FLORIDA BOARD OF NURSING CERTIFIED
EMERGENCY NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 67-year-old patient arrives in the emergency department with
severe substernal chest pressure radiating to the left arm,
diaphoresis, nausea, and shortness of breath. The ECG
demonstrates ST-segment elevation in leads II, III, and aVF. His
blood pressure is 84/56 mm Hg, heart rate 52/min, and lungs are
clear. Which intervention should the emergency nurse anticipate as
the priority?
A. Administer sublingual nitroglycerin
B. Administer a rapid IV bolus of isotonic crystalloid
C. Administer IV furosemide
D. Place the patient in a high-Fowler position and administer
nitroglycerin
Answer: B. Administer a rapid IV bolus of isotonic crystalloid
Rationale: Inferior STEMI can involve right ventricular infarction,
producing reduced right ventricular preload, hypotension, and
bradycardia. With clear lungs and hypotension, cautious IV fluid
administration is appropriate to improve preload. Nitroglycerin can
further decrease preload and precipitate severe hypotension in right
ventricular infarction.
1
,2. A patient presents after a motor-vehicle collision with severe
respiratory distress. Assessment reveals absent breath sounds on the
left, distended neck veins, hypotension, tachycardia, and tracheal
deviation toward the right. What is the most appropriate immediate
intervention?
A. Obtain a portable chest radiograph
B. Perform needle or finger thoracostomy according to the emergency
protocol
C. Administer IV furosemide
D. Place the patient on noninvasive positive-pressure ventilation
Answer: B. Perform needle or finger thoracostomy according to the
emergency protocol
Rationale: The findings strongly indicate tension pneumothorax with
obstructive shock. This is a clinical emergency requiring immediate
decompression; treatment should not be delayed for radiographic
confirmation in an unstable patient. Definitive management generally
includes tube thoracostomy.
3. A 24-year-old patient with type 1 diabetes presents with vomiting,
abdominal pain, dehydration, Kussmaul respirations, and altered
mental status. Laboratory results show glucose 610 mg/dL, pH 7.08,
bicarbonate 7 mEq/L, and potassium 5.6 mEq/L. Which
intervention should occur first?
A. Begin IV regular insulin immediately
B. Administer IV sodium bicarbonate routinely
C. Begin isotonic IV fluid resuscitation
D. Administer IV potassium chloride
Answer: C. Begin isotonic IV fluid resuscitation
2
,Rationale: Diabetic ketoacidosis produces profound osmotic diuresis
and volume depletion. Initial management prioritizes restoration of
circulating volume with isotonic crystalloid. Insulin is subsequently
initiated after initial fluid assessment and confirmation that potassium
is not dangerously low. Routine bicarbonate therapy is generally not
indicated except in extreme acidemia under specific protocols.
4. A patient with suspected bacterial meningitis arrives with fever,
severe headache, photophobia, nuchal rigidity, and altered mental
status. Which nursing intervention has the highest priority
regarding infection control?
A. Place the patient on airborne precautions
B. Place the patient on droplet precautions
C. Place the patient on contact precautions only
D. Place the patient in a negative-pressure room
Answer: B. Place the patient on droplet precautions
Rationale: Suspected meningococcal meningitis requires droplet
precautions in addition to standard precautions. Appropriate
precautions should be initiated promptly because transmission can
occur through respiratory and oral secretions.
5. A 35-year-old patient presents after an intentional overdose of an
opioid medication. The patient is somnolent, has pinpoint pupils,
respirations of 6/min, oxygen saturation of 78%, and a palpable
pulse. Which intervention is the priority?
A. Administer activated charcoal
B. Administer naloxone and provide ventilatory support as needed
C. Induce vomiting
D. Administer flumazenil
3
, Answer: B. Administer naloxone and provide ventilatory support as
needed
Rationale: The immediate threat is opioid-induced respiratory
depression. Airway management and ventilation take priority, while
naloxone reverses opioid effects. Activated charcoal is not the first
priority in a patient with severe respiratory compromise and an
unprotected airway. Flumazenil reverses benzodiazepines, not opioids,
and may cause seizures in selected patients.
6. A patient arrives after a house fire with facial burns, soot around
the mouth, hoarseness, and progressive stridor. Which action is
most appropriate?
A. Delay airway management until significant edema develops
B. Prepare for early definitive airway management
C. Administer oral fluids
D. Apply topical antimicrobial cream to the airway
Answer: B. Prepare for early definitive airway management
Rationale: Facial burns, soot, hoarseness, and stridor suggest
inhalation injury and impending upper-airway obstruction. Airway
edema can progress rapidly, making later intubation considerably
more difficult. Early airway control should therefore be anticipated.
7. A patient with septic shock remains hypotensive after appropriate
initial crystalloid administration. Which medication is generally the
preferred first-line vasopressor?
A. Norepinephrine
B. Dopamine
C. Dobutamine
D. Nitroglycerin
4
EMERGENCY NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 67-year-old patient arrives in the emergency department with
severe substernal chest pressure radiating to the left arm,
diaphoresis, nausea, and shortness of breath. The ECG
demonstrates ST-segment elevation in leads II, III, and aVF. His
blood pressure is 84/56 mm Hg, heart rate 52/min, and lungs are
clear. Which intervention should the emergency nurse anticipate as
the priority?
A. Administer sublingual nitroglycerin
B. Administer a rapid IV bolus of isotonic crystalloid
C. Administer IV furosemide
D. Place the patient in a high-Fowler position and administer
nitroglycerin
Answer: B. Administer a rapid IV bolus of isotonic crystalloid
Rationale: Inferior STEMI can involve right ventricular infarction,
producing reduced right ventricular preload, hypotension, and
bradycardia. With clear lungs and hypotension, cautious IV fluid
administration is appropriate to improve preload. Nitroglycerin can
further decrease preload and precipitate severe hypotension in right
ventricular infarction.
1
,2. A patient presents after a motor-vehicle collision with severe
respiratory distress. Assessment reveals absent breath sounds on the
left, distended neck veins, hypotension, tachycardia, and tracheal
deviation toward the right. What is the most appropriate immediate
intervention?
A. Obtain a portable chest radiograph
B. Perform needle or finger thoracostomy according to the emergency
protocol
C. Administer IV furosemide
D. Place the patient on noninvasive positive-pressure ventilation
Answer: B. Perform needle or finger thoracostomy according to the
emergency protocol
Rationale: The findings strongly indicate tension pneumothorax with
obstructive shock. This is a clinical emergency requiring immediate
decompression; treatment should not be delayed for radiographic
confirmation in an unstable patient. Definitive management generally
includes tube thoracostomy.
3. A 24-year-old patient with type 1 diabetes presents with vomiting,
abdominal pain, dehydration, Kussmaul respirations, and altered
mental status. Laboratory results show glucose 610 mg/dL, pH 7.08,
bicarbonate 7 mEq/L, and potassium 5.6 mEq/L. Which
intervention should occur first?
A. Begin IV regular insulin immediately
B. Administer IV sodium bicarbonate routinely
C. Begin isotonic IV fluid resuscitation
D. Administer IV potassium chloride
Answer: C. Begin isotonic IV fluid resuscitation
2
,Rationale: Diabetic ketoacidosis produces profound osmotic diuresis
and volume depletion. Initial management prioritizes restoration of
circulating volume with isotonic crystalloid. Insulin is subsequently
initiated after initial fluid assessment and confirmation that potassium
is not dangerously low. Routine bicarbonate therapy is generally not
indicated except in extreme acidemia under specific protocols.
4. A patient with suspected bacterial meningitis arrives with fever,
severe headache, photophobia, nuchal rigidity, and altered mental
status. Which nursing intervention has the highest priority
regarding infection control?
A. Place the patient on airborne precautions
B. Place the patient on droplet precautions
C. Place the patient on contact precautions only
D. Place the patient in a negative-pressure room
Answer: B. Place the patient on droplet precautions
Rationale: Suspected meningococcal meningitis requires droplet
precautions in addition to standard precautions. Appropriate
precautions should be initiated promptly because transmission can
occur through respiratory and oral secretions.
5. A 35-year-old patient presents after an intentional overdose of an
opioid medication. The patient is somnolent, has pinpoint pupils,
respirations of 6/min, oxygen saturation of 78%, and a palpable
pulse. Which intervention is the priority?
A. Administer activated charcoal
B. Administer naloxone and provide ventilatory support as needed
C. Induce vomiting
D. Administer flumazenil
3
, Answer: B. Administer naloxone and provide ventilatory support as
needed
Rationale: The immediate threat is opioid-induced respiratory
depression. Airway management and ventilation take priority, while
naloxone reverses opioid effects. Activated charcoal is not the first
priority in a patient with severe respiratory compromise and an
unprotected airway. Flumazenil reverses benzodiazepines, not opioids,
and may cause seizures in selected patients.
6. A patient arrives after a house fire with facial burns, soot around
the mouth, hoarseness, and progressive stridor. Which action is
most appropriate?
A. Delay airway management until significant edema develops
B. Prepare for early definitive airway management
C. Administer oral fluids
D. Apply topical antimicrobial cream to the airway
Answer: B. Prepare for early definitive airway management
Rationale: Facial burns, soot, hoarseness, and stridor suggest
inhalation injury and impending upper-airway obstruction. Airway
edema can progress rapidly, making later intubation considerably
more difficult. Early airway control should therefore be anticipated.
7. A patient with septic shock remains hypotensive after appropriate
initial crystalloid administration. Which medication is generally the
preferred first-line vasopressor?
A. Norepinephrine
B. Dopamine
C. Dobutamine
D. Nitroglycerin
4
