TNCC Practice Exam with Rationale questions and
answers 2026\2027 A+ Grade
What is the key to a high performing trauma team?
- correct answer effective communication
rationale: skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care
When obtaining a history for an injured patient, understanding the kinematic concepts associated with
the mechanism of injury and energy transfer can initially assist the trauma provider in:
- correct answer evaluating and anticipating the types of injuries that may be present
rationale: mechanism of injury and energy transfer can assist the provider in evaluating and anticipating
damage
the major preventable cause of death in the trauma patient is:
- correct answer uncontrolled hemorrhage
rationale: uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment
to identify uncontrolled hemorrhage is key to the initial assessment process
the across-the-room observation step in the initial assessment provides the opportunity to
- correct answer reprioritize circulation before airway or breathing
rationale: the across-the-room observation is done at the beginning of the primary survey to rapidly
assess the need to reprioritize circulation before airway or breathing. This is done if uncontrolled
external hemorrhage is identified.
, Which of the following accurately describes ventilation prinicples associated with a bag-mask device?
- correct answer ventilate at a rate of 10-12 breaths/minute
rationale: if ventilation is ineffective, assist ventilation at 10-12 breaths/minute or one every 5-6
seconds
Which of the following is the best measure of the adequacy of cellular perfusion and helps to predict the
outcome of resuscitation?
- correct answer base deficit
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and
when used in conjunction with serum lactate helps predict the success of resuciation
What is the safe pharmacological alternative to opioids for rib fracture pain management in the
anticoagulated patient?
- correct answer intercostal nerve blocks
rationale: continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and
effective pain management for the anticoagulated patient.
In a patient with severe traumatic brain injury, hypocapnia causes:
- correct answer cerebral vasoconstriction
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the
cerebra; vasculature
A patient with a knife injury to the neck has an intact airway and is hemodynamically stable. He
complains of difficulty swallowing and speaking. Further assessment is indicated next for which of the
following?
- correct answer damage to spinal cord
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other common
concurrent injury is to the spinal cord
answers 2026\2027 A+ Grade
What is the key to a high performing trauma team?
- correct answer effective communication
rationale: skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care
When obtaining a history for an injured patient, understanding the kinematic concepts associated with
the mechanism of injury and energy transfer can initially assist the trauma provider in:
- correct answer evaluating and anticipating the types of injuries that may be present
rationale: mechanism of injury and energy transfer can assist the provider in evaluating and anticipating
damage
the major preventable cause of death in the trauma patient is:
- correct answer uncontrolled hemorrhage
rationale: uncontrolled hemorrhage is the major cause of preventable death after injury, so assessment
to identify uncontrolled hemorrhage is key to the initial assessment process
the across-the-room observation step in the initial assessment provides the opportunity to
- correct answer reprioritize circulation before airway or breathing
rationale: the across-the-room observation is done at the beginning of the primary survey to rapidly
assess the need to reprioritize circulation before airway or breathing. This is done if uncontrolled
external hemorrhage is identified.
, Which of the following accurately describes ventilation prinicples associated with a bag-mask device?
- correct answer ventilate at a rate of 10-12 breaths/minute
rationale: if ventilation is ineffective, assist ventilation at 10-12 breaths/minute or one every 5-6
seconds
Which of the following is the best measure of the adequacy of cellular perfusion and helps to predict the
outcome of resuscitation?
- correct answer base deficit
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular perfusion and
when used in conjunction with serum lactate helps predict the success of resuciation
What is the safe pharmacological alternative to opioids for rib fracture pain management in the
anticoagulated patient?
- correct answer intercostal nerve blocks
rationale: continuous intercostal nerve blocks use long-acting anesthetics and can provide safe and
effective pain management for the anticoagulated patient.
In a patient with severe traumatic brain injury, hypocapnia causes:
- correct answer cerebral vasoconstriction
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in the
cerebra; vasculature
A patient with a knife injury to the neck has an intact airway and is hemodynamically stable. He
complains of difficulty swallowing and speaking. Further assessment is indicated next for which of the
following?
- correct answer damage to spinal cord
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other common
concurrent injury is to the spinal cord
