ENA Triage Practice Exam
1. The primary purpose of triage is to:
A. Diagnose the patient's condition
B. Prioritize patients based on acuity and urgency of need
C. Register the patient in the EHR
D. Assign a treatment room
Answer: B
Rationale: Triage is a rapid sorting process designed to prioritize patients so that those
with the most urgent needs are identified and seen first, not to render a diagnosis.
2. The Emergency Severity Index (ESI) is a triage system based on:
A. Patient's insurance status
B. Acuity and anticipated resource needs
C. Time of arrival only
D. Chief complaint listed alphabetically
Answer: B
Rationale: ESI stratifies patients using both clinical acuity and the number of resources
they are expected to need, rather than arrival order or payer status.
3. How many levels does the ESI triage system use?
A. 3
B. 4
C. 5
D. 7
Answer: C
Rationale: ESI is a five-level triage algorithm, ranging from Level 1 (most urgent) to
Level 5 (least urgent).
,4. ESI Level 1 is assigned to patients who:
A. Require immediate life-saving intervention
B. Can safely wait several hours
C. Have entirely stable vital signs
D. Need only one resource
Answer: A
Rationale: ESI Level 1 is reserved for patients requiring immediate life-saving
intervention, such as those in cardiac or respiratory arrest.
5. ESI Level 2 is assigned to a 'high-risk situation' patient, generally defined as
one who:
A. Is dying and needs immediate resuscitation
B. Should not wait because the condition could deteriorate rapidly, or who is in
severe pain or distress
C. Requires zero resources
D. Has entirely normal vital signs and mild symptoms
Answer: B
Rationale: Level 2 captures patients who are not yet in extremis but who cannot safely
wait, including those in severe pain/distress or a high-risk clinical situation.
6. The first decision point in the ESI algorithm asks whether the patient:
A. Has insurance coverage
B. Requires immediate life-saving intervention
C. Needs an X-ray
D. Speaks English
Answer: B
Rationale: The very first ESI decision point determines whether the patient is dying and
needs immediate life-saving intervention, which would make them ESI Level 1.
,7. The second decision point in the ESI algorithm asks whether the patient:
A. Is a high-risk situation, is confused/lethargic/disoriented, or is in severe
pain/distress
B. Needs a wheelchair
C. Has a fever
D. Arrived by ambulance
Answer: A
Rationale: If the patient is not Level 1, the nurse next assesses whether they meet
Level 2 criteria: a high-risk situation, new confusion/lethargy/disorientation, or severe
pain/distress.
8. For ESI Levels 3, 4, and 5, triage acuity is further differentiated based on:
A. The patient's age alone
B. Predicted number of resources needed
C. Insurance type
D. Time of day
Answer: B
Rationale: Once a patient is determined not to be Level 1 or 2, ESI uses the anticipated
number of resources needed to further sort patients into Levels 3, 4, or 5.
9. Under the ESI system, a 'resource' refers to:
A. A staff member's personal opinion
B. Interventions such as labs, ECG, imaging, IV fluids, or specialty consultation
beyond history and physical exam
C. The patient's family members
D. Waiting room seating
Answer: B
Rationale: ESI resources are the diagnostic and therapeutic interventions a clinician
anticipates using to reach a disposition, such as labs, imaging, IV fluids, or
consultations.
, 10. Which of the following is generally NOT counted as a resource under the ESI
system?
A. Point-of-care testing and simple wound care
B. A CT scan
C. IV fluids for hydration
D. Specialty consultation
Answer: A
Rationale: Point-of-care testing (e.g., a urine dip or glucose check) and simple wound
care such as a dressing change are specifically excluded from the ESI resource count,
unlike imaging, IV fluids, or consultations.
11. An example of an ESI Level 1 presentation is:
A. Cardiac arrest
B. A sprained ankle
C. A mild headache
D. A sore throat
Answer: A
Rationale: Cardiac arrest requires immediate resuscitative intervention and is a classic
example of an ESI Level 1 presentation.
12. Vital sign 'danger zone' criteria may be used to consider upgrading a
patient's acuity, particularly for patients who:
A. Are being considered for ESI Level 3 but have concerning vital sign abnormalities
per ESI age-based tables
B. Have entirely normal vital signs
C. Are requesting to be seen faster
D. Have already been discharged
Answer: A
Rationale: ESI includes age-based vital sign thresholds that prompt the nurse to
consider upgrading a patient who would otherwise be Level 3 to Level 2.
1. The primary purpose of triage is to:
A. Diagnose the patient's condition
B. Prioritize patients based on acuity and urgency of need
C. Register the patient in the EHR
D. Assign a treatment room
Answer: B
Rationale: Triage is a rapid sorting process designed to prioritize patients so that those
with the most urgent needs are identified and seen first, not to render a diagnosis.
2. The Emergency Severity Index (ESI) is a triage system based on:
A. Patient's insurance status
B. Acuity and anticipated resource needs
C. Time of arrival only
D. Chief complaint listed alphabetically
Answer: B
Rationale: ESI stratifies patients using both clinical acuity and the number of resources
they are expected to need, rather than arrival order or payer status.
3. How many levels does the ESI triage system use?
A. 3
B. 4
C. 5
D. 7
Answer: C
Rationale: ESI is a five-level triage algorithm, ranging from Level 1 (most urgent) to
Level 5 (least urgent).
,4. ESI Level 1 is assigned to patients who:
A. Require immediate life-saving intervention
B. Can safely wait several hours
C. Have entirely stable vital signs
D. Need only one resource
Answer: A
Rationale: ESI Level 1 is reserved for patients requiring immediate life-saving
intervention, such as those in cardiac or respiratory arrest.
5. ESI Level 2 is assigned to a 'high-risk situation' patient, generally defined as
one who:
A. Is dying and needs immediate resuscitation
B. Should not wait because the condition could deteriorate rapidly, or who is in
severe pain or distress
C. Requires zero resources
D. Has entirely normal vital signs and mild symptoms
Answer: B
Rationale: Level 2 captures patients who are not yet in extremis but who cannot safely
wait, including those in severe pain/distress or a high-risk clinical situation.
6. The first decision point in the ESI algorithm asks whether the patient:
A. Has insurance coverage
B. Requires immediate life-saving intervention
C. Needs an X-ray
D. Speaks English
Answer: B
Rationale: The very first ESI decision point determines whether the patient is dying and
needs immediate life-saving intervention, which would make them ESI Level 1.
,7. The second decision point in the ESI algorithm asks whether the patient:
A. Is a high-risk situation, is confused/lethargic/disoriented, or is in severe
pain/distress
B. Needs a wheelchair
C. Has a fever
D. Arrived by ambulance
Answer: A
Rationale: If the patient is not Level 1, the nurse next assesses whether they meet
Level 2 criteria: a high-risk situation, new confusion/lethargy/disorientation, or severe
pain/distress.
8. For ESI Levels 3, 4, and 5, triage acuity is further differentiated based on:
A. The patient's age alone
B. Predicted number of resources needed
C. Insurance type
D. Time of day
Answer: B
Rationale: Once a patient is determined not to be Level 1 or 2, ESI uses the anticipated
number of resources needed to further sort patients into Levels 3, 4, or 5.
9. Under the ESI system, a 'resource' refers to:
A. A staff member's personal opinion
B. Interventions such as labs, ECG, imaging, IV fluids, or specialty consultation
beyond history and physical exam
C. The patient's family members
D. Waiting room seating
Answer: B
Rationale: ESI resources are the diagnostic and therapeutic interventions a clinician
anticipates using to reach a disposition, such as labs, imaging, IV fluids, or
consultations.
, 10. Which of the following is generally NOT counted as a resource under the ESI
system?
A. Point-of-care testing and simple wound care
B. A CT scan
C. IV fluids for hydration
D. Specialty consultation
Answer: A
Rationale: Point-of-care testing (e.g., a urine dip or glucose check) and simple wound
care such as a dressing change are specifically excluded from the ESI resource count,
unlike imaging, IV fluids, or consultations.
11. An example of an ESI Level 1 presentation is:
A. Cardiac arrest
B. A sprained ankle
C. A mild headache
D. A sore throat
Answer: A
Rationale: Cardiac arrest requires immediate resuscitative intervention and is a classic
example of an ESI Level 1 presentation.
12. Vital sign 'danger zone' criteria may be used to consider upgrading a
patient's acuity, particularly for patients who:
A. Are being considered for ESI Level 3 but have concerning vital sign abnormalities
per ESI age-based tables
B. Have entirely normal vital signs
C. Are requesting to be seen faster
D. Have already been discharged
Answer: A
Rationale: ESI includes age-based vital sign thresholds that prompt the nurse to
consider upgrading a patient who would otherwise be Level 3 to Level 2.
