TNCC 9TH EDITION TNP EXAM 2026/2027 | Complete 75-
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Section 1: Trauma Nursing Process (TNP) - Systematic Approach
(Questions 1-12)
Q1. A trauma patient arrives via EMS after a motor vehicle collision. The trauma team
leader asks the primary nurse to begin the Trauma Nursing Process (TNP). Which
sequence correctly represents the TNP framework as applied to trauma care?
A. Assessment → Planning → Diagnosis → Implementation → Evaluation
B. Assessment → Diagnosis → Outcomes → Implementation → Evaluation
C. Primary Survey → Secondary Survey → Interventions → Discharge Planning
D. Triage → Resuscitation → Secondary Survey → Definitive Care → Rehabilitation
B. Assessment → Diagnosis → Outcomes → Implementation → Evaluation
[CORRECT]
Rationale: The TNCC 9th Edition TNP framework follows the nursing process adapted
for trauma: Assessment (A through J mnemonic), Diagnosis (identification of actual or
potential problems), Outcomes (measurable goals), Implementation (interventions),
and Evaluation (reassessment of effectiveness). Option A incorrectly places Planning
before Diagnosis. Option C describes ATLS phases, not the TNP. Option D describes
trauma system phases, not the nursing process.
Correct Answer: B
Q2. During a TNP skill station evaluation, a nurse is caring for a 28-year-old motorcycle
crash victim. The instructor notes the nurse is correctly following the A through J
mnemonic. Which component corresponds to "G" in the primary assessment sequence?
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A. Glasgow Coma Scale assessment
B. Get monitoring devices and give comfort
C. Gastrointestinal assessment
D. Glucose check
B. Get monitoring devices and give comfort [CORRECT]
Rationale: In the TNCC A through J primary assessment mnemonic, "G" stands for "Get
monitoring devices and give comfort." This includes applying cardiac monitoring, pulse
oximetry, and ensuring patient comfort while maintaining spinal precautions. The
LMNOP mnemonic is used within this step (Labs, Monitor, Nasogastric/Orogastric tube,
Oxygen, Pain). Option A (GCS) is part of "D" (Disability). Option C is assessed during the
secondary survey. Option D (glucose) is checked under "D" (Disability) in the 9th
Edition.
Correct Answer: B
Q3. A trauma nurse is applying the TNP to a patient who fell from a second-story
balcony. During the Assessment phase, which action is MOST appropriate for the nurse
to perform?
A. Immediately order a CT scan of the head and cervical spine
B. Perform a systematic primary survey using inspection, auscultation, and palpation
C. Document the patient's allergies and medication list from the electronic health record
D. Call the patient's family to obtain a complete medical history
B. Perform a systematic primary survey using inspection, auscultation, and
palpation [CORRECT]
Rationale: The Assessment phase of the TNP requires the nurse to perform a systematic
primary survey using the A through J mnemonic with inspection, auscultation, and
palpation techniques. Nurses do not independently order CT scans (Option A).
Obtaining allergies and medication history (Option C) and calling family (Option D) are
important but occur during the secondary survey or history-taking phase, not during
the immediate primary assessment.
Correct Answer: B
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Q4. In the TNCC 9th Edition, which update was made to the Trauma Nursing Process
teaching activities?
A. Reduced from eight scenarios to six scenarios
B. Increased from six scenarios to eight scenarios
C. Changed from scenario-based to lecture-only format
D. Eliminated the TNP skill station requirement
B. Increased from six scenarios to eight scenarios [CORRECT]
Rationale: The TNCC 9th Edition (2023/2026 update) expanded Trauma Nursing
Process teaching activities from six scenarios to eight scenarios, providing additional
opportunities for nurses to apply course content in simulated patient exercises. This
change enhances hands-on learning and clinical decision-making practice.
Correct Answer: B
Q5. A trauma nurse is formulating nursing diagnoses during the TNP. For a patient with
a tension pneumothorax, which nursing diagnosis would be the HIGHEST priority
according to the TNP framework?
A. Risk for infection related to invasive procedures
B. Ineffective breathing pattern related to increased intrathoracic pressure
C. Anxiety related to traumatic event and unfamiliar environment
D. Impaired skin integrity related to exposure and environmental factors
B. Ineffective breathing pattern related to increased intrathoracic pressure
[CORRECT]
Rationale: In the TNP framework, nursing diagnoses are prioritized based on immediate
life threats. A tension pneumothorax causes life-threatening respiratory compromise by
collapsing the lung and shifting the mediastinum, compressing the opposite lung and
great vessels. Ineffective breathing pattern is the highest priority because it addresses
the immediate threat to oxygenation and ventilation. Options A, C, and D are important
but do not represent immediate life threats.
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Correct Answer: B
Q6. During the Implementation phase of the TNP, a trauma nurse is caring for a patient
with a suspected spinal cord injury. Which intervention is MOST consistent with the
TNP Implementation phase?
A. Reassessing the patient's neurological status every 15 minutes
B. Establishing the goal of maintaining spinal alignment throughout care
C. Applying a cervical collar and maintaining log-roll precautions during all patient
movement
D. Evaluating whether the patient's pain level decreased after medication
administration
C. Applying a cervical collar and maintaining log-roll precautions during all
patient movement [CORRECT]
Rationale: The Implementation phase of the TNP involves executing planned
interventions. Applying a cervical collar and maintaining log-roll precautions are direct
nursing actions/interventions. Option A describes Evaluation (reevaluation). Option B
describes Outcomes (goal setting). Option D describes Evaluation (assessing
effectiveness of interventions).
Correct Answer: C
Q7. A trauma team is caring for a 45-year-old patient with multiple stab wounds. The
primary nurse completes the primary survey and identifies the following: patent
airway, absent breath sounds on the right, weak radial pulses, GCS 14, and cool skin.
According to the TNP, what is the NEXT appropriate action?
A. Obtain a complete set of vital signs and apply cardiac monitoring
B. Perform a detailed head-to-toe secondary assessment
C. Immediately prepare for needle decompression of the right chest
D. Insert a nasogastric tube and Foley catheter