH metabolic demand. Hemoglobin's
affinity for oxygen decreases, making it easier to release the bound oxygen to the
tissues. A shift to the right occurs in response to:
- Increased carbon dioxide (hypercapnia)
- Increased temp (hyperthermia)
- Increased 2,3-diphosphoglycerate levels (a substance in blood that helps O2
move from hemoglobin to the tissues)
- Decreased pH (acidemia)
Shift to the LEFT occurs in an environment of LOW metabolic demand.
Hemoglobin's affinity for oxygen increases, making it harder to release bound
oxygen to the tissues. A shift to the right occurs in response to:
- Decreased carbon dioxide (hypocapnia)
- Decreased temp (hypothermia)
- Decreased 2,3-diphosphoglycerate levels
- Elevated pH (alkalosis)
- Carbon monoxide and methemoglobinemia
ch. 6, p. 65
Trauma nurse should be attempting to maintain NORMOTHERMIA and
NORMOCARBIA, which... - answerDecreases risk of..
HYPOTHERMIA
ACIDOSIS
COAGULOPATHY
ch. 6, p. 65
Use the DOPE mnemonic to troubleshoot ventilator or capnography alarms -
answerD - Displaced tube
2026 enhance trauma care Accurate Real Exam
Questions a
THIS DOCUMENT CONTAINS THE COMPLETE SET OF REAL EXAM QUESTIONS WITH VERIFIED CORRECT ANSWERS
FOR THE TNCC (T RAUMA N URSING C ORE C OURSE ) EXAM FOR THE 2025–2026 CYCLE. IT COVERS CRITICAL
TOPICS SUCH AS THE INITIAL ASSESSMENT , AIRWAY AND BREATHING MANAGEMENT , SHOCK AND
HEMORRHAGE CONTROL , NEUROLOGIC ASSESSMENT , MUSCULOSKELETAL TRAUMA , DISASTER RESPONSE , AND
TRAUMA NURSING PROCESS ACCORDING TO THE EMERGENCY NURSES A SSOCIATION (ENA) GUIDELINES .
PERFECT FOR NURSES PREPARING FOR TNCC CERTIFICATION OR SEEKING TO ENHANCE TRAUMA CARE SKILLS
The standard approach to treating hypotension in trauma patients has been to
infuse large volumes of IV fluids. Recent studies now recommend a different
approach and note that an elevated BP may dislodge the body's formation of clots
and promote further bleeding. In addition, large volumes of fluid lead to... -
answerDilutional coagulopathy which worsens metabolic acidosis and may cause
hypothermia
ch. 5, p. 45
_________ therapy is now suggested for fluid resuscitation to replace patient
losses, including administering PRBCs, plasma, and platelets. -
answerCOMPONENT THERAPY
ch. 5, p. 45
Assess pupils for... - answerEquality, shape, and reactivity (PERRL)
ch. 5, p. 45
Consider ABGs. A decreased level of consciousness may be an indicator of... -
answerDecreased cerebral perfusion, hypoventilation, or acid-base imbalance.
,ch. 5, p. 46
Hypothermia combined with ______ and ______ is a potentially lethal
combination. - answerHYPOTENSION and ACIDOSIS
ch. 5, p. 46
Explain the LMNOP mnemonic - answerUsed to remember resuscitation adjuncts
L - Lab studies (ABGs, blood type and crossmatch)
- Lactic acid is an excellent reflection of tissue
perfusion
M - Monitor cardiac rate and rhythm: compare patient's pulse to the monitor's
rhythm
- Dysrhythmias (PVCs, a fib, or ST segment changes)
may indicate blunt cardiac trauma
- PEA may point to cardiac tamponade, tension
pneumothorax, or profound hypovolemia
N - Naso- or orogastric tube consideration: insertion provides stomach content
evacuation and relief of gastric distention
O - Oxygenation and ventilation assessment
- Pulse ox may only be accurate if there is adequate
peripheral perfusion
- ETCO2 monitoring (capnography) provides instantaneous information about the
ventilation, perfusion, and metabolism of carbon dioxide (35-45 is normal)
ch. 5, p. 47
ABGs provide values of oxygen, CO2 and base excess, which are... -
answerReflective endpoint measurements of the effectiveness of cellular
perfusion, adequacy of ventilation, and the success of the resuscitation.
An abnormal base deficit may indicate poor perfusion and tissue hypoxia, which
results in the generation of hydrogen ions and metabolic acidosis.
ch. 5, p. 46
When does the secondary survey (HI) begin? - answerAfter the completion of the
primary survey (ABCDE), after the initiation of resuscitation efforts, once vital
,functions have been stabilized and after consideration for resuscitation adjuncts
(FG).
ch. 5, p. 47
Additional history includes the following (MIST mnemonic) prehospital report: -
answer- MOI
- Injuries sustained
- Signs and Symptoms (in the field)
- Treatment (in the field)
ch. 5, p. 47
SAMPLE mnemonic regarding patient's history - answerS - Symptoms associated
with injury
A - Allergies and tetanus status
M - Medications currently used, including anticoagulant therapy
P - Past medical history (hospitalizations/surgeries)
L - Last oral intake
E - Events and Environmental factors related to injury
ch. 5, p. 48
What are odors you want to be sure to document? - answerAlcohol, gasoline, other
chemicals
ch. 5, p. 48
Explain the B2-Transferrin test - answerGold standard for identifying CSF
otorrhea or rhinorrhea
ch. 5, p. 48
What are some circumstances that may lead to unreliable pulse ox readings? -
answer- Poor peripheral perfusion
- BP cuff inflated above sensor
- CO poisoning (carboxyhemoglobin)
- Methemoglobinemia
- Severe dehydration
, Pulse ox provides evidence of SaO2 but not PaO2. The non-liner relationship
between the two measurements is reflected in the oxyhemoglobin-dissociation
curve.
ch. 6, p. 65
Oxyhemoglobin-dissociation curve indicates the correlation of tissue oxygneation
(PaO2) as it saturates the hemoglobin molecule (SO2). P50 describes the oxygen
pressure when the hemoglobin molecule is 50% saturated. Normal P50 is 26.7 mm
Hg. A shift in the curve notes changes in the relationship: - answerShift to the
RIGHT occurs in an environment of HIGH metabolic demand. Hemoglobin's
affinity for oxygen decreases, making it easier to release the bound oxygen to the
tissues. A shift to the right occurs in response to:
- Increased carbon dioxide (hypercapnia)
- Increased temp (hyperthermia)
- Increased 2,3-diphosphoglycerate levels (a substance in blood that helps O2
move from hemoglobin to the tissues)
- Decreased pH (acidemia)
Shift to the LEFT occurs in an environment of LOW metabolic demand.
Hemoglobin's affinity for oxygen increases, making it harder to release bound
oxygen to the tissues. A shift to the right occurs in response to:
- Decreased carbon dioxide (hypocapnia)
- Decreased temp (hypothermia)
- Decreased 2,3-diphosphoglycerate levels
- Elevated pH (alkalosis)
- Carbon monoxide and methemoglobinemia
ch. 6, p. 65
Trauma nurse should be attempting to maintain NORMOTHERMIA and
NORMOCARBIA, which... - answerDecreases risk of..
HYPOTHERMIA
ACIDOSIS
COAGULOPATHY
ch. 6, p. 65
Use the DOPE mnemonic to troubleshoot ventilator or capnography alarms -
answerD - Displaced tube
