1|Page
# TNCC EXAM STUDY GUIDE 2026
## TRAUMA NURSING CORE COURSE |
9TH/10TH EDITION
### *A+ GRADED | FIRST-TIME PASS
GUARANTEE*
## Table of Contents
| Section | Topic | Page |
|---------|-------|------|
| 1 | TNCC Exam Overview & Format | 3 |
| 2 | The Trauma Nursing Process (TNP) | 5 |
| 3 | Primary Survey (ABCDE) with Mnemonics | 8 |
| 4 | Shock: Types, Recognition & Management | 12 |
| 5 | Head & Spinal Cord Trauma | 15 |
| 6 | Thoracic & Abdominal Trauma | 18 |
| 7 | Musculoskeletal & Burn Trauma | 21 |
| 8 | Special Populations | 23 |
| 9 | Psychosocial & Disaster Management | 25 |
| 10 | Practice Questions with Rationales (100+ Questions) | 27 |
,2|Page
| 11 | Skills Station Preparation | 42 |
| 12 | 2-Week Study Plan | 44 |
---
# Section 1: TNCC Exam Overview & Format
## Course Requirements
| Component | Details |
|-----------|---------|
| **Course Length** | 16-20 hours |
| **Provider Manual** | ENA TNCC Provider Manual, 9th Edition
(mandatory) |
| **Certification Period** | 4 years |
| **Eligibility** | Registered Nurse |
## Exam Structure
| Exam Component | Format | Passing Score |
|----------------|--------|---------------|
| **Written Exam** | 50 multiple-choice questions | 80% (40 correct) |
,3|Page
| **Skills Station** | Trauma Nursing Process (ABCDE) | Pass/Fail (all
critical steps required) |
## Key Changes for 2026 (9th/10th Edition)
The 9th Edition (and emerging 10th Edition) of TNCC includes:
- Updated A-I mnemonic (expanded assessment framework)
- Enhanced focus on **balanced resuscitation** and hemorrhage control
- Updated guidelines for **pediatric, geriatric, and pregnant trauma
patients**
- New emphasis on **Just Culture** and team communication
---
# Section 2: The Trauma Nursing Process (TNP)
The **Trauma Nursing Process** is the systematic framework that
guides all TNCC assessment and intervention. Memorize this
sequence—it is the foundation of both the written exam and skills station
.
## The Four Phases
, 4|Page
| Phase | Key Actions |
|-------|-------------|
| **1. Primary Survey** | ABCDE with spinal motion restriction |
| **2. Resuscitation** | Stabilize life threats identified in primary survey
|
| **3. Secondary Survey** | Head-to-toe assessment, AMPLE history,
diagnostics |
| **4. Definitive Care/Transfer** | OR, ICU, or transfer to higher-level
trauma center |
## The A-I Mnemonic (Updated for 9th/10th Edition)
The expanded assessment framework now includes:
| Letter | Component | Key Actions |
|--------|-----------|-------------|
| **A** | Airway with cervical spine protection | Assess patency, jaw
thrust, suction, airway adjuncts |
| **B** | Breathing | Rate, depth, symmetry, SpO2, breath sounds,
ETCO2 |
| **C** | Circulation | Pulse quality, skin color/temp, bleeding control,
IV access |
| **D** | Disability | GCS, pupil response, AVPU, blood glucose |
# TNCC EXAM STUDY GUIDE 2026
## TRAUMA NURSING CORE COURSE |
9TH/10TH EDITION
### *A+ GRADED | FIRST-TIME PASS
GUARANTEE*
## Table of Contents
| Section | Topic | Page |
|---------|-------|------|
| 1 | TNCC Exam Overview & Format | 3 |
| 2 | The Trauma Nursing Process (TNP) | 5 |
| 3 | Primary Survey (ABCDE) with Mnemonics | 8 |
| 4 | Shock: Types, Recognition & Management | 12 |
| 5 | Head & Spinal Cord Trauma | 15 |
| 6 | Thoracic & Abdominal Trauma | 18 |
| 7 | Musculoskeletal & Burn Trauma | 21 |
| 8 | Special Populations | 23 |
| 9 | Psychosocial & Disaster Management | 25 |
| 10 | Practice Questions with Rationales (100+ Questions) | 27 |
,2|Page
| 11 | Skills Station Preparation | 42 |
| 12 | 2-Week Study Plan | 44 |
---
# Section 1: TNCC Exam Overview & Format
## Course Requirements
| Component | Details |
|-----------|---------|
| **Course Length** | 16-20 hours |
| **Provider Manual** | ENA TNCC Provider Manual, 9th Edition
(mandatory) |
| **Certification Period** | 4 years |
| **Eligibility** | Registered Nurse |
## Exam Structure
| Exam Component | Format | Passing Score |
|----------------|--------|---------------|
| **Written Exam** | 50 multiple-choice questions | 80% (40 correct) |
,3|Page
| **Skills Station** | Trauma Nursing Process (ABCDE) | Pass/Fail (all
critical steps required) |
## Key Changes for 2026 (9th/10th Edition)
The 9th Edition (and emerging 10th Edition) of TNCC includes:
- Updated A-I mnemonic (expanded assessment framework)
- Enhanced focus on **balanced resuscitation** and hemorrhage control
- Updated guidelines for **pediatric, geriatric, and pregnant trauma
patients**
- New emphasis on **Just Culture** and team communication
---
# Section 2: The Trauma Nursing Process (TNP)
The **Trauma Nursing Process** is the systematic framework that
guides all TNCC assessment and intervention. Memorize this
sequence—it is the foundation of both the written exam and skills station
.
## The Four Phases
, 4|Page
| Phase | Key Actions |
|-------|-------------|
| **1. Primary Survey** | ABCDE with spinal motion restriction |
| **2. Resuscitation** | Stabilize life threats identified in primary survey
|
| **3. Secondary Survey** | Head-to-toe assessment, AMPLE history,
diagnostics |
| **4. Definitive Care/Transfer** | OR, ICU, or transfer to higher-level
trauma center |
## The A-I Mnemonic (Updated for 9th/10th Edition)
The expanded assessment framework now includes:
| Letter | Component | Key Actions |
|--------|-----------|-------------|
| **A** | Airway with cervical spine protection | Assess patency, jaw
thrust, suction, airway adjuncts |
| **B** | Breathing | Rate, depth, symmetry, SpO2, breath sounds,
ETCO2 |
| **C** | Circulation | Pulse quality, skin color/temp, bleeding control,
IV access |
| **D** | Disability | GCS, pupil response, AVPU, blood glucose |
