UTA NURS 5338 Urgent Emergencies
Across the Lifespan Exam ACTUAL
EXAM 2026/2027 | Urgent
Emergencies | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: Triage & Rapid Assessment Across the Lifespan (10 Questions)
Q1: A 4-year-old child is brought to the emergency department by parents. The Pediatric Assessment
Triangle reveals: Appearance – interactive, smiling; Work of Breathing – mild nasal flaring, no
retractions; Circulation to Skin – pink with brisk capillary refill. Using the Emergency Severity Index (ESI),
what is the appropriate triage level?
A. ESI Level 1 (requires immediate life-saving intervention)
B. ESI Level 2 (high-risk situation, confused/lethargic/disoriented or severe pain/distress)
C. ESI Level 3 (stable, multiple resources needed)
D. ESI Level 4 (stable, one resource needed) [CORRECT]
Rationale: Per ESI Triage Algorithm (AHRQ/ENA), this child has stable appearance, mild increased work
of breathing without severe distress, and normal circulation. No high-risk features, no severe pain, and
likely needs only one resource (possible nasal suctioning or simple intervention). ESI Level 4 is
appropriate for stable patients requiring one resource.
Distractor A: No life-threatening condition present; child is interactive and stable.
Distractor B: No high-risk features; child is not confused, lethargic, or in severe distress.
Distractor C: Multiple resources not anticipated; child appears stable with minimal intervention
needed.
,Q2: An 82-year-old female presents with "feeling weak" for 2 days. Vital signs: BP 110/70, HR 105, RR
18, Temp 38.1°C (100.6°F), O2 sat 95%. She is alert but slightly confused to date. White blood cell count
is 14,000. What is the MOST concerning finding requiring immediate intervention?
A. Systolic BP of 110
B. Altered mental status with fever and tachycardia [CORRECT]
C. Respiratory rate of 18
D. O2 saturation of 95%
Rationale: Per ACEP Geriatric Emergency Medicine guidelines, altered mental status in elderly with
infection (evidenced by fever and leukocytosis) indicates possible sepsis or severe infection. This is a
high-risk presentation requiring immediate evaluation and possible sepsis protocol activation. Geriatric
patients often present atypically with "weakness" rather than classic symptoms.
Distractor A: Systolic BP 110 is low-normal but not immediately concerning without other signs
of shock.
Distractor C: RR 18 is within normal range (12-20).
Distractor D: O2 sat 95% is acceptable; not immediately concerning.
Q3: In a mass casualty incident using START triage, a victim has spontaneous respirations, RR 24,
capillary refill 3 seconds, and follows commands. What is the appropriate triage category?
A. Immediate (Red)
B. Delayed (Yellow) [CORRECT]
C. Minimal (Green)
D. Expectant (Black)
Rationale: Per START (Simple Triage and Rapid Treatment) protocol: Respirations present, RR <30 (pass);
Perfusion: capillary refill <2 seconds is deferred, but 3 seconds suggests possible compromise; Mental
status: follows commands (pass). This patient has one failure (capillary refill), placing them in Delayed
(Yellow) category. They need medical care but can wait for Immediate (Red) patients.
Distractor A: Immediate requires respiratory failure, no radial pulse, or altered mental status.
Distractor C: Minimal (Green) requires all START criteria to pass (RPM: Respirations, Perfusion,
Mental status).
Distractor D: Expectant is for unsalvageable or those who fail all criteria with minimal chance of
survival.
,Q4: A 6-month-old infant presents with fever of 39.5°C (103.1°F) and irritability. The nurse practitioner
notes bulging fontanelle, stiff neck, and petechial rash. What is the FIRST priority intervention?
A. Obtain detailed family history
B. Administer empiric antibiotics immediately [CORRECT]
C. Perform lumbar puncture before antibiotics
D. Administer acetaminophen for fever only
Rationale: Per AAP guidelines for febrile infants and meningitis management, this presentation (fever,
bulging fontanelle, stiff neck, petechiae) suggests bacterial meningitis/possible sepsis. Empiric
antibiotics (ceftriaxone + vancomycin ± ampicillin) should be administered within 30 minutes of
presentation. LP should not delay antibiotics if patient is unstable.
Distractor A: History is important but should not delay life-saving antibiotics.
Distractor C: LP is important for diagnosis but should not delay antibiotics; perform if stable
after antibiotics.
Distractor D: Fever reduction is supportive but not priority over antibiotics for suspected
meningitis.
Q5: Using the qSOFA (quick Sepsis-Related Organ Failure Assessment) criteria, which combination
indicates high risk for poor outcome in suspected sepsis?
A. Systolic BP ≤100, Respiratory rate ≥22, Altered mentation *CORRECT+
B. Temperature >38°C, Heart rate >90, White blood cell count >12,000
C. Systolic BP ≤90, Heart rate >100, Temperature <36°C
D. Respiratory rate >20, O2 sat <90%, Systolic BP <110
Rationale: Per Sepsis-3 guidelines (SCCM/ESICM), qSOFA criteria are: systolic BP ≤100 mmHg,
respiratory rate ≥22/min, altered mentation (GCS <15). Presence of 2+ qSOFA criteria suggests high risk
for poor outcome. This is distinct from SIRS criteria (option B) which are less specific.
Distractor B: These are SIRS criteria, not qSOFA; less predictive of sepsis outcomes.
Distractor C: These are elements of SIRS and severe sepsis criteria, not qSOFA.
Distractor D: O2 sat is not part of qSOFA; this combination mixes different criteria.
Q6: A 78-year-old male presents after a fall. He is on warfarin with INR 3.5. GCS is 13 (E3, V4, M6). CT
scan shows small subdural hematoma. What is the ESI level?
, A. ESI Level 1
B. ESI Level 2 [CORRECT]
C. ESI Level 3
D. ESI Level 4
Rationale: Per ESI guidelines, this patient is high-risk due to: anticoagulation with therapeutic INR,
traumatic brain injury with GCS <14, and intracranial hemorrhage on imaging. ESI Level 2 is appropriate
for high-risk patients requiring prompt evaluation and multiple resources, even if currently stable.
Distractor A: ESI 1 requires immediate life-saving intervention (intubation, CPR); patient is
stable with GCS 13.
Distractor C: Underestimates risk; anticoagulation and intracranial bleed are high-risk features.
Distractor D: Far too low; this is a potentially life-threatening condition.
Q7: In the primary survey (ABCDE approach), which finding requires immediate intervention before
proceeding?
A. Airway obstruction [CORRECT]
B. Abdominal tenderness
C. Distal pulse deficit
D. Pelvic instability
Rationale: Per ATLS and emergency nursing protocols, the ABCDE approach prioritizes Airway first. Any
airway obstruction must be addressed immediately before breathing, circulation, disability, or exposure.
This follows the "airway is always first" principle of resuscitation.
Distractor B: Abdominal tenderness is important but addressed in secondary survey.
Distractor C: Pulse deficit is addressed in Circulation (C), after Airway and Breathing.
Distractor D: Pelvic instability is also Circulation (C) priority, not before airway.
Q8: A 35-year-old female presents with abdominal pain. She is 8 weeks postpartum. Vital signs: BP
88/60, HR 128, RR 24, Temp 38.2°C. She appears toxic. What is the FIRST priority?
A. Obtain detailed obstetric history
B. Aggressive fluid resuscitation and broad-spectrum antibiotics [CORRECT]
C. CT scan of abdomen with contrast
D. Urine pregnancy test
Across the Lifespan Exam ACTUAL
EXAM 2026/2027 | Urgent
Emergencies | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: Triage & Rapid Assessment Across the Lifespan (10 Questions)
Q1: A 4-year-old child is brought to the emergency department by parents. The Pediatric Assessment
Triangle reveals: Appearance – interactive, smiling; Work of Breathing – mild nasal flaring, no
retractions; Circulation to Skin – pink with brisk capillary refill. Using the Emergency Severity Index (ESI),
what is the appropriate triage level?
A. ESI Level 1 (requires immediate life-saving intervention)
B. ESI Level 2 (high-risk situation, confused/lethargic/disoriented or severe pain/distress)
C. ESI Level 3 (stable, multiple resources needed)
D. ESI Level 4 (stable, one resource needed) [CORRECT]
Rationale: Per ESI Triage Algorithm (AHRQ/ENA), this child has stable appearance, mild increased work
of breathing without severe distress, and normal circulation. No high-risk features, no severe pain, and
likely needs only one resource (possible nasal suctioning or simple intervention). ESI Level 4 is
appropriate for stable patients requiring one resource.
Distractor A: No life-threatening condition present; child is interactive and stable.
Distractor B: No high-risk features; child is not confused, lethargic, or in severe distress.
Distractor C: Multiple resources not anticipated; child appears stable with minimal intervention
needed.
,Q2: An 82-year-old female presents with "feeling weak" for 2 days. Vital signs: BP 110/70, HR 105, RR
18, Temp 38.1°C (100.6°F), O2 sat 95%. She is alert but slightly confused to date. White blood cell count
is 14,000. What is the MOST concerning finding requiring immediate intervention?
A. Systolic BP of 110
B. Altered mental status with fever and tachycardia [CORRECT]
C. Respiratory rate of 18
D. O2 saturation of 95%
Rationale: Per ACEP Geriatric Emergency Medicine guidelines, altered mental status in elderly with
infection (evidenced by fever and leukocytosis) indicates possible sepsis or severe infection. This is a
high-risk presentation requiring immediate evaluation and possible sepsis protocol activation. Geriatric
patients often present atypically with "weakness" rather than classic symptoms.
Distractor A: Systolic BP 110 is low-normal but not immediately concerning without other signs
of shock.
Distractor C: RR 18 is within normal range (12-20).
Distractor D: O2 sat 95% is acceptable; not immediately concerning.
Q3: In a mass casualty incident using START triage, a victim has spontaneous respirations, RR 24,
capillary refill 3 seconds, and follows commands. What is the appropriate triage category?
A. Immediate (Red)
B. Delayed (Yellow) [CORRECT]
C. Minimal (Green)
D. Expectant (Black)
Rationale: Per START (Simple Triage and Rapid Treatment) protocol: Respirations present, RR <30 (pass);
Perfusion: capillary refill <2 seconds is deferred, but 3 seconds suggests possible compromise; Mental
status: follows commands (pass). This patient has one failure (capillary refill), placing them in Delayed
(Yellow) category. They need medical care but can wait for Immediate (Red) patients.
Distractor A: Immediate requires respiratory failure, no radial pulse, or altered mental status.
Distractor C: Minimal (Green) requires all START criteria to pass (RPM: Respirations, Perfusion,
Mental status).
Distractor D: Expectant is for unsalvageable or those who fail all criteria with minimal chance of
survival.
,Q4: A 6-month-old infant presents with fever of 39.5°C (103.1°F) and irritability. The nurse practitioner
notes bulging fontanelle, stiff neck, and petechial rash. What is the FIRST priority intervention?
A. Obtain detailed family history
B. Administer empiric antibiotics immediately [CORRECT]
C. Perform lumbar puncture before antibiotics
D. Administer acetaminophen for fever only
Rationale: Per AAP guidelines for febrile infants and meningitis management, this presentation (fever,
bulging fontanelle, stiff neck, petechiae) suggests bacterial meningitis/possible sepsis. Empiric
antibiotics (ceftriaxone + vancomycin ± ampicillin) should be administered within 30 minutes of
presentation. LP should not delay antibiotics if patient is unstable.
Distractor A: History is important but should not delay life-saving antibiotics.
Distractor C: LP is important for diagnosis but should not delay antibiotics; perform if stable
after antibiotics.
Distractor D: Fever reduction is supportive but not priority over antibiotics for suspected
meningitis.
Q5: Using the qSOFA (quick Sepsis-Related Organ Failure Assessment) criteria, which combination
indicates high risk for poor outcome in suspected sepsis?
A. Systolic BP ≤100, Respiratory rate ≥22, Altered mentation *CORRECT+
B. Temperature >38°C, Heart rate >90, White blood cell count >12,000
C. Systolic BP ≤90, Heart rate >100, Temperature <36°C
D. Respiratory rate >20, O2 sat <90%, Systolic BP <110
Rationale: Per Sepsis-3 guidelines (SCCM/ESICM), qSOFA criteria are: systolic BP ≤100 mmHg,
respiratory rate ≥22/min, altered mentation (GCS <15). Presence of 2+ qSOFA criteria suggests high risk
for poor outcome. This is distinct from SIRS criteria (option B) which are less specific.
Distractor B: These are SIRS criteria, not qSOFA; less predictive of sepsis outcomes.
Distractor C: These are elements of SIRS and severe sepsis criteria, not qSOFA.
Distractor D: O2 sat is not part of qSOFA; this combination mixes different criteria.
Q6: A 78-year-old male presents after a fall. He is on warfarin with INR 3.5. GCS is 13 (E3, V4, M6). CT
scan shows small subdural hematoma. What is the ESI level?
, A. ESI Level 1
B. ESI Level 2 [CORRECT]
C. ESI Level 3
D. ESI Level 4
Rationale: Per ESI guidelines, this patient is high-risk due to: anticoagulation with therapeutic INR,
traumatic brain injury with GCS <14, and intracranial hemorrhage on imaging. ESI Level 2 is appropriate
for high-risk patients requiring prompt evaluation and multiple resources, even if currently stable.
Distractor A: ESI 1 requires immediate life-saving intervention (intubation, CPR); patient is
stable with GCS 13.
Distractor C: Underestimates risk; anticoagulation and intracranial bleed are high-risk features.
Distractor D: Far too low; this is a potentially life-threatening condition.
Q7: In the primary survey (ABCDE approach), which finding requires immediate intervention before
proceeding?
A. Airway obstruction [CORRECT]
B. Abdominal tenderness
C. Distal pulse deficit
D. Pelvic instability
Rationale: Per ATLS and emergency nursing protocols, the ABCDE approach prioritizes Airway first. Any
airway obstruction must be addressed immediately before breathing, circulation, disability, or exposure.
This follows the "airway is always first" principle of resuscitation.
Distractor B: Abdominal tenderness is important but addressed in secondary survey.
Distractor C: Pulse deficit is addressed in Circulation (C), after Airway and Breathing.
Distractor D: Pelvic instability is also Circulation (C) priority, not before airway.
Q8: A 35-year-old female presents with abdominal pain. She is 8 weeks postpartum. Vital signs: BP
88/60, HR 128, RR 24, Temp 38.2°C. She appears toxic. What is the FIRST priority?
A. Obtain detailed obstetric history
B. Aggressive fluid resuscitation and broad-spectrum antibiotics [CORRECT]
C. CT scan of abdomen with contrast
D. Urine pregnancy test
