Emergency & Trauma Nursing NCLEX
Exam Rated A+ 2025
A nurse is evaluating levels and functions of trauma centers. Which function is
appropriately paired with the level of the trauma center?
a. Level I Located within remote areas and provides advanced life support within
resource capabilities
b. Level II Located within community hospitals and provides care to most injured clients
c. Level III Located in rural communities and provides only basic care to clients
d. Level IV Located in large teaching hospitals and provides a full continuum of trauma
care for all clients - ANSWER-B ~ Level I trauma centers are usually located in large
teaching hospital systems and provide a full continuum of trauma care for all clients.
Both Level II and Level III facilities are usually located in community hospitals. These
trauma centers provide care for most clients and transport to Level I centers when client
needs exceed resource capabilities. Level IV trauma centers are usually located in rural
and remote areas. These centers provide basic care, stabilization, and advanced life
support while transfer arrangements to higher-level trauma centers are made.
A nurse is triaging clients in the emergency department (ED). Which client should the
nurse prioritize to receive care first?
a. A 22-year-old with a painful and swollen right wrist
b. A 45-year-old reporting chest pain and diaphoresis
c. A 60-year-old reporting difficulty swallowing and nausea
d. An 81-year-old with a respiratory rate of 28 breaths/min and a temperature of 101 F -
ANSWER-B ~ A client experiencing chest pain and diaphoresis would be classified as
emergent and would be triaged immediately to a treatment room in the ED. The other
clients are more stable.
A nurse is triaging clients in the emergency department. Which client should be
considered urgent?
a. A 20-year-old female with a chest stab wound and tachycardia
b. A 45-year-old homeless man with a skin rash and sore throat
c. A 75-year-old female with a cough and a temperature of 102 F
d. A 50-year-old male with new-onset confusion and slurred speech - ANSWER-C ~ A
client with a cough and a temperature of 102 F is urgent. This client is at risk for
deterioration and needs to be seen quickly, but is not in an immediately life-threatening
situation. The client with a chest stab wound and tachycardia and the client with new-
onset confusion and slurred speech should be triaged as emergent. The client with a
skin rash and a sore throat is not at risk for deterioration and would be triaged as
nonurgent.
A nurse is triaging clients in the emergency department. Which client should the nurse
classify as nonurgent?
, a. A 44-year-old with chest pain and diaphoresis
b. A 50-year-old with chest trauma and absent breath sounds
c. A 62-year-old with a simple fracture of the left arm
d. A 79-year-old with a temperature of 104 F - ANSWER-C ~ A client in a nonurgent
category can tolerate waiting several hours for health care services without a significant
risk of clinical deterioration. The client with a simple arm fracture and palpable radial
pulses is currently stable, is not at significant risk of clinical deterioration, and would be
considered nonurgent. The client with chest pain and diaphoresis and the client with
chest trauma are emergent owing to the potential for clinical deterioration and would be
seen immediately. The client with a high fever may be stable now but also has a risk of
deterioration.
A nurse prepares to discharge an older adult client home from the emergency
department (ED). Which actions should the nurse take to prevent future ED visits?
(SATA)
a. Provide medical supplies to the family.
b. Consult a home health agency.
c. Encourage participation in community activities.
d. Screen for depression and suicide.
e. Complete a functional assessment. - ANSWER-D, E ~ Due to the high rate of suicide
among older adults, a nurse should assess all older adults for depression and suicide.
The nurse should also screen older adults for functional assessment, cognitive
assessment, and risk for falls to prevent future ED visits.
A trauma client with multiple open wounds is brought to the emergency department in
cardiac arrest. Which action should the nurse take prior to providing advanced cardiac
life support?
a. Contact the on-call orthopedic surgeon.
b. Don personal protective equipment.
c. Notify the Rapid Response Team.
d. Obtain a complete history from the paramedic. - ANSWER-B ~ Nurses must
recognize and plan for a high risk of contamination with blood and body fluids when
engaging in trauma resuscitation. Standard Precautions should be taken in all
resuscitation situations and at other times when exposure to blood and body fluids is
likely. Proper attire consists of an impervious cover gown, gloves, eye protection, a
facemask, a surgical cap, and shoe covers.
An emergency department (ED) case manager is consulted for a client who is
homeless. Which intervention should the case manager provide?
a. Communicate client needs and restrictions to support staff.
b. Prescribe low-cost antibiotics to treat community-acquired infection.
c. Provide referrals to subsidized community-based health clinics.
d. Offer counseling for substance abuse and mental health disorders. - ANSWER-C ~
Case management interventions include facilitating referrals to primary care providers
who are accepting new clients or to subsidized community-based health clinics for
clients or families in need of routine services. The ED nurse is accountable for
Exam Rated A+ 2025
A nurse is evaluating levels and functions of trauma centers. Which function is
appropriately paired with the level of the trauma center?
a. Level I Located within remote areas and provides advanced life support within
resource capabilities
b. Level II Located within community hospitals and provides care to most injured clients
c. Level III Located in rural communities and provides only basic care to clients
d. Level IV Located in large teaching hospitals and provides a full continuum of trauma
care for all clients - ANSWER-B ~ Level I trauma centers are usually located in large
teaching hospital systems and provide a full continuum of trauma care for all clients.
Both Level II and Level III facilities are usually located in community hospitals. These
trauma centers provide care for most clients and transport to Level I centers when client
needs exceed resource capabilities. Level IV trauma centers are usually located in rural
and remote areas. These centers provide basic care, stabilization, and advanced life
support while transfer arrangements to higher-level trauma centers are made.
A nurse is triaging clients in the emergency department (ED). Which client should the
nurse prioritize to receive care first?
a. A 22-year-old with a painful and swollen right wrist
b. A 45-year-old reporting chest pain and diaphoresis
c. A 60-year-old reporting difficulty swallowing and nausea
d. An 81-year-old with a respiratory rate of 28 breaths/min and a temperature of 101 F -
ANSWER-B ~ A client experiencing chest pain and diaphoresis would be classified as
emergent and would be triaged immediately to a treatment room in the ED. The other
clients are more stable.
A nurse is triaging clients in the emergency department. Which client should be
considered urgent?
a. A 20-year-old female with a chest stab wound and tachycardia
b. A 45-year-old homeless man with a skin rash and sore throat
c. A 75-year-old female with a cough and a temperature of 102 F
d. A 50-year-old male with new-onset confusion and slurred speech - ANSWER-C ~ A
client with a cough and a temperature of 102 F is urgent. This client is at risk for
deterioration and needs to be seen quickly, but is not in an immediately life-threatening
situation. The client with a chest stab wound and tachycardia and the client with new-
onset confusion and slurred speech should be triaged as emergent. The client with a
skin rash and a sore throat is not at risk for deterioration and would be triaged as
nonurgent.
A nurse is triaging clients in the emergency department. Which client should the nurse
classify as nonurgent?
, a. A 44-year-old with chest pain and diaphoresis
b. A 50-year-old with chest trauma and absent breath sounds
c. A 62-year-old with a simple fracture of the left arm
d. A 79-year-old with a temperature of 104 F - ANSWER-C ~ A client in a nonurgent
category can tolerate waiting several hours for health care services without a significant
risk of clinical deterioration. The client with a simple arm fracture and palpable radial
pulses is currently stable, is not at significant risk of clinical deterioration, and would be
considered nonurgent. The client with chest pain and diaphoresis and the client with
chest trauma are emergent owing to the potential for clinical deterioration and would be
seen immediately. The client with a high fever may be stable now but also has a risk of
deterioration.
A nurse prepares to discharge an older adult client home from the emergency
department (ED). Which actions should the nurse take to prevent future ED visits?
(SATA)
a. Provide medical supplies to the family.
b. Consult a home health agency.
c. Encourage participation in community activities.
d. Screen for depression and suicide.
e. Complete a functional assessment. - ANSWER-D, E ~ Due to the high rate of suicide
among older adults, a nurse should assess all older adults for depression and suicide.
The nurse should also screen older adults for functional assessment, cognitive
assessment, and risk for falls to prevent future ED visits.
A trauma client with multiple open wounds is brought to the emergency department in
cardiac arrest. Which action should the nurse take prior to providing advanced cardiac
life support?
a. Contact the on-call orthopedic surgeon.
b. Don personal protective equipment.
c. Notify the Rapid Response Team.
d. Obtain a complete history from the paramedic. - ANSWER-B ~ Nurses must
recognize and plan for a high risk of contamination with blood and body fluids when
engaging in trauma resuscitation. Standard Precautions should be taken in all
resuscitation situations and at other times when exposure to blood and body fluids is
likely. Proper attire consists of an impervious cover gown, gloves, eye protection, a
facemask, a surgical cap, and shoe covers.
An emergency department (ED) case manager is consulted for a client who is
homeless. Which intervention should the case manager provide?
a. Communicate client needs and restrictions to support staff.
b. Prescribe low-cost antibiotics to treat community-acquired infection.
c. Provide referrals to subsidized community-based health clinics.
d. Offer counseling for substance abuse and mental health disorders. - ANSWER-C ~
Case management interventions include facilitating referrals to primary care providers
who are accepting new clients or to subsidized community-based health clinics for
clients or families in need of routine services. The ED nurse is accountable for
