TNCC 9th Edition TNP 75 Updated 2026 | Trauma Nursing Process
Comprehensive Study Guide, Practice Exam Questions and Answers,
Exam Prep Test Bank, Trauma Patient Assessment, Primary and
Secondary Survey Review, Critical Thinking in Trauma Care, Emergency
Nursing Interventions, Injury Management Strategies, and Detailed
Rationales for Certification Preparation
Question 1: What is the primary goal of trauma triage?
A. Determine exact mechanism B. Route patient to right facility timely C. Initiate
definitive surgery D. Complete head-to-toe assessment
CORRECT ANSWER: B. Route patient to right facility timely
Rationale: Triage aims to minimize time to definitive care by routing severely injured
patients to appropriate trauma centers.
Question 2: Which designation indicates a comprehensive regional resource
providing definitive care for all aspects of trauma?
A. Level I B. Level II C. Level III D. Level IV
CORRECT ANSWER: A. Level I
Rationale: Level I trauma centers provide comprehensive care, research, and
education, serving as the highest level of definitive care.
Question 3: What is the primary function of a Level III trauma center?
A. Provide comprehensive research B. Stabilize and transfer severe trauma C. Manage
all surgical subspecialties D. Serve as a regional referral hub
CORRECT ANSWER: B. Stabilize and transfer severe trauma
Rationale: Level III centers stabilize patients and arrange transfer to higher-level centers
when definitive care is unavailable.
Question 4: What is the purpose of "zeroing the room" before patient arrival?
A. Assign patient roles B. Ensure all equipment is functional and available C. Clean the
trauma bay D. Review the patient's medical history
CORRECT ANSWER: B. Ensure all equipment is functional and available
Rationale: Zeroing the room ensures all necessary equipment is checked, functional,
and ready for immediate use.
Question 5: Who is responsible for maintaining the overall flow of the trauma
resuscitation?
A. Airway nurse B. Scribe C. Trauma team leader D. Primary nurse
CORRECT ANSWER: C. Trauma team leader
,Rationale: The team leader directs care, prioritizes interventions, and maintains the
overall flow of the resuscitation.
Question 6: What is the primary role of the scribe during a trauma resuscitation?
A. Administer medications B. Document care and interventions in real time C. Manage
the airway D. Communicate with the family
CORRECT ANSWER: B. Document care and interventions in real time
Rationale: The scribe accurately documents all assessments, interventions, and
medications in real time to maintain the medical record.
Question 7: What is the first priority in the primary survey of a trauma patient?
A. Breathing B. Circulation C. Airway with C-spine protection D. Disability
CORRECT ANSWER: C. Airway with C-spine protection
Rationale: The primary survey follows the ABCDE approach, starting with Airway
maintenance while protecting the cervical spine.
Question 8: Which maneuver is preferred to open the airway in a trauma patient
with suspected C-spine injury?
A. Head tilt-chin lift B. Jaw thrust C. Neck extension D. Cricoid pressure
CORRECT ANSWER: B. Jaw thrust
Rationale: The jaw thrust maneuver opens the airway without extending the neck,
protecting a potentially injured cervical spine.
Question 9: What Glasgow Coma Scale (GCS) score generally indicates the need for
an advanced airway?
A. 15 B. 12 C. 8 or less D. 10
CORRECT ANSWER: C. 8 or less
Rationale: A GCS of 8 or less indicates severe brain injury and inability to protect the
airway, necessitating intubation.
Question 10: When is an oropharyngeal airway (OPA) indicated?
A. Conscious patient with gag reflex B. Unconscious patient without a gag reflex C.
Patient with facial trauma D. Patient with a suspected C-spine injury
CORRECT ANSWER: B. Unconscious patient without a gag reflex
Rationale: OPAs are used in unconscious patients lacking a gag reflex to prevent
vomiting and aspiration.
Question 11: What is an absolute contraindication for inserting a nasopharyngeal
airway (NPA)?
,A. Seizure disorder B. Suspected basilar skull fracture C. Hypertension D. Diabetes
CORRECT ANSWER: B. Suspected basilar skull fracture
Rationale: NPA insertion is contraindicated in basilar skull fractures due to the risk of
intracranial placement.
Question 12: What is the recommended ventilation rate for an adult using a bag-
valve-mask (BVM)?
A. 5 breaths per minute B. 10 breaths per minute C. 20 breaths per minute D. 30 breaths
per minute
CORRECT ANSWER: B. 10 breaths per minute
Rationale: Adult BVM ventilation should be provided at a rate of 10 breaths per minute
to avoid hyperventilation.
Question 13: What concentration of oxygen does a nonrebreather mask typically
deliver?
A. 24-44% B. 40-60% C. 60-90% D. 100%
CORRECT ANSWER: C. 60-90%
Rationale: A nonrebreather mask with adequate flow delivers high-concentration
oxygen, typically 60-90%.
Question 14: When is a needle cricothyroidotomy primarily indicated?
A. Adult with facial trauma B. Child under 12 with airway obstruction C. Patient with a
neck hematoma D. Patient requiring long-term ventilation
CORRECT ANSWER: B. Child under 12 with airway obstruction
Rationale: Needle cricothyroidotomy is preferred in children under 12 because their
cricothyroid membrane is small and surgical airways risk damage.
Question 15: What is the preferred initial assessment technique for evaluating
breathing?
A. Palpation B. Inspection C. Percussion D. Auscultation
CORRECT ANSWER: B. Inspection
Rationale: Inspection is the first step in assessing breathing, evaluating chest rise,
symmetry, and work of breathing.
Question 16: Which assessment technique evaluates for subcutaneous
emphysema?
A. Inspection B. Palpation C. Percussion D. Auscultation
CORRECT ANSWER: B. Palpation
, Rationale: Palpation of the chest wall identifies crepitus, indicating subcutaneous
emphysema from a pneumothorax.
Question 17: What percussion note is expected over a tension pneumothorax?
A. Dullness B. Flatness C. Hyperresonance D. Tympany
CORRECT ANSWER: C. Hyperresonance
Rationale: Air in the pleural space causes a hyperresonant percussion note on the
affected side.
Question 18: What is the primary pathophysiological mechanism of a tension
pneumothorax?
A. Fluid in the pleural space B. Air entering but not leaving the pleural space C. Blood in
the pericardial sac D. Lung parenchyma collapse
CORRECT ANSWER: B. Air entering but not leaving the pleural space
Rationale: A one-way valve effect traps air, increasing intrathoracic pressure and
compressing the vena cava.
Question 19: Which clinical sign is a late indicator of tension pneumothorax?
A. Tracheal deviation B. Tachycardia C. Dyspnea D. Hypoxia
CORRECT ANSWER: A. Tracheal deviation
Rationale: Tracheal deviation away from the affected side is a late and ominous sign of
tension pneumothorax.
Question 20: What is the immediate treatment for a tension pneumothorax?
A. Needle decompression B. Chest tube insertion C. Intubation D. Fluid resuscitation
CORRECT ANSWER: A. Needle decompression
Rationale: Immediate needle decompression converts the tension pneumothorax to a
simple pneumothorax, relieving pressure.
Question 21: How is an open pneumothorax initially managed?
A. Occlusive dressing taped on three sides B. Completely sealed occlusive dressing C.
Immediate chest tube D. Needle decompression
CORRECT ANSWER: A. Occlusive dressing taped on three sides
Rationale: A three-sided dressing acts as a flutter valve, allowing air to escape during
exhalation but preventing entry during inhalation.
Question 22: What defines a hemothorax?
A. Air in the pleural space B. Blood in the pleural space C. Fluid in the pericardium D. Air
in the mediastinum
Comprehensive Study Guide, Practice Exam Questions and Answers,
Exam Prep Test Bank, Trauma Patient Assessment, Primary and
Secondary Survey Review, Critical Thinking in Trauma Care, Emergency
Nursing Interventions, Injury Management Strategies, and Detailed
Rationales for Certification Preparation
Question 1: What is the primary goal of trauma triage?
A. Determine exact mechanism B. Route patient to right facility timely C. Initiate
definitive surgery D. Complete head-to-toe assessment
CORRECT ANSWER: B. Route patient to right facility timely
Rationale: Triage aims to minimize time to definitive care by routing severely injured
patients to appropriate trauma centers.
Question 2: Which designation indicates a comprehensive regional resource
providing definitive care for all aspects of trauma?
A. Level I B. Level II C. Level III D. Level IV
CORRECT ANSWER: A. Level I
Rationale: Level I trauma centers provide comprehensive care, research, and
education, serving as the highest level of definitive care.
Question 3: What is the primary function of a Level III trauma center?
A. Provide comprehensive research B. Stabilize and transfer severe trauma C. Manage
all surgical subspecialties D. Serve as a regional referral hub
CORRECT ANSWER: B. Stabilize and transfer severe trauma
Rationale: Level III centers stabilize patients and arrange transfer to higher-level centers
when definitive care is unavailable.
Question 4: What is the purpose of "zeroing the room" before patient arrival?
A. Assign patient roles B. Ensure all equipment is functional and available C. Clean the
trauma bay D. Review the patient's medical history
CORRECT ANSWER: B. Ensure all equipment is functional and available
Rationale: Zeroing the room ensures all necessary equipment is checked, functional,
and ready for immediate use.
Question 5: Who is responsible for maintaining the overall flow of the trauma
resuscitation?
A. Airway nurse B. Scribe C. Trauma team leader D. Primary nurse
CORRECT ANSWER: C. Trauma team leader
,Rationale: The team leader directs care, prioritizes interventions, and maintains the
overall flow of the resuscitation.
Question 6: What is the primary role of the scribe during a trauma resuscitation?
A. Administer medications B. Document care and interventions in real time C. Manage
the airway D. Communicate with the family
CORRECT ANSWER: B. Document care and interventions in real time
Rationale: The scribe accurately documents all assessments, interventions, and
medications in real time to maintain the medical record.
Question 7: What is the first priority in the primary survey of a trauma patient?
A. Breathing B. Circulation C. Airway with C-spine protection D. Disability
CORRECT ANSWER: C. Airway with C-spine protection
Rationale: The primary survey follows the ABCDE approach, starting with Airway
maintenance while protecting the cervical spine.
Question 8: Which maneuver is preferred to open the airway in a trauma patient
with suspected C-spine injury?
A. Head tilt-chin lift B. Jaw thrust C. Neck extension D. Cricoid pressure
CORRECT ANSWER: B. Jaw thrust
Rationale: The jaw thrust maneuver opens the airway without extending the neck,
protecting a potentially injured cervical spine.
Question 9: What Glasgow Coma Scale (GCS) score generally indicates the need for
an advanced airway?
A. 15 B. 12 C. 8 or less D. 10
CORRECT ANSWER: C. 8 or less
Rationale: A GCS of 8 or less indicates severe brain injury and inability to protect the
airway, necessitating intubation.
Question 10: When is an oropharyngeal airway (OPA) indicated?
A. Conscious patient with gag reflex B. Unconscious patient without a gag reflex C.
Patient with facial trauma D. Patient with a suspected C-spine injury
CORRECT ANSWER: B. Unconscious patient without a gag reflex
Rationale: OPAs are used in unconscious patients lacking a gag reflex to prevent
vomiting and aspiration.
Question 11: What is an absolute contraindication for inserting a nasopharyngeal
airway (NPA)?
,A. Seizure disorder B. Suspected basilar skull fracture C. Hypertension D. Diabetes
CORRECT ANSWER: B. Suspected basilar skull fracture
Rationale: NPA insertion is contraindicated in basilar skull fractures due to the risk of
intracranial placement.
Question 12: What is the recommended ventilation rate for an adult using a bag-
valve-mask (BVM)?
A. 5 breaths per minute B. 10 breaths per minute C. 20 breaths per minute D. 30 breaths
per minute
CORRECT ANSWER: B. 10 breaths per minute
Rationale: Adult BVM ventilation should be provided at a rate of 10 breaths per minute
to avoid hyperventilation.
Question 13: What concentration of oxygen does a nonrebreather mask typically
deliver?
A. 24-44% B. 40-60% C. 60-90% D. 100%
CORRECT ANSWER: C. 60-90%
Rationale: A nonrebreather mask with adequate flow delivers high-concentration
oxygen, typically 60-90%.
Question 14: When is a needle cricothyroidotomy primarily indicated?
A. Adult with facial trauma B. Child under 12 with airway obstruction C. Patient with a
neck hematoma D. Patient requiring long-term ventilation
CORRECT ANSWER: B. Child under 12 with airway obstruction
Rationale: Needle cricothyroidotomy is preferred in children under 12 because their
cricothyroid membrane is small and surgical airways risk damage.
Question 15: What is the preferred initial assessment technique for evaluating
breathing?
A. Palpation B. Inspection C. Percussion D. Auscultation
CORRECT ANSWER: B. Inspection
Rationale: Inspection is the first step in assessing breathing, evaluating chest rise,
symmetry, and work of breathing.
Question 16: Which assessment technique evaluates for subcutaneous
emphysema?
A. Inspection B. Palpation C. Percussion D. Auscultation
CORRECT ANSWER: B. Palpation
, Rationale: Palpation of the chest wall identifies crepitus, indicating subcutaneous
emphysema from a pneumothorax.
Question 17: What percussion note is expected over a tension pneumothorax?
A. Dullness B. Flatness C. Hyperresonance D. Tympany
CORRECT ANSWER: C. Hyperresonance
Rationale: Air in the pleural space causes a hyperresonant percussion note on the
affected side.
Question 18: What is the primary pathophysiological mechanism of a tension
pneumothorax?
A. Fluid in the pleural space B. Air entering but not leaving the pleural space C. Blood in
the pericardial sac D. Lung parenchyma collapse
CORRECT ANSWER: B. Air entering but not leaving the pleural space
Rationale: A one-way valve effect traps air, increasing intrathoracic pressure and
compressing the vena cava.
Question 19: Which clinical sign is a late indicator of tension pneumothorax?
A. Tracheal deviation B. Tachycardia C. Dyspnea D. Hypoxia
CORRECT ANSWER: A. Tracheal deviation
Rationale: Tracheal deviation away from the affected side is a late and ominous sign of
tension pneumothorax.
Question 20: What is the immediate treatment for a tension pneumothorax?
A. Needle decompression B. Chest tube insertion C. Intubation D. Fluid resuscitation
CORRECT ANSWER: A. Needle decompression
Rationale: Immediate needle decompression converts the tension pneumothorax to a
simple pneumothorax, relieving pressure.
Question 21: How is an open pneumothorax initially managed?
A. Occlusive dressing taped on three sides B. Completely sealed occlusive dressing C.
Immediate chest tube D. Needle decompression
CORRECT ANSWER: A. Occlusive dressing taped on three sides
Rationale: A three-sided dressing acts as a flutter valve, allowing air to escape during
exhalation but preventing entry during inhalation.
Question 22: What defines a hemothorax?
A. Air in the pleural space B. Blood in the pleural space C. Fluid in the pericardium D. Air
in the mediastinum
