CAISS Final Exam 2026/2027 | Certified Abbreviated Injury Scale
Specialist Certification Exam Study Guide, CAISS Exam Prep, AIS
Coding, Injury Severity Scoring, Trauma Registry, Injury
Identification, Anatomy, Medical Terminology, Trauma
Documentation, AIS Coding Rules, Practice Questions, Answers &
Rationales
Question 1: A client with a history of alcohol use disorder is admitted with
confusion, ataxia, and ophthalmoplegia. Which condition should the nurse
suspect?
A. Hepatic encephalopathy
B. Wernicke encephalopathy
C. Korsakoff syndrome
D. Delirium tremens
CORRECT ANSWER: B. Wernicke encephalopathy
Rationale: Wernicke encephalopathy is an acute neurological condition caused by
thiamine (vitamin B1) deficiency, commonly seen in clients with chronic alcohol
use. The classic triad includes confusion, ataxia, and ophthalmoplegia. Immediate
thiamine replacement is essential to prevent progression to Korsakoff syndrome.
Question 2: A nurse is caring for a client experiencing acute alcohol withdrawal.
Which assessment finding indicates the highest risk for complications?
A. Heart rate of 92 beats per minute
B. Blood pressure of 138/86 mm Hg
C. Temperature of 101.8°F (38.8°C)
D. Respiratory rate of 18 breaths per minute
CORRECT ANSWER: C. Temperature of 101.8°F (38.8°C)
Rationale: Fever during alcohol withdrawal may indicate impending delirium
tremens, a medical emergency associated with autonomic hyperactivity, severe
agitation, and seizures. Elevated temperature requires immediate intervention
and close monitoring.
Question 3: A client with cirrhosis is admitted with ascites. Which intervention
should the nurse implement first?
,A. Administer furosemide as prescribed
B. Measure abdominal girth daily
C. Restrict dietary sodium intake
D. Assess respiratory status and oxygenation
CORRECT ANSWER: D. Assess respiratory status and oxygenation
Rationale: Ascites can cause upward displacement of the diaphragm, leading to
respiratory compromise. The nurse's priority is to assess airway, breathing, and
circulation. Respiratory status must be evaluated before other interventions.
Question 4: A client is prescribed lactulose for hepatic encephalopathy. Which
finding indicates therapeutic effectiveness?
A. Increased urine output
B. Decreased serum ammonia level
C. Improved appetite
D. Decreased abdominal girth
CORRECT ANSWER: B. Decreased serum ammonia level
Rationale: Lactulose traps ammonia in the gut and promotes its excretion through
stool. A decrease in serum ammonia level indicates the medication is working.
The nurse should also monitor for increased bowel movements as an expected
effect.
Question 5: A nurse is assessing a client with suspected peptic ulcer disease.
Which symptom is most characteristic of a duodenal ulcer?
A. Pain that worsens with eating
B. Pain relieved by food intake
C. Hematemesis immediately after meals
D. Pain localized to the left upper quadrant
CORRECT ANSWER: B. Pain relieved by food intake
Rationale: Duodenal ulcers typically cause pain that is relieved by eating because
food buffers gastric acid. Pain often returns 2 to 4 hours after meals and may
awaken the client at night. Gastric ulcers, by contrast, cause pain that worsens
with eating.
,Question 6: A client is admitted with upper gastrointestinal bleeding. Which
finding requires immediate notification of the provider?
A. Hemoglobin of 11.2 g/dL
B. Heart rate of 118 beats per minute
C. Blood pressure of 110/70 mm Hg
D. Dark, tarry stool
CORRECT ANSWER: B. Heart rate of 118 beats per minute
Rationale: Tachycardia is an early compensatory sign of hypovolemic shock from
blood loss. A heart rate of 118 beats per minute indicates significant volume
depletion and requires immediate provider notification and intervention.
Question 7: A nurse is teaching a client about preventing dumping syndrome
after gastric surgery. Which instruction should the nurse include?
A. Drink fluids with meals
B. Eat three large meals daily
C. Lie down after eating
D. Consume high-carbohydrate meals
CORRECT ANSWER: C. Lie down after eating
Rationale: Lying down after meals slows gastric emptying and reduces the rapid
delivery of food to the small intestine, helping prevent dumping syndrome.
Clients should also eat small, frequent meals and avoid fluids with meals.
Question 8: A client with ulcerative colitis is experiencing frequent bloody
diarrhea. Which complication should the nurse monitor for?
A. Weight gain
B. Hyperkalemia
C. Fluid volume deficit
D. Increased hemoglobin
CORRECT ANSWER: C. Fluid volume deficit
Rationale: Frequent bloody diarrhea leads to significant fluid and electrolyte
losses. The nurse should monitor for signs of dehydration, including tachycardia,
hypotension, dry mucous membranes, and decreased urine output.
, Question 9: A nurse is caring for a client with a new ileostomy. Which finding
should be reported immediately?
A. Output of 500 mL in 24 hours
B. Stoma that is pink and moist
C. Stoma that appears dark and dusky
D. Mild peristomal skin irritation
CORRECT ANSWER: C. Stoma that appears dark and dusky
Rationale: A dark, dusky, or cyanotic stoma indicates inadequate blood supply and
possible necrosis. This is a medical emergency requiring immediate provider
notification to prevent further tissue damage.
Question 10: A client with Crohn's disease is prescribed sulfasalazine. Which
instruction should the nurse include in teaching?
A. Take the medication on an empty stomach
B. Increase fluid intake and report decreased urine output
C. Expect dark stools as a common side effect
D. Discontinue the medication if nausea occurs
CORRECT ANSWER: B. Increase fluid intake and report decreased urine output
Rationale: Sulfasalazine can cause crystalluria and kidney stone formation. Clients
should maintain adequate hydration and report any decrease in urine output or
flank pain. Taking the medication with food reduces gastrointestinal upset.
Question 11: A nurse is assessing a client with acute pancreatitis. Which
laboratory finding is most indicative of this condition?
A. Decreased serum amylase
B. Elevated serum lipase
C. Decreased serum glucose
D. Elevated hemoglobin
CORRECT ANSWER: B. Elevated serum lipase
Rationale: Serum lipase is the most specific and sensitive marker for acute
pancreatitis. It remains elevated longer than amylase and is considered the gold
Specialist Certification Exam Study Guide, CAISS Exam Prep, AIS
Coding, Injury Severity Scoring, Trauma Registry, Injury
Identification, Anatomy, Medical Terminology, Trauma
Documentation, AIS Coding Rules, Practice Questions, Answers &
Rationales
Question 1: A client with a history of alcohol use disorder is admitted with
confusion, ataxia, and ophthalmoplegia. Which condition should the nurse
suspect?
A. Hepatic encephalopathy
B. Wernicke encephalopathy
C. Korsakoff syndrome
D. Delirium tremens
CORRECT ANSWER: B. Wernicke encephalopathy
Rationale: Wernicke encephalopathy is an acute neurological condition caused by
thiamine (vitamin B1) deficiency, commonly seen in clients with chronic alcohol
use. The classic triad includes confusion, ataxia, and ophthalmoplegia. Immediate
thiamine replacement is essential to prevent progression to Korsakoff syndrome.
Question 2: A nurse is caring for a client experiencing acute alcohol withdrawal.
Which assessment finding indicates the highest risk for complications?
A. Heart rate of 92 beats per minute
B. Blood pressure of 138/86 mm Hg
C. Temperature of 101.8°F (38.8°C)
D. Respiratory rate of 18 breaths per minute
CORRECT ANSWER: C. Temperature of 101.8°F (38.8°C)
Rationale: Fever during alcohol withdrawal may indicate impending delirium
tremens, a medical emergency associated with autonomic hyperactivity, severe
agitation, and seizures. Elevated temperature requires immediate intervention
and close monitoring.
Question 3: A client with cirrhosis is admitted with ascites. Which intervention
should the nurse implement first?
,A. Administer furosemide as prescribed
B. Measure abdominal girth daily
C. Restrict dietary sodium intake
D. Assess respiratory status and oxygenation
CORRECT ANSWER: D. Assess respiratory status and oxygenation
Rationale: Ascites can cause upward displacement of the diaphragm, leading to
respiratory compromise. The nurse's priority is to assess airway, breathing, and
circulation. Respiratory status must be evaluated before other interventions.
Question 4: A client is prescribed lactulose for hepatic encephalopathy. Which
finding indicates therapeutic effectiveness?
A. Increased urine output
B. Decreased serum ammonia level
C. Improved appetite
D. Decreased abdominal girth
CORRECT ANSWER: B. Decreased serum ammonia level
Rationale: Lactulose traps ammonia in the gut and promotes its excretion through
stool. A decrease in serum ammonia level indicates the medication is working.
The nurse should also monitor for increased bowel movements as an expected
effect.
Question 5: A nurse is assessing a client with suspected peptic ulcer disease.
Which symptom is most characteristic of a duodenal ulcer?
A. Pain that worsens with eating
B. Pain relieved by food intake
C. Hematemesis immediately after meals
D. Pain localized to the left upper quadrant
CORRECT ANSWER: B. Pain relieved by food intake
Rationale: Duodenal ulcers typically cause pain that is relieved by eating because
food buffers gastric acid. Pain often returns 2 to 4 hours after meals and may
awaken the client at night. Gastric ulcers, by contrast, cause pain that worsens
with eating.
,Question 6: A client is admitted with upper gastrointestinal bleeding. Which
finding requires immediate notification of the provider?
A. Hemoglobin of 11.2 g/dL
B. Heart rate of 118 beats per minute
C. Blood pressure of 110/70 mm Hg
D. Dark, tarry stool
CORRECT ANSWER: B. Heart rate of 118 beats per minute
Rationale: Tachycardia is an early compensatory sign of hypovolemic shock from
blood loss. A heart rate of 118 beats per minute indicates significant volume
depletion and requires immediate provider notification and intervention.
Question 7: A nurse is teaching a client about preventing dumping syndrome
after gastric surgery. Which instruction should the nurse include?
A. Drink fluids with meals
B. Eat three large meals daily
C. Lie down after eating
D. Consume high-carbohydrate meals
CORRECT ANSWER: C. Lie down after eating
Rationale: Lying down after meals slows gastric emptying and reduces the rapid
delivery of food to the small intestine, helping prevent dumping syndrome.
Clients should also eat small, frequent meals and avoid fluids with meals.
Question 8: A client with ulcerative colitis is experiencing frequent bloody
diarrhea. Which complication should the nurse monitor for?
A. Weight gain
B. Hyperkalemia
C. Fluid volume deficit
D. Increased hemoglobin
CORRECT ANSWER: C. Fluid volume deficit
Rationale: Frequent bloody diarrhea leads to significant fluid and electrolyte
losses. The nurse should monitor for signs of dehydration, including tachycardia,
hypotension, dry mucous membranes, and decreased urine output.
, Question 9: A nurse is caring for a client with a new ileostomy. Which finding
should be reported immediately?
A. Output of 500 mL in 24 hours
B. Stoma that is pink and moist
C. Stoma that appears dark and dusky
D. Mild peristomal skin irritation
CORRECT ANSWER: C. Stoma that appears dark and dusky
Rationale: A dark, dusky, or cyanotic stoma indicates inadequate blood supply and
possible necrosis. This is a medical emergency requiring immediate provider
notification to prevent further tissue damage.
Question 10: A client with Crohn's disease is prescribed sulfasalazine. Which
instruction should the nurse include in teaching?
A. Take the medication on an empty stomach
B. Increase fluid intake and report decreased urine output
C. Expect dark stools as a common side effect
D. Discontinue the medication if nausea occurs
CORRECT ANSWER: B. Increase fluid intake and report decreased urine output
Rationale: Sulfasalazine can cause crystalluria and kidney stone formation. Clients
should maintain adequate hydration and report any decrease in urine output or
flank pain. Taking the medication with food reduces gastrointestinal upset.
Question 11: A nurse is assessing a client with acute pancreatitis. Which
laboratory finding is most indicative of this condition?
A. Decreased serum amylase
B. Elevated serum lipase
C. Decreased serum glucose
D. Elevated hemoglobin
CORRECT ANSWER: B. Elevated serum lipase
Rationale: Serum lipase is the most specific and sensitive marker for acute
pancreatitis. It remains elevated longer than amylase and is considered the gold
