TNCC Exam Questions & Answers (Latest 2023 / 2024)

TNCC EXAM
Initial Assessment

1. Preparation and Triage
2. Primary Survey (A, B, C, D & E) with resuscitation adjuncts (F, G)
3. Reevaluation (consideration of transfer)
4. Secondary Survey (H, I) with reevaluation adjuncts
5. Reevaluation and post resuscitation care
6. Definitive care of transfer to an appropriate trauma nurse
   ABCDEFGHI
7. A – Airway and Alertness with simultaneous cervical spinal stabilization
8. B – Breathing and Ventilation
9. C – Circulation and control of hemorrhage
10. D – Disability (neurologic status)
11. E – Exposure and Environmental Control
12. F – Full set of vitals and Family presence
13. 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 carbon
    dioxide (ETC02) monitoring and capnography
14. H – History and head to toe assessment
15. I – Inspect posterior surfaces

When should PPE be placed?
Before the arrival of the pt
Safe Care:
Pt is at hospital in the right amount of time, right care, right trauma facility, right
resources
Major cause of preventable death?
Uncontrolled Hemorrhage
If uncontrolled hemorrhage?
Reorganize care to C-ABC
Airway and AVPU:
Used at the beginning of the initial assessment

1. An 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 check 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?
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?
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:

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
   Auscultate or listen for:
7. Obstructive airway sounds such as snoring or gurgling
8. Possible occlusive maxillofacial bony deformity
9. Subcutaneous emphysema
   If the pt has a definitive airway in what should you do?
10. Check the presence of adequate rise and fall of the chest with assisted ventilation
11. Absence of gurgling on auscultation over the epigastrium
12. Bilateral breath sounds present on auscultation
13. Presence of carbon dioxide (CO2) verified by a CO2 device or monitor