Page 1 of 107
EMERGENCY NURSE PRACTITIONER (ENP EXAM)
QUESTIONS AND CORRECT ANSWERS
EMERGENCY NURSE PRACTITIONER (ENP) ULTIMATE EXAM Practice Questions
10 MOST TESTED EXAM COVERAGE AREAS
1. Medical Screening & Patient Acuity (16%) - Performing focused history and physical exams
based on chief complaint, establishing patient acuity levels to determine need for rapid
regulations
2. Medical Decision Making & Differential Diagnosis (24%) - Identifying differential diagnoses
based on greatest likelihood of occurrence, prioritizing differentials considering risk of morbidity
or mortality, and evaluating diagnostic studies based on differential diagnoses
3. Patient Management & Resuscitation (36%) - Rapid intervention to resuscitate/stabilize
patients, prescribing appropriate pharmacologic agents, initiating non-pharmacologic
therapeutic interventions, performing diagnostic and therapeutic procedures, consulting with
other healthcare providers, and prioritizing multiple patients of varying acuity simultaneously
4. Transitions of Care & Disposition (16%) - Determining appropriate and timely patient
disposition including admission, discharge, observation, or transfer, formulating specific
disposition plans with appropriate resource utilization, and engaging patients/caregivers to
coordinate transitions of care
5. Professional Practices & Regulatory Compliance (8%) - Integrating diverse, equitable, and
inclusive practices into patient management, managing unique needs of vulnerable populations,
demonstrating knowledge of EMTALA regulations, and adhering to professional, ethical, quality,
safety, and regulatory/legal standards in emergency care
6. Thoracic-Respiratory & Cardiovascular Disorders (21%) - Management of respiratory distress,
asthma, COPD exacerbation, pneumonia, pulmonary embolism, acute coronary syndrome, heart
failure, arrhythmias, and hypertensive emergencies across the lifespan
7. Abdominal & Gastrointestinal Disorders (13%) - Acute abdomen evaluation, appendicitis, bowel
obstruction, pancreatitis, cholecystitis, gastrointestinal bleeding, diverticulitis, and perforated
viscus management
8. Traumatic Disorders & Musculoskeletal Injuries (15%) - Primary and secondary trauma survey,
fracture and dislocation management, compartment syndrome, spinal cord injury, traumatic
brain injury, penetrating and blunt trauma, and soft tissue injury management
9. Neurological & Psychobehavioral Disorders (12%) - Stroke assessment and management,
seizure disorders, altered mental status, headache, meningitis, substance use disorders, suicidal
ideation, agitation management, and psychiatric emergencies
10. Procedural Skills & Emergency Interventions - Airway management (intubation, surgical airway,
mechanical ventilation), resuscitation (CPR, defibrillation, vascular access), procedural sedation,
wound closure, fracture reduction, lumbar puncture, thoracentesis, pericardiocentesis, and
point-of-care ultrasound
SECTION 1: MEDICAL SCREENING & PATIENT ACUITY (Questions 1-30)
, Page 2 of 107
1. A 24-year-old male presents after a motor vehicle collision with a GCS of 15, chest pain, and
tachypnea. According to the primary survey framework used in emergency care, which component
should be addressed first to ensure patient safety and proper stabilization?
A) Breathing and ventilation to assess for pneumothorax or hemothorax
B) Circulation with hemorrhage control to identify life-threatening bleeding
C) Airway with cervical spine protection to prevent hypoxia and further injury
D) Disability (neurologic status) to establish baseline GCS
Correct Answer: C
Rationale: The primary survey follows ABCDE; airway with C-spine protection is always the first priority
to prevent hypoxia and further injury .
2. According to EMTALA regulations, which of the following is legally required for every individual who
presents to an emergency department requesting care, regardless of their ability to pay?
A) Full definitive treatment for all presenting complaints before any assessment
B) A medical screening examination to determine presence of an emergency medical condition
C) Admission to the hospital if the patient requests to be admitted
D) Immediate discharge if the patient cannot provide proof of insurance
, Page 3 of 107
Correct Answer: B
Rationale: EMTALA obligates hospitals to perform a medical screening exam to identify emergency
medical conditions, irrespective of ability to pay .
3. A 68-year-old female presents with acute onset of right-sided weakness and difficulty speaking that
began 45 minutes ago. What is the most appropriate initial step in the medical screening of this
patient?
A) Obtain a stat CT head without contrast
B) Perform a focused neurological examination and establish time of symptom onset
C) Administer aspirin 325 mg immediately
D) Order a complete blood count and coagulation panel
Correct Answer: B
Rationale: The initial step in stroke screening is performing a focused neurological examination and
establishing the exact time of symptom onset to determine eligibility for thrombolytic therapy. CT head
is important but follows the initial assessment .
4. A patient presents with chest pain and an ECG showing ST-segment elevation in leads II, III, and
aVF. What is the most appropriate initial step in the medical screening and management of this
patient?
, Page 4 of 107
A) Administer sublingual nitroglycerin and obtain serial troponins
B) Activate the STEMI protocol and arrange immediate reperfusion therapy
C) Order a transthoracic echocardiogram to assess wall motion
D) Begin a high-dose intravenous beta-blocker infusion
Correct Answer: B
Rationale: ST-segment elevation myocardial infarction (STEMI) requires rapid activation of the
reperfusion pathway (PCI or thrombolysis) to restore coronary flow and limit myocardial damage .
5. A 2-year-old child presents with respiratory distress, stridor, and drooling. On examination, the
child is sitting upright with the neck extended and is febrile. What is the most appropriate initial step
in the medical screening of this patient?
A) Perform a throat examination using a tongue depressor
B) Obtain a lateral neck radiograph in the emergency department
C) Maintain the child in a position of comfort and prepare for potential airway intervention
D) Administer nebulized racemic epinephrine
Correct Answer: C
Rationale: This presentation is concerning for epiglottitis. The child should be maintained in a position of
comfort; throat examination and radiographs should not be performed as they may precipitate airway
obstruction .
EMERGENCY NURSE PRACTITIONER (ENP EXAM)
QUESTIONS AND CORRECT ANSWERS
EMERGENCY NURSE PRACTITIONER (ENP) ULTIMATE EXAM Practice Questions
10 MOST TESTED EXAM COVERAGE AREAS
1. Medical Screening & Patient Acuity (16%) - Performing focused history and physical exams
based on chief complaint, establishing patient acuity levels to determine need for rapid
regulations
2. Medical Decision Making & Differential Diagnosis (24%) - Identifying differential diagnoses
based on greatest likelihood of occurrence, prioritizing differentials considering risk of morbidity
or mortality, and evaluating diagnostic studies based on differential diagnoses
3. Patient Management & Resuscitation (36%) - Rapid intervention to resuscitate/stabilize
patients, prescribing appropriate pharmacologic agents, initiating non-pharmacologic
therapeutic interventions, performing diagnostic and therapeutic procedures, consulting with
other healthcare providers, and prioritizing multiple patients of varying acuity simultaneously
4. Transitions of Care & Disposition (16%) - Determining appropriate and timely patient
disposition including admission, discharge, observation, or transfer, formulating specific
disposition plans with appropriate resource utilization, and engaging patients/caregivers to
coordinate transitions of care
5. Professional Practices & Regulatory Compliance (8%) - Integrating diverse, equitable, and
inclusive practices into patient management, managing unique needs of vulnerable populations,
demonstrating knowledge of EMTALA regulations, and adhering to professional, ethical, quality,
safety, and regulatory/legal standards in emergency care
6. Thoracic-Respiratory & Cardiovascular Disorders (21%) - Management of respiratory distress,
asthma, COPD exacerbation, pneumonia, pulmonary embolism, acute coronary syndrome, heart
failure, arrhythmias, and hypertensive emergencies across the lifespan
7. Abdominal & Gastrointestinal Disorders (13%) - Acute abdomen evaluation, appendicitis, bowel
obstruction, pancreatitis, cholecystitis, gastrointestinal bleeding, diverticulitis, and perforated
viscus management
8. Traumatic Disorders & Musculoskeletal Injuries (15%) - Primary and secondary trauma survey,
fracture and dislocation management, compartment syndrome, spinal cord injury, traumatic
brain injury, penetrating and blunt trauma, and soft tissue injury management
9. Neurological & Psychobehavioral Disorders (12%) - Stroke assessment and management,
seizure disorders, altered mental status, headache, meningitis, substance use disorders, suicidal
ideation, agitation management, and psychiatric emergencies
10. Procedural Skills & Emergency Interventions - Airway management (intubation, surgical airway,
mechanical ventilation), resuscitation (CPR, defibrillation, vascular access), procedural sedation,
wound closure, fracture reduction, lumbar puncture, thoracentesis, pericardiocentesis, and
point-of-care ultrasound
SECTION 1: MEDICAL SCREENING & PATIENT ACUITY (Questions 1-30)
, Page 2 of 107
1. A 24-year-old male presents after a motor vehicle collision with a GCS of 15, chest pain, and
tachypnea. According to the primary survey framework used in emergency care, which component
should be addressed first to ensure patient safety and proper stabilization?
A) Breathing and ventilation to assess for pneumothorax or hemothorax
B) Circulation with hemorrhage control to identify life-threatening bleeding
C) Airway with cervical spine protection to prevent hypoxia and further injury
D) Disability (neurologic status) to establish baseline GCS
Correct Answer: C
Rationale: The primary survey follows ABCDE; airway with C-spine protection is always the first priority
to prevent hypoxia and further injury .
2. According to EMTALA regulations, which of the following is legally required for every individual who
presents to an emergency department requesting care, regardless of their ability to pay?
A) Full definitive treatment for all presenting complaints before any assessment
B) A medical screening examination to determine presence of an emergency medical condition
C) Admission to the hospital if the patient requests to be admitted
D) Immediate discharge if the patient cannot provide proof of insurance
, Page 3 of 107
Correct Answer: B
Rationale: EMTALA obligates hospitals to perform a medical screening exam to identify emergency
medical conditions, irrespective of ability to pay .
3. A 68-year-old female presents with acute onset of right-sided weakness and difficulty speaking that
began 45 minutes ago. What is the most appropriate initial step in the medical screening of this
patient?
A) Obtain a stat CT head without contrast
B) Perform a focused neurological examination and establish time of symptom onset
C) Administer aspirin 325 mg immediately
D) Order a complete blood count and coagulation panel
Correct Answer: B
Rationale: The initial step in stroke screening is performing a focused neurological examination and
establishing the exact time of symptom onset to determine eligibility for thrombolytic therapy. CT head
is important but follows the initial assessment .
4. A patient presents with chest pain and an ECG showing ST-segment elevation in leads II, III, and
aVF. What is the most appropriate initial step in the medical screening and management of this
patient?
, Page 4 of 107
A) Administer sublingual nitroglycerin and obtain serial troponins
B) Activate the STEMI protocol and arrange immediate reperfusion therapy
C) Order a transthoracic echocardiogram to assess wall motion
D) Begin a high-dose intravenous beta-blocker infusion
Correct Answer: B
Rationale: ST-segment elevation myocardial infarction (STEMI) requires rapid activation of the
reperfusion pathway (PCI or thrombolysis) to restore coronary flow and limit myocardial damage .
5. A 2-year-old child presents with respiratory distress, stridor, and drooling. On examination, the
child is sitting upright with the neck extended and is febrile. What is the most appropriate initial step
in the medical screening of this patient?
A) Perform a throat examination using a tongue depressor
B) Obtain a lateral neck radiograph in the emergency department
C) Maintain the child in a position of comfort and prepare for potential airway intervention
D) Administer nebulized racemic epinephrine
Correct Answer: C
Rationale: This presentation is concerning for epiglottitis. The child should be maintained in a position of
comfort; throat examination and radiographs should not be performed as they may precipitate airway
obstruction .
