Nursing 354 Emergency Nursing
Practice Exam Questions And Correct
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Rationales 2026 Q&A Instant Download
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1. A patient arrives in the emergency department with severe respiratory distress,
cyanosis, and an oxygen saturation of 78%. What is the nurse's priority action?
A. Obtain a complete health history
B. Start an intravenous line
C. Administer supplemental oxygen
D. Obtain a chest x-ray
Answer: C. Administer supplemental oxygen
Rationale: Airway and breathing are immediate priorities. Severe hypoxemia
requires prompt oxygen therapy while the underlying cause is evaluated.
2. Which patient should the emergency department nurse assess first?
A. A patient with a closed ankle fracture and pain rated 8/10
B. A patient with nausea and vomiting for 12 hours
C. A patient with sudden difficulty speaking and right-sided weakness
D. A patient with a superficial forearm laceration
,Answer: C. A patient with sudden difficulty speaking and right-sided weakness
Rationale: Sudden neurologic deficits suggest an acute stroke. Rapid assessment
and treatment are essential to preserve neurologic function.
3. During the primary survey of a trauma patient, which assessment is performed
first?
A. Circulation
B. Disability
C. Exposure
D. Airway with cervical spine protection
Answer: D. Airway with cervical spine protection
Rationale: The primary trauma survey begins with airway assessment while
protecting the cervical spine when spinal injury is possible.
4. A patient with chest pain is pale, diaphoretic, and hypotensive. Which condition
should the nurse suspect?
A. Stable angina
B. Cardiogenic shock
C. Chronic heart failure
D. Peripheral vascular disease
Answer: B. Cardiogenic shock
Rationale: Hypotension, pallor, diaphoresis, and acute chest symptoms can
indicate inadequate cardiac output caused by cardiogenic shock.
5. A patient arrives after a motor vehicle collision with suspected cervical spine
injury. Which action is most appropriate?
,A. Flex the patient's neck to assess range of motion
B. Place the patient in high-Fowler position
C. Maintain manual cervical spine stabilization
D. Ask the patient to sit upright
Answer: C. Maintain manual cervical spine stabilization
Rationale: Cervical spine movement can worsen an unstable spinal injury.
Stabilization should be maintained until the spine has been appropriately
evaluated.
6. Which finding is most concerning in a patient experiencing anaphylaxis?
A. Mild itching
B. Facial flushing
C. Stridor and difficulty breathing
D. Localized skin redness
Answer: C. Stridor and difficulty breathing
Rationale: Stridor indicates upper-airway compromise. Airway obstruction is a
life-threatening complication of anaphylaxis requiring immediate intervention.
7. Which medication is the priority treatment for severe anaphylaxis?
A. Diphenhydramine
B. Hydrocortisone
C. Albuterol
D. Epinephrine
Answer: D. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis because it
rapidly improves airway edema, bronchoconstriction, and cardiovascular
compromise.
, 8. A patient with suspected opioid toxicity has slow, shallow respirations and
decreased consciousness. Which medication should the nurse anticipate?
A. Flumazenil
B. Atropine
C. Naloxone
D. Adenosine
Answer: C. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory and central nervous system depression.
9. A patient with a possible myocardial infarction reports crushing substernal
chest pain. Which diagnostic test should be obtained rapidly?
A. Abdominal ultrasound
B. 12-lead electrocardiogram
C. Pulmonary function test
D. Colonoscopy
Answer: B. 12-lead electrocardiogram
Rationale: A 12-lead ECG should be obtained rapidly in suspected acute coronary
syndrome to identify ischemic changes and possible ST-elevation myocardial
infarction.
10. Which assessment finding is characteristic of hypovolemic shock?
A. Bounding pulse
B. Bradycardia
C. Warm, flushed skin
D. Tachycardia with cool, clammy skin
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A patient arrives in the emergency department with severe respiratory distress,
cyanosis, and an oxygen saturation of 78%. What is the nurse's priority action?
A. Obtain a complete health history
B. Start an intravenous line
C. Administer supplemental oxygen
D. Obtain a chest x-ray
Answer: C. Administer supplemental oxygen
Rationale: Airway and breathing are immediate priorities. Severe hypoxemia
requires prompt oxygen therapy while the underlying cause is evaluated.
2. Which patient should the emergency department nurse assess first?
A. A patient with a closed ankle fracture and pain rated 8/10
B. A patient with nausea and vomiting for 12 hours
C. A patient with sudden difficulty speaking and right-sided weakness
D. A patient with a superficial forearm laceration
,Answer: C. A patient with sudden difficulty speaking and right-sided weakness
Rationale: Sudden neurologic deficits suggest an acute stroke. Rapid assessment
and treatment are essential to preserve neurologic function.
3. During the primary survey of a trauma patient, which assessment is performed
first?
A. Circulation
B. Disability
C. Exposure
D. Airway with cervical spine protection
Answer: D. Airway with cervical spine protection
Rationale: The primary trauma survey begins with airway assessment while
protecting the cervical spine when spinal injury is possible.
4. A patient with chest pain is pale, diaphoretic, and hypotensive. Which condition
should the nurse suspect?
A. Stable angina
B. Cardiogenic shock
C. Chronic heart failure
D. Peripheral vascular disease
Answer: B. Cardiogenic shock
Rationale: Hypotension, pallor, diaphoresis, and acute chest symptoms can
indicate inadequate cardiac output caused by cardiogenic shock.
5. A patient arrives after a motor vehicle collision with suspected cervical spine
injury. Which action is most appropriate?
,A. Flex the patient's neck to assess range of motion
B. Place the patient in high-Fowler position
C. Maintain manual cervical spine stabilization
D. Ask the patient to sit upright
Answer: C. Maintain manual cervical spine stabilization
Rationale: Cervical spine movement can worsen an unstable spinal injury.
Stabilization should be maintained until the spine has been appropriately
evaluated.
6. Which finding is most concerning in a patient experiencing anaphylaxis?
A. Mild itching
B. Facial flushing
C. Stridor and difficulty breathing
D. Localized skin redness
Answer: C. Stridor and difficulty breathing
Rationale: Stridor indicates upper-airway compromise. Airway obstruction is a
life-threatening complication of anaphylaxis requiring immediate intervention.
7. Which medication is the priority treatment for severe anaphylaxis?
A. Diphenhydramine
B. Hydrocortisone
C. Albuterol
D. Epinephrine
Answer: D. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis because it
rapidly improves airway edema, bronchoconstriction, and cardiovascular
compromise.
, 8. A patient with suspected opioid toxicity has slow, shallow respirations and
decreased consciousness. Which medication should the nurse anticipate?
A. Flumazenil
B. Atropine
C. Naloxone
D. Adenosine
Answer: C. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory and central nervous system depression.
9. A patient with a possible myocardial infarction reports crushing substernal
chest pain. Which diagnostic test should be obtained rapidly?
A. Abdominal ultrasound
B. 12-lead electrocardiogram
C. Pulmonary function test
D. Colonoscopy
Answer: B. 12-lead electrocardiogram
Rationale: A 12-lead ECG should be obtained rapidly in suspected acute coronary
syndrome to identify ischemic changes and possible ST-elevation myocardial
infarction.
10. Which assessment finding is characteristic of hypovolemic shock?
A. Bounding pulse
B. Bradycardia
C. Warm, flushed skin
D. Tachycardia with cool, clammy skin
