TNCC EXAM Questions and Answers
Initial Assessment - ANSW 1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
ABCDEFGHI - ANSW 1. A- airway and Alertness with simultaneous cervical spinal
stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces
When should PPE be placed: - ANSW Before the arrival of the pt
Safe Care: - ANSW Pt is at hospital in the right amount of time, right care, right trauma
facility, right resources
Major cause of preventable death: - ANSW Uncontrolled Hemorrhage
If uncontrolled hemorrhage .. - ANSW reorganize care to C-ABC
Airway and AVPU: - ANSW Used at the beginning of the initial assessment
1. A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is
clear.
2. V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation
to respond, an airway adjunct may be needed to keep the tongue from obstructing the
airway.
3. P responds to pain. If the pt. responds only to pain, he or she may not be able to
maintain his or her airway adjunct may need to be placed while further assessment is
made to determine the need for intubation.
4. U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct
someone to chk in the pt is pulseless while assessing if the cause of the problem is the
airway.
, While assessing airway the patient is alert and responds to verbal stimuli you should.. -
ANSW ask pt to pen his or her mouth
While assessing airway pt is unable to open mouth, responds only to pain, or is
unresponsive you should.. - ANSW jaw thrust maneuver to open airway and assess for
obstruction. If pt has a suspected csi, the jaw thrust procedure should be done by two
providers. One provider can maintain c-spine and the other can perform the jaw thrust
maneuver.
Inspect the mouth for: - ANSW 1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema
If the pt has a definitive airway in what should you do? - ANSW 1. Check the presence
of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor
If Airway is not patent - ANSW 1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method
Following conditions might require a definitive airway - ANSW 1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation
B - ANSW Breathing: To assess breathing expose the chest:
1. Inspect for
a. spontaneous breathing
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
Initial Assessment - ANSW 1. Preparation and Triage
2. Primary Survery (ABCDE) with resuscitation adjuncts (F,G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (HI) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
ABCDEFGHI - ANSW 1. A- airway and Alertness with simultaneous cervical spinal
stabilization
2. B- breathing and Ventilation
3. circulation and control of hemorrhage
4. D - disability (neurologic status)
5. F - full set of vitals and Family presence
6. G - Get resuscitation adjuncts
L- Lab results (arterial gases, blood type and crossmatch)
M- monitor for continuous cardiac rhythm and rate assessment
N- naso or orogastric tube consideration
O- oxygenation and ventilation analysis: Pulse oxygemetry and end-tidal caron dioxide
(ETC02) monitoring and capnopgraphy
H- History and head to toe assessment
I- Inspect posterior surfaces
When should PPE be placed: - ANSW Before the arrival of the pt
Safe Care: - ANSW Pt is at hospital in the right amount of time, right care, right trauma
facility, right resources
Major cause of preventable death: - ANSW Uncontrolled Hemorrhage
If uncontrolled hemorrhage .. - ANSW reorganize care to C-ABC
Airway and AVPU: - ANSW Used at the beginning of the initial assessment
1. A Alert. If the pt is alert he or she will be able to maintain his or her airway once it is
clear.
2. V responds to verbal stimuli responds to pain. If the patient needs verbal stimulation
to respond, an airway adjunct may be needed to keep the tongue from obstructing the
airway.
3. P responds to pain. If the pt. responds only to pain, he or she may not be able to
maintain his or her airway adjunct may need to be placed while further assessment is
made to determine the need for intubation.
4. U Unresponsive. If the pt. is unresponsive, announce it loudly to the team and direct
someone to chk in the pt is pulseless while assessing if the cause of the problem is the
airway.
, While assessing airway the patient is alert and responds to verbal stimuli you should.. -
ANSW ask pt to pen his or her mouth
While assessing airway pt is unable to open mouth, responds only to pain, or is
unresponsive you should.. - ANSW jaw thrust maneuver to open airway and assess for
obstruction. If pt has a suspected csi, the jaw thrust procedure should be done by two
providers. One provider can maintain c-spine and the other can perform the jaw thrust
maneuver.
Inspect the mouth for: - ANSW 1. The tongue obstructing the airway
2. loose or missing teeth
3. foreign objects
4. blood, vomit, or secretions'
5. edema
6. burns or evidence of inhalation injury
Auscultiate or listen for:
1. Obstructive airway sounds such as snoring or gurgling
2. Possible occlusive maxillofacial bony deformity
3. Subcutaneous emphysema
If the pt has a definitive airway in what should you do? - ANSW 1. Check the presence
of adequate rise and fall of the chest with assisted ventilation
2. Absence of gurgling on auscultation over the epigastrium
3. Bilateral breath sounds present on auscultation
4. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor
If Airway is not patent - ANSW 1. Suction the airway
2, Use care to avoid stimulating the gag reflex
3. If the airway is obstructed by blood or vomitus secretions, use a rigid suction device
If foreign body is noted, remove it carefully with forceps or another appropriate method
Following conditions might require a definitive airway - ANSW 1. Apnea
2. GCS 8 or less
3. Maxillary fractures
4. Evidence of inhalation injury (facial burns)
5. Laryngeal or tracheal injury or neck hematoma
6. High risk of aspiration and patients inability to protect the airway
7. Compromised or ineffective ventilation
B - ANSW Breathing: To assess breathing expose the chest:
1. Inspect for
a. spontaneous breathing
b. symmetrical rise and fall
c. depth, pattern, and rate of respiration
