TNCC Notes for Written Exam LATEST2
v v v v v v
024-2025 LATEST A+ v v
TNCC Notes for Written Exam
v v v v
Whatvisvkinematics?v-
✅vAvbranchvofvmechanicsv(energyvtransfer)vthatvrefersvtovmotionvandvdoesvnotvconsidervt
hevconceptsvofvforcevandvmassv ofvthevobjectv orvbody.
WhatvisvNewton'svFirstvLaw?v -
✅vAvbodyvatvrestvwillvremainvatvrest.vAvbodyvinvmotionvwillvremainvinvmotionvuntilvacted
v onvbyvanvoutsidevforce.
WhatvisvthevLawvofv ConservationvofvEnergy?v-
✅vEnergyvcanvneithervbevcreatedv norvdestroyed.v Itv isvonlyvchangedvfromvonevformvtovanot
her.
Whatvisv Newton'svSecondvLaw?v-
✅vForcev equalsvmassvmultipliedvbyvaccelerationvofvdeceleration.
Whatvisvkineticvenergyv(KE)?v -
✅vKEvequalsv1/2v thevmassv (M)v multipliedvbyvthevvelocityvsquared.
Whatvisvthev Mnemonicvforvthev InitialvAssessment?v-
✅vAv=vAirwayvwithvsimultaneousvcervicalvspinevprotectionv
Bv=vBreathing
Cv =v Circulation
Dv =v Disabilityv(neurologicvstatus)
Ev =v Expose/Environmentalvcontrolsv(removev clothingvandvkeepvthev patientvwarm)
Whatvisvthev Mnemonicvforvthev SecondaryvAssessment?v-
✅vFv=vFullvsetvofvVS/Focusedvadjunctsv(includesvcardiacvmonitor,vurinaryvcatheter,va
ndvgastricv tube)/Familyvpresence
Gv=vGivevcomfortvmeasuresv(verbalvreassurance,vtouch,vandvpharmacologicvandvnonpha
rmacologicvmanagementvofvpain).
Hv =v HxvandvHead-to-
toev assessmentvIv=vInspectvposteriorvs
urfaces
Wherevdovyouvlistenvtov auscultatevbreathvsounds?v-
✅vAuscultatevthevlungsvbilaterallyvatvthevsecondvintercostalvspacevmidclavicularvlinevand
vatv thevfifthvintercostalvspacevatv thevanteriorvaxillaryvlinve.
Whatvarevthevlatevsignsvofv breathingvcompromise?v -
✅v-vTrachealvdeviation
v-v JVD
Whatvarev signsvofv ineffectivevbreathing?v-
✅v-vAMS
,TNCC Notes for Written Exam LATEST2
v v v v v v
024-2025 LATEST A+ v v
- Cyanosis,vespeciallyvaroundvthevmouth
v v
- Asymmetricv expansionvofvchestvwall
v v
v-v Paradoxicalvmovementvofv thev chestvwallvduringvinspirationvandvexpiration
v-
v Usevofv accessoryvmusclesvorvabdominalvmusclesvorvbothv orv diaphragmaticvbreathing
v-v Suckingvchestvwounds
v-v Absentvorvdiminishedvbreathv sounds
v-v AdministervO2v viav NRBvorv assistvventilationsvwithv avbag-maskv device,vasvindicated
v-v Anticipatevdefinitivevairwayvmanagementvtov supportv ventilation.
Uponvinitialvassessment,vwhatvtypevofvoxygenvshouldvbevusedvforvavptvbreathingveffectivel
y?v-
✅vAv tight-fittingvnonrebreathervmaskvatv12-15v lpm.
Whatvinterventionv shouldvbevdonevifvav ptv presentsvwithv effectivevcirculation?v -
✅v-v Insertv 2vlargevcalibervIV's
v-v Administervwarmedv isotonicvcrystalloidvsolutionvatvanv appropriatevrate
Whatvarev signsvofv ineffectivevcirculation?v -
✅v-v Tachycardia
v-v AMS
v-v Uncontrolledvexternalvbleeding
v-v Pale,vcool,vmoistv skin
v-v Distendedvorv abnormallyvflattenedvexternalvjugularvveins
v-v Distantvheartvsounds
Whatvarev thev interventionsvforvEffective/IneffectivevCirculation?v -
✅v-v Controlvanyvuncontrolledvexternalvbleedingvby:
v-v Applyingvdirectvpressurevoverv bleedingvsite
v-v Elevatingv bleedingv extremity
v-v Applyingvpressurevovervarterialv pressurevpoints
v-v Usingvtourniquetv(lastvresort).
v-v Cannulatev2vlarge-
calibervIV'sv andvinitiatevinfusionsvofvanv isotonicvcrystalloidvsolution
v-v Usev warmedv solution
v-v Usevpressurevbagsvtov increasevspeedvofv IVFv infusion
v-v Usev bloodv administrationv tubingvforvpossiblevadministrationv ofvblood
v-v Usev rapidvinfusionvdevicevbasedvonvprotocol
v-v UsevNSv 0.9%v invsamevtubingvasvbloodvproduct
v-v IVv =v surgicalvcut-down,vcentralvline,vorvboth.
v-v BloodvsamplevtovdeterminevABOvandvRhvgroup
v-v IOv invsternum,vlegs,varmsv orv pelvis
v-v Administervbloodv products
v-v PASGv (withoutvinterferingvwithv fluidvresuscitation)
Howvdov youvassessvMnemonicv"D"?v-
✅vDISABILITY
, TNCC Notes for Written Exam LATEST2
v v v v v v
024-2025 LATEST A+ v v
Av=v Alertv
Vv=vVerbalv
Pv=v Pain
Uv =v Unresponsive
v-v GCS
v-v PERRL?
v-v Determinev presencevofv lateralizingvsignsvincluding:
v-v Unilateralvdeteriorationv invmotorv movementsvorv unequalvpupils
v-v Symptomsv thatvhelpvtov locatevareav ofvinjuryvinvbrain
Whatvarev thev interventionsvforvDisability?v -
✅v-
v Ifv assessmentvindicatesvav decreasedv LOC,vconductvfurthervinvestigationv duringvseconda
ryvfocusedvassessments
v-v Ifv ptvisvnotvalertv orvverbal,v continuevtovmonitorvforv anyvcompromisevtov ABC's
v-
v Ifv ptvdemonstratesv signsvofvherniationv orvneurologicvdeterioration,vconsidervhyperventilat
ion.
Whatvisv assessedv andvintervenedvforvExpose/EnvironmentalvControls?v -
✅v-v Removev clothing
v-v Ensurevappropriatev decontaminationv ifvexposedvtov hazardousvmaterial
v-v Keepvptv warm
v-v Keepv clothingvforvevidence
Whatvisv thev firstvthingvassessedvundervthevSecondaryvAssessment?v -
✅vFULLvSETvVSv/v FOCUSEDvADJUNCTSv/v FAMILYv PRESENCE
v-v ABCDEvshouldvbevcompleted
v-v Labs,v X-rays,v CT,v Foley,
v-v Familyv Presence
Whatvisv thev secondvthingvassessedvundervthevSecondaryvAssessment?v -
✅vGIVEv COMFORTvMEASURES
v-v Talkingvtov pt
v-v Pharmacologic/Nonpharmacologicvpainv management
v-v Observev forvphysicalvsignsvofvpain
Whatvisv assessedv undervthevMnemonicv"H"?v -
✅vHISTORYv /vHEAD-TO-TOEv ASSESSMENT
v-vMIVT
v-v Mv =v Mechanismvofvinjury
v-v Iv =v Injuriesvsustained
v-v Vv =v Vitalv Signs
v-vTv=vTreatment
v-v Ptv generatedvinformation
v-v PMH
v-v Head-to-toev assessment
Whatvisv assessedv undervthevMnemonicv"I"?v-
v v v v v v
024-2025 LATEST A+ v v
TNCC Notes for Written Exam
v v v v
Whatvisvkinematics?v-
✅vAvbranchvofvmechanicsv(energyvtransfer)vthatvrefersvtovmotionvandvdoesvnotvconsidervt
hevconceptsvofvforcevandvmassv ofvthevobjectv orvbody.
WhatvisvNewton'svFirstvLaw?v -
✅vAvbodyvatvrestvwillvremainvatvrest.vAvbodyvinvmotionvwillvremainvinvmotionvuntilvacted
v onvbyvanvoutsidevforce.
WhatvisvthevLawvofv ConservationvofvEnergy?v-
✅vEnergyvcanvneithervbevcreatedv norvdestroyed.v Itv isvonlyvchangedvfromvonevformvtovanot
her.
Whatvisv Newton'svSecondvLaw?v-
✅vForcev equalsvmassvmultipliedvbyvaccelerationvofvdeceleration.
Whatvisvkineticvenergyv(KE)?v -
✅vKEvequalsv1/2v thevmassv (M)v multipliedvbyvthevvelocityvsquared.
Whatvisvthev Mnemonicvforvthev InitialvAssessment?v-
✅vAv=vAirwayvwithvsimultaneousvcervicalvspinevprotectionv
Bv=vBreathing
Cv =v Circulation
Dv =v Disabilityv(neurologicvstatus)
Ev =v Expose/Environmentalvcontrolsv(removev clothingvandvkeepvthev patientvwarm)
Whatvisvthev Mnemonicvforvthev SecondaryvAssessment?v-
✅vFv=vFullvsetvofvVS/Focusedvadjunctsv(includesvcardiacvmonitor,vurinaryvcatheter,va
ndvgastricv tube)/Familyvpresence
Gv=vGivevcomfortvmeasuresv(verbalvreassurance,vtouch,vandvpharmacologicvandvnonpha
rmacologicvmanagementvofvpain).
Hv =v HxvandvHead-to-
toev assessmentvIv=vInspectvposteriorvs
urfaces
Wherevdovyouvlistenvtov auscultatevbreathvsounds?v-
✅vAuscultatevthevlungsvbilaterallyvatvthevsecondvintercostalvspacevmidclavicularvlinevand
vatv thevfifthvintercostalvspacevatv thevanteriorvaxillaryvlinve.
Whatvarevthevlatevsignsvofv breathingvcompromise?v -
✅v-vTrachealvdeviation
v-v JVD
Whatvarev signsvofv ineffectivevbreathing?v-
✅v-vAMS
,TNCC Notes for Written Exam LATEST2
v v v v v v
024-2025 LATEST A+ v v
- Cyanosis,vespeciallyvaroundvthevmouth
v v
- Asymmetricv expansionvofvchestvwall
v v
v-v Paradoxicalvmovementvofv thev chestvwallvduringvinspirationvandvexpiration
v-
v Usevofv accessoryvmusclesvorvabdominalvmusclesvorvbothv orv diaphragmaticvbreathing
v-v Suckingvchestvwounds
v-v Absentvorvdiminishedvbreathv sounds
v-v AdministervO2v viav NRBvorv assistvventilationsvwithv avbag-maskv device,vasvindicated
v-v Anticipatevdefinitivevairwayvmanagementvtov supportv ventilation.
Uponvinitialvassessment,vwhatvtypevofvoxygenvshouldvbevusedvforvavptvbreathingveffectivel
y?v-
✅vAv tight-fittingvnonrebreathervmaskvatv12-15v lpm.
Whatvinterventionv shouldvbevdonevifvav ptv presentsvwithv effectivevcirculation?v -
✅v-v Insertv 2vlargevcalibervIV's
v-v Administervwarmedv isotonicvcrystalloidvsolutionvatvanv appropriatevrate
Whatvarev signsvofv ineffectivevcirculation?v -
✅v-v Tachycardia
v-v AMS
v-v Uncontrolledvexternalvbleeding
v-v Pale,vcool,vmoistv skin
v-v Distendedvorv abnormallyvflattenedvexternalvjugularvveins
v-v Distantvheartvsounds
Whatvarev thev interventionsvforvEffective/IneffectivevCirculation?v -
✅v-v Controlvanyvuncontrolledvexternalvbleedingvby:
v-v Applyingvdirectvpressurevoverv bleedingvsite
v-v Elevatingv bleedingv extremity
v-v Applyingvpressurevovervarterialv pressurevpoints
v-v Usingvtourniquetv(lastvresort).
v-v Cannulatev2vlarge-
calibervIV'sv andvinitiatevinfusionsvofvanv isotonicvcrystalloidvsolution
v-v Usev warmedv solution
v-v Usevpressurevbagsvtov increasevspeedvofv IVFv infusion
v-v Usev bloodv administrationv tubingvforvpossiblevadministrationv ofvblood
v-v Usev rapidvinfusionvdevicevbasedvonvprotocol
v-v UsevNSv 0.9%v invsamevtubingvasvbloodvproduct
v-v IVv =v surgicalvcut-down,vcentralvline,vorvboth.
v-v BloodvsamplevtovdeterminevABOvandvRhvgroup
v-v IOv invsternum,vlegs,varmsv orv pelvis
v-v Administervbloodv products
v-v PASGv (withoutvinterferingvwithv fluidvresuscitation)
Howvdov youvassessvMnemonicv"D"?v-
✅vDISABILITY
, TNCC Notes for Written Exam LATEST2
v v v v v v
024-2025 LATEST A+ v v
Av=v Alertv
Vv=vVerbalv
Pv=v Pain
Uv =v Unresponsive
v-v GCS
v-v PERRL?
v-v Determinev presencevofv lateralizingvsignsvincluding:
v-v Unilateralvdeteriorationv invmotorv movementsvorv unequalvpupils
v-v Symptomsv thatvhelpvtov locatevareav ofvinjuryvinvbrain
Whatvarev thev interventionsvforvDisability?v -
✅v-
v Ifv assessmentvindicatesvav decreasedv LOC,vconductvfurthervinvestigationv duringvseconda
ryvfocusedvassessments
v-v Ifv ptvisvnotvalertv orvverbal,v continuevtovmonitorvforv anyvcompromisevtov ABC's
v-
v Ifv ptvdemonstratesv signsvofvherniationv orvneurologicvdeterioration,vconsidervhyperventilat
ion.
Whatvisv assessedv andvintervenedvforvExpose/EnvironmentalvControls?v -
✅v-v Removev clothing
v-v Ensurevappropriatev decontaminationv ifvexposedvtov hazardousvmaterial
v-v Keepvptv warm
v-v Keepv clothingvforvevidence
Whatvisv thev firstvthingvassessedvundervthevSecondaryvAssessment?v -
✅vFULLvSETvVSv/v FOCUSEDvADJUNCTSv/v FAMILYv PRESENCE
v-v ABCDEvshouldvbevcompleted
v-v Labs,v X-rays,v CT,v Foley,
v-v Familyv Presence
Whatvisv thev secondvthingvassessedvundervthevSecondaryvAssessment?v -
✅vGIVEv COMFORTvMEASURES
v-v Talkingvtov pt
v-v Pharmacologic/Nonpharmacologicvpainv management
v-v Observev forvphysicalvsignsvofvpain
Whatvisv assessedv undervthevMnemonicv"H"?v -
✅vHISTORYv /vHEAD-TO-TOEv ASSESSMENT
v-vMIVT
v-v Mv =v Mechanismvofvinjury
v-v Iv =v Injuriesvsustained
v-v Vv =v Vitalv Signs
v-vTv=vTreatment
v-v Ptv generatedvinformation
v-v PMH
v-v Head-to-toev assessment
Whatvisv assessedv undervthevMnemonicv"I"?v-
