KAPLAN EMERGENCY NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Trauma Assessment and Management*
*- Cardiovascular Emergencies*
*- Respiratory Emergencies*
*- Neurologic Emergencies*
*- Gastrointestinal/GU/OB Emergencies*
*- Mental Health and Medical Emergencies*
*- Toxicologic and Environmental Emergencies*
*- Triage and Disaster Preparedness*
*- Legal, Regulatory, and Ethical Issues*
*- Professionalism and Leadership*
Introduction
This comprehensive assessment evaluates critical knowledge and clinical decision-making skills essential for emergency nursing practice. The
exam assesses competency in patient assessment, triage priorities, resuscitation techniques, pharmacology, and management of acute medical and
trauma emergencies. Through multiple-choice and scenario-based questions, candidates demonstrate their ability to apply evidence-based
practice, prioritize care under time-sensitive conditions, and make sound clinical judgments. The questions emphasize real-world application,
requiring nurses to integrate foundational theory with practical clinical skills while maintaining regulatory compliance and adhering to
professional ethical standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient arrives in the emergency department with severe chest pain, diaphoresis, and shortness of breath. Vital signs show BP 88/52 mmHg, HR
128 bpm, RR 28/min, and O2 saturation 89%. What is the priority intervention?
A. Administer 324 mg aspirin orally
B. Obtain a 12-lead ECG within 10 minutes
C. Initiate rapid fluid resuscitation
D. Administer sublingual nitroglycerin
,🟢 B. Obtain a 12-lead ECG within 10 minutes
🔴 RATIONALE: In patients with suspected acute coronary syndrome, obtaining a 12-lead ECG within 10 minutes is the priority to identify ST-
elevation myocardial infarction (STEMI), which requires immediate reperfusion therapy. While aspirin is important, diagnosing the type of MI
guides all subsequent interventions. Fluid resuscitation may be harmful if the patient has cardiogenic shock, and nitroglycerin is contraindicated in
hypotension (BP <90 mmHg).
Question 2
During triage, a patient presents with a 4-inch laceration on the forearm with active bleeding. The patient is alert, BP 132/84 mmHg, HR 98 bpm.
Which triage level is most appropriate?
A. Level I (Resuscitation)
B. Level II (Emergent)
C. Level III (Urgent)
D. Level IV (Less Urgent)
🟢 C. Level III (Urgent)
🔴 RATIONALE: Emergency Severity Index (ESI) Level III is appropriate for patients who require multiple resources (e.g., wound care, imaging,
splinting) but are stable with normal vital signs and no high-risk features. Level I requires immediate life-saving intervention, Level II includes high-
risk situations or severe pain, and Level IV requires only one resource or none.
Question 3
A 65-year-old patient with type 2 diabetes presents with confusion, tremors, and sweating. Random glucose is 42 mg/dL. The patient cannot swallow
safely. What is the best initial treatment?
A. Oral glucose 15 g
B. Intravenous dextrose 50% (D50) 25 mL
C. Intramuscular glucagon 1 mg
D. Subcutaneous regular insulin
🟢 B. Intravenous dextrose 50% (D50) 25 mL
,🔴 RATIONALE: For severe hypoglycemia with impaired swallowing, IV dextrose is the fastest and most effective treatment. D50 25 mL provides
rapid glucose elevation. Oral glucose is unsafe due to aspiration risk. Glucagon is appropriate when IV access is unavailable but is less reliable.
Insulin would worsen hypoglycemia.
Question 4
A trauma patient with a mechanism of injury suggesting spinal injury is alert but has numbness in both legs. What is the most appropriate initial
management?
A. Immediate CT of the entire spine
B. Apply a cervical collar and maintain spinal precautions
C. Perform a straight leg raise test
D. Administer IV methylprednisolone 30 mg
🟢 B. Apply a cervical collar and maintain spinal precautions
🔴 RATIONALE: Spinal precautions with cervical collar application are the initial priority for any trauma patient with suspected spinal injury and
neurological symptoms. CT imaging follows after stabilization. Methylprednisolone for spinal injury is no longer routinely recommended due to lack
of proven benefit and increased complication risk. Straight leg raise is not appropriate in this acute setting.
Question 5
Which ethical principle is demonstrated when a nurse respects a patient's right to refuse life-saving treatment after providing full information?
A. Beneficence
B. Justice
C. Autonomy
D. Fidelity
🟢 C. Autonomy
🔴 RATIONALE: Autonomy is the ethical principle recognizing the patient's right to make informed decisions about their own care, including
refusing treatment. Beneficence involves acting to benefit the patient, justice involves fair resource distribution, and fidelity involves maintaining
trust and confidentiality.
Question 6
A patient with suspected pulmonary embolism has a Wells score of 7. What does this indicate?
, A. Low risk for PE
B. Moderate risk for PE
C. High risk for PE
D. No risk for PE
🟢 C. High risk for PE
🔴 RATIONALE: A Wells score ≥6 indicates high risk for pulmonary embolism. Scores 4.5–6 indicate moderate risk, and scores <4.5 indicate low
risk. High-risk patients require immediate CT pulmonary angiography or ventilation-perfusion scanning.
Question 7
During a cardiac arrest, the team is performing CPR. The defibrillator is charged. What is the critical step before delivering the shock?
A. Administer epinephrine 1 mg IV
B. Ensure everyone is clear of the patient
C. Intubate the patient
D. Check for a pulse
🟢 B. Ensure everyone is clear of the patient
🔴 RATIONALE: Before delivering a defibrillation shock, all personnel must be clear of the patient to prevent injury from electrical current.
Epinephrine is given after the shock if no pulse returns. Intubation is not the priority during shock delivery. Pulse check occurs after the shock, not
before.
Question 8
A patient presents with abdominal pain, fever 39.4°C, and right upper quadrant tenderness. Murphy's sign is positive. What is the most likely
diagnosis?
A. Cholecystitis
B. Peptic ulcer disease
C. Appendicitis
D. Diverticulitis
🟢 A. Cholecystitis
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Trauma Assessment and Management*
*- Cardiovascular Emergencies*
*- Respiratory Emergencies*
*- Neurologic Emergencies*
*- Gastrointestinal/GU/OB Emergencies*
*- Mental Health and Medical Emergencies*
*- Toxicologic and Environmental Emergencies*
*- Triage and Disaster Preparedness*
*- Legal, Regulatory, and Ethical Issues*
*- Professionalism and Leadership*
Introduction
This comprehensive assessment evaluates critical knowledge and clinical decision-making skills essential for emergency nursing practice. The
exam assesses competency in patient assessment, triage priorities, resuscitation techniques, pharmacology, and management of acute medical and
trauma emergencies. Through multiple-choice and scenario-based questions, candidates demonstrate their ability to apply evidence-based
practice, prioritize care under time-sensitive conditions, and make sound clinical judgments. The questions emphasize real-world application,
requiring nurses to integrate foundational theory with practical clinical skills while maintaining regulatory compliance and adhering to
professional ethical standards.
SECTION ONE: QUESTIONS 1–100
Question 1
A patient arrives in the emergency department with severe chest pain, diaphoresis, and shortness of breath. Vital signs show BP 88/52 mmHg, HR
128 bpm, RR 28/min, and O2 saturation 89%. What is the priority intervention?
A. Administer 324 mg aspirin orally
B. Obtain a 12-lead ECG within 10 minutes
C. Initiate rapid fluid resuscitation
D. Administer sublingual nitroglycerin
,🟢 B. Obtain a 12-lead ECG within 10 minutes
🔴 RATIONALE: In patients with suspected acute coronary syndrome, obtaining a 12-lead ECG within 10 minutes is the priority to identify ST-
elevation myocardial infarction (STEMI), which requires immediate reperfusion therapy. While aspirin is important, diagnosing the type of MI
guides all subsequent interventions. Fluid resuscitation may be harmful if the patient has cardiogenic shock, and nitroglycerin is contraindicated in
hypotension (BP <90 mmHg).
Question 2
During triage, a patient presents with a 4-inch laceration on the forearm with active bleeding. The patient is alert, BP 132/84 mmHg, HR 98 bpm.
Which triage level is most appropriate?
A. Level I (Resuscitation)
B. Level II (Emergent)
C. Level III (Urgent)
D. Level IV (Less Urgent)
🟢 C. Level III (Urgent)
🔴 RATIONALE: Emergency Severity Index (ESI) Level III is appropriate for patients who require multiple resources (e.g., wound care, imaging,
splinting) but are stable with normal vital signs and no high-risk features. Level I requires immediate life-saving intervention, Level II includes high-
risk situations or severe pain, and Level IV requires only one resource or none.
Question 3
A 65-year-old patient with type 2 diabetes presents with confusion, tremors, and sweating. Random glucose is 42 mg/dL. The patient cannot swallow
safely. What is the best initial treatment?
A. Oral glucose 15 g
B. Intravenous dextrose 50% (D50) 25 mL
C. Intramuscular glucagon 1 mg
D. Subcutaneous regular insulin
🟢 B. Intravenous dextrose 50% (D50) 25 mL
,🔴 RATIONALE: For severe hypoglycemia with impaired swallowing, IV dextrose is the fastest and most effective treatment. D50 25 mL provides
rapid glucose elevation. Oral glucose is unsafe due to aspiration risk. Glucagon is appropriate when IV access is unavailable but is less reliable.
Insulin would worsen hypoglycemia.
Question 4
A trauma patient with a mechanism of injury suggesting spinal injury is alert but has numbness in both legs. What is the most appropriate initial
management?
A. Immediate CT of the entire spine
B. Apply a cervical collar and maintain spinal precautions
C. Perform a straight leg raise test
D. Administer IV methylprednisolone 30 mg
🟢 B. Apply a cervical collar and maintain spinal precautions
🔴 RATIONALE: Spinal precautions with cervical collar application are the initial priority for any trauma patient with suspected spinal injury and
neurological symptoms. CT imaging follows after stabilization. Methylprednisolone for spinal injury is no longer routinely recommended due to lack
of proven benefit and increased complication risk. Straight leg raise is not appropriate in this acute setting.
Question 5
Which ethical principle is demonstrated when a nurse respects a patient's right to refuse life-saving treatment after providing full information?
A. Beneficence
B. Justice
C. Autonomy
D. Fidelity
🟢 C. Autonomy
🔴 RATIONALE: Autonomy is the ethical principle recognizing the patient's right to make informed decisions about their own care, including
refusing treatment. Beneficence involves acting to benefit the patient, justice involves fair resource distribution, and fidelity involves maintaining
trust and confidentiality.
Question 6
A patient with suspected pulmonary embolism has a Wells score of 7. What does this indicate?
, A. Low risk for PE
B. Moderate risk for PE
C. High risk for PE
D. No risk for PE
🟢 C. High risk for PE
🔴 RATIONALE: A Wells score ≥6 indicates high risk for pulmonary embolism. Scores 4.5–6 indicate moderate risk, and scores <4.5 indicate low
risk. High-risk patients require immediate CT pulmonary angiography or ventilation-perfusion scanning.
Question 7
During a cardiac arrest, the team is performing CPR. The defibrillator is charged. What is the critical step before delivering the shock?
A. Administer epinephrine 1 mg IV
B. Ensure everyone is clear of the patient
C. Intubate the patient
D. Check for a pulse
🟢 B. Ensure everyone is clear of the patient
🔴 RATIONALE: Before delivering a defibrillation shock, all personnel must be clear of the patient to prevent injury from electrical current.
Epinephrine is given after the shock if no pulse returns. Intubation is not the priority during shock delivery. Pulse check occurs after the shock, not
before.
Question 8
A patient presents with abdominal pain, fever 39.4°C, and right upper quadrant tenderness. Murphy's sign is positive. What is the most likely
diagnosis?
A. Cholecystitis
B. Peptic ulcer disease
C. Appendicitis
D. Diverticulitis
🟢 A. Cholecystitis
