What Is the Format of the TNCC Exam? (2025 Complete Breakdown)

When I was first preparing for the Trauma Nursing Core Course (TNCC) exam, one of my biggest questions was: “What does the TNCC exam format actually look like?” Knowing the exam structure makes studying so much easier — because you’ll know exactly what to expect on test day. Let’s break down the written test, the skills station, and how both work together in 2025.

Overview of the TNCC Exam Format

The TNCC exam, developed by the Emergency Nurses Association (ENA), is designed to test both your theoretical knowledge and your hands-on trauma nursing skills. To earn your TNCC certification, you must successfully pass two components:

  1. Written Exam (Multiple Choice)
  2. Skills Station (Trauma Nursing Process Test)

You must pass both parts to be awarded your provider card.

Format of the TNCC Written Exam

The written test is the first major component of the TNCC exam.

  • Question Type: Multiple choice (single best answer).
  • Number of Questions: 50 questions.
  • Passing Score: 80% (40 out of 50 correct).
  • Time Limit: Typically 2 hours, though many finish sooner.
  • Content Source: All questions are based directly on the TNCC Provider Manual (9th Edition, 2025 updates included).

Written Exam Focus Areas:

  • Primary survey (ABCDE approach).
  • Secondary survey and ongoing assessment.
  • Shock recognition and management.
  • Head, chest, abdominal, and musculoskeletal trauma.
  • Special populations (pediatrics, geriatrics, pregnancy).

Format of the TNCC Skills Station

The second part of the exam is the skills check, also called the Trauma Nursing Process test. This is a hands-on, pass/fail station where you demonstrate trauma care in real time.

  • Structure: You’re given a simulated trauma patient scenario.
  • Task: Perform the ABCDE primary survey and initial interventions systematically.
  • Scoring: Evaluators use a checklist of critical actions you must complete.
  • Outcome: Missing a critical action (like securing an airway or controlling major bleeding) usually means failing the station.

Unlike the written exam, the skills test isn’t about choosing an answer — it’s about showing you can think, prioritize, and act under pressure.

How the Two Parts Work Together

To pass the TNCC certification exam:

  • You must score at least 80% on the written exam, and
  • Successfully pass the skills station.

Failing either part means you won’t earn certification, but many facilities allow a retest option depending on local ENA policy.

Pro Study Tip 📘

Knowing the TNCC exam format is the first step — the next step is practicing it.

👉 Check out our TNCC Practice Questions + Study Guide — designed to mirror both the written multiple-choice exam and the trauma process scenarios. Updated for 2025, it’s the best way to prepare for the real format and walk in ready.

Written Exam vs Skills Station

Component Format Passing Requirement Focus Difficulty Level
Written Exam 50 multiple-choice questions 80% (40 correct) Trauma knowledge, theory, protocols Moderate
Skills Station Hands-on trauma scenario Pass/fail (must complete all critical steps) Trauma nursing process, ABCDE, quick decision-making High-pressure
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