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EMERGENCY NURSING EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
EMERGENCY NURSING EXAM
250 Practice Questions with Rationales
SECTION 1: TRIAGE & EMERGENCY ASSESSMENT (Questions 1-25)
1. A nurse is triaging patients in the emergency department (ED). Which patient should
be seen first?
A. A 45-year-old with chest pain and diaphoresis
B. A 32-year-old with a sprained ankle
C. A 60-year-old with a fever and cough
D. A 25-year-old with a laceration on the hand
Correct Answer: A
Rationale: Chest pain with diaphoresis may indicate a myocardial infarction and is a life-
threatening emergency. This patient should be seen immediately (ESI Level 1). The other
patients have less urgent conditions that can be seen after the unstable patient.
2. A nurse is using the Emergency Severity Index (ESI) for triage. Which patient would
be classified as ESI Level 1?
A. A patient with a severe headache and vomiting
B. A patient with chest pain and difficulty breathing
C. A patient with an allergic reaction with stridor
D. A patient with a laceration requiring sutures
Correct Answer: C
Rationale: ESI Level 1 patients are those who require immediate life-saving intervention.
Stridor indicates impending airway compromise, which requires immediate intervention.
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Chest pain with difficulty breathing (B) would be ESI Level 2. A severe headache (A) would
be ESI Level 2. A laceration (D) would be ESI Level 3 or 4.
3. A nurse is performing a primary survey on a trauma patient. Which of the following
is assessed first?
A. Breathing
B. Circulation
C. Disability
D. Airway
Correct Answer: D
Rationale: The primary survey follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability, Exposure. The airway is assessed first to ensure it is patent and
protected. Without a patent airway, oxygenation and ventilation are compromised.
4. A nurse is assessing a patient's airway during a primary survey. Which of the
following is a sign of airway obstruction?
A. Stridor
B. Wheezing
C. Crackles
D. Rhonchi
Correct Answer: A
Rationale: Stridor is a high-pitched, crowing sound that indicates upper airway obstruction.
Wheezing (B) indicates lower airway obstruction (asthma, bronchospasm). Crackles (C)
indicate fluid in the lungs. Rhonchi (D) indicate secretions in the large airways.
5. A nurse is assessing a patient's breathing during a primary survey. Which of the
following is a sign of respiratory distress?
A. Respiratory rate of 16 breaths/min
B. Use of accessory muscles
C. Clear breath sounds
D. Normal breath sounds
Correct Answer: B
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Rationale: Use of accessory muscles (sternocleidomastoid, intercostal muscles) indicates
increased work of breathing and respiratory distress. A respiratory rate of 16 (A) is normal.
Clear breath sounds (C) and normal breath sounds (D) are normal findings.
6. A nurse is assessing a patient's circulation during a primary survey. Which of the
following is a sign of shock?
A. Warm, dry skin
B. Capillary refill of 2 seconds
C. Weak, thready pulse
D. Blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: A weak, thready pulse is a sign of decreased cardiac output and shock. Warm, dry
skin (A) is normal. Capillary refill of 2 seconds (B) is normal. A blood pressure of 120/80
(D) is normal.
7. A nurse is using the Glasgow Coma Scale (GCS) to assess a patient's level of
consciousness. Which of the following is a component of the GCS?
A. Eye opening
B. Verbal response
C. Motor response
D. All of the above
Correct Answer: D
Rationale: The Glasgow Coma Scale assesses three components: eye opening (1-4), verbal
response (1-5), and motor response (1-6). The total score ranges from 3 to 15, with a score ≤8
indicating severe brain injury.
8. A nurse is assessing a patient's pulse. Which of the following pulse sites is most
appropriate for assessing circulation in a trauma patient?
A. Radial pulse
B. Brachial pulse
C. Carotid pulse
D. Femoral pulse
Correct Answer: C
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Rationale: The carotid pulse is the most appropriate site for assessing circulation in a trauma
patient because it is centrally located and can be assessed quickly. If the carotid pulse is
absent, the patient is in cardiac arrest. The radial pulse (A) may not be palpable in shock.
9. A nurse is performing a secondary survey on a trauma patient. Which of the
following is included in the secondary survey?
A. Full head-to-toe assessment
B. Vital signs
C. Focused history
D. All of the above
Correct Answer: D
Rationale: The secondary survey includes a full head-to-toe assessment, vital signs, and a
focused history (AMPLE: Allergies, Medications, Past medical history, Last meal, Events
leading to injury). The secondary survey is performed after the primary survey is completed.
10. A nurse is assessing a patient's pupils. Which of the following is a sign of increased
intracranial pressure?
A. Bilateral reactive pupils
B. Unilateral dilated pupil
C. Pinpoint pupils
D. Normal pupils
Correct Answer: B
Rationale: A unilateral dilated pupil that is non-reactive indicates herniation and increased
intracranial pressure. Bilateral reactive pupils (A) are normal. Pinpoint pupils (C) indicate
opioid overdose or pontine hemorrhage. Normal pupils (D) are normal.
11. A nurse is assessing a patient's breathing. Which of the following is a normal
respiratory rate for an adult?
A. 8-10 breaths/min
B. 12-20 breaths/min
C. 20-24 breaths/min
D. 24-28 breaths/min
Correct Answer: B
EMERGENCY NURSING EXAM 2026 QUESTIONS
LATEST VERSION QUESTIONS AND ANSWERS
EMERGENCY NURSING EXAM
250 Practice Questions with Rationales
SECTION 1: TRIAGE & EMERGENCY ASSESSMENT (Questions 1-25)
1. A nurse is triaging patients in the emergency department (ED). Which patient should
be seen first?
A. A 45-year-old with chest pain and diaphoresis
B. A 32-year-old with a sprained ankle
C. A 60-year-old with a fever and cough
D. A 25-year-old with a laceration on the hand
Correct Answer: A
Rationale: Chest pain with diaphoresis may indicate a myocardial infarction and is a life-
threatening emergency. This patient should be seen immediately (ESI Level 1). The other
patients have less urgent conditions that can be seen after the unstable patient.
2. A nurse is using the Emergency Severity Index (ESI) for triage. Which patient would
be classified as ESI Level 1?
A. A patient with a severe headache and vomiting
B. A patient with chest pain and difficulty breathing
C. A patient with an allergic reaction with stridor
D. A patient with a laceration requiring sutures
Correct Answer: C
Rationale: ESI Level 1 patients are those who require immediate life-saving intervention.
Stridor indicates impending airway compromise, which requires immediate intervention.
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Chest pain with difficulty breathing (B) would be ESI Level 2. A severe headache (A) would
be ESI Level 2. A laceration (D) would be ESI Level 3 or 4.
3. A nurse is performing a primary survey on a trauma patient. Which of the following
is assessed first?
A. Breathing
B. Circulation
C. Disability
D. Airway
Correct Answer: D
Rationale: The primary survey follows the ABCDE sequence: Airway, Breathing,
Circulation, Disability, Exposure. The airway is assessed first to ensure it is patent and
protected. Without a patent airway, oxygenation and ventilation are compromised.
4. A nurse is assessing a patient's airway during a primary survey. Which of the
following is a sign of airway obstruction?
A. Stridor
B. Wheezing
C. Crackles
D. Rhonchi
Correct Answer: A
Rationale: Stridor is a high-pitched, crowing sound that indicates upper airway obstruction.
Wheezing (B) indicates lower airway obstruction (asthma, bronchospasm). Crackles (C)
indicate fluid in the lungs. Rhonchi (D) indicate secretions in the large airways.
5. A nurse is assessing a patient's breathing during a primary survey. Which of the
following is a sign of respiratory distress?
A. Respiratory rate of 16 breaths/min
B. Use of accessory muscles
C. Clear breath sounds
D. Normal breath sounds
Correct Answer: B
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Rationale: Use of accessory muscles (sternocleidomastoid, intercostal muscles) indicates
increased work of breathing and respiratory distress. A respiratory rate of 16 (A) is normal.
Clear breath sounds (C) and normal breath sounds (D) are normal findings.
6. A nurse is assessing a patient's circulation during a primary survey. Which of the
following is a sign of shock?
A. Warm, dry skin
B. Capillary refill of 2 seconds
C. Weak, thready pulse
D. Blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: A weak, thready pulse is a sign of decreased cardiac output and shock. Warm, dry
skin (A) is normal. Capillary refill of 2 seconds (B) is normal. A blood pressure of 120/80
(D) is normal.
7. A nurse is using the Glasgow Coma Scale (GCS) to assess a patient's level of
consciousness. Which of the following is a component of the GCS?
A. Eye opening
B. Verbal response
C. Motor response
D. All of the above
Correct Answer: D
Rationale: The Glasgow Coma Scale assesses three components: eye opening (1-4), verbal
response (1-5), and motor response (1-6). The total score ranges from 3 to 15, with a score ≤8
indicating severe brain injury.
8. A nurse is assessing a patient's pulse. Which of the following pulse sites is most
appropriate for assessing circulation in a trauma patient?
A. Radial pulse
B. Brachial pulse
C. Carotid pulse
D. Femoral pulse
Correct Answer: C
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Rationale: The carotid pulse is the most appropriate site for assessing circulation in a trauma
patient because it is centrally located and can be assessed quickly. If the carotid pulse is
absent, the patient is in cardiac arrest. The radial pulse (A) may not be palpable in shock.
9. A nurse is performing a secondary survey on a trauma patient. Which of the
following is included in the secondary survey?
A. Full head-to-toe assessment
B. Vital signs
C. Focused history
D. All of the above
Correct Answer: D
Rationale: The secondary survey includes a full head-to-toe assessment, vital signs, and a
focused history (AMPLE: Allergies, Medications, Past medical history, Last meal, Events
leading to injury). The secondary survey is performed after the primary survey is completed.
10. A nurse is assessing a patient's pupils. Which of the following is a sign of increased
intracranial pressure?
A. Bilateral reactive pupils
B. Unilateral dilated pupil
C. Pinpoint pupils
D. Normal pupils
Correct Answer: B
Rationale: A unilateral dilated pupil that is non-reactive indicates herniation and increased
intracranial pressure. Bilateral reactive pupils (A) are normal. Pinpoint pupils (C) indicate
opioid overdose or pontine hemorrhage. Normal pupils (D) are normal.
11. A nurse is assessing a patient's breathing. Which of the following is a normal
respiratory rate for an adult?
A. 8-10 breaths/min
B. 12-20 breaths/min
C. 20-24 breaths/min
D. 24-28 breaths/min
Correct Answer: B
