EMERGENCY NURSING {GEN} & CLINICAL DECISION-MAKING |
2025–2026 COMPREHENSIVE STUDY GUIDE |170 VERIFIED NCLEX &
CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
This study guide offers a comprehensive collection of high-yield emergency
nursing and clinical scenarios with verified, exam-style questions and correct
answers, fully aligned with NCLEX, CEN, and acute care certification standards
for 2025–2026. It includes case-based reasoning for trauma, pulmonary
embolism, behavioral emergencies, endocrine disorders, infectious disease
protocols, anxiety presentations, and shock states. Perfect for nurses
preparing for NCLEX, emergency nursing certifications, or clinical rotations in
ED, ICU, or urgent care settings.
Which of the following statements made by a patient would lead the nurse to conclude that the
patient understands risk factors for pulmonary embolism?
While on a long flight, I should get up and walk to stretch my legs every hour.
Resuming my birth control pills will lower my risk of cancer and my risk of another clot.
If I drink plenty of water while driving on a long trip, this shouldn't happen again.
Switching from my regular cigarettes to the electronic ones can reduce my risk. - CORRECT
ANSWER-While on a long flight, I should get up and walk to stretch my legs every hour.
A middle-aged male patient presents to the ED with complaint of fever. He is awake, alert, and in no
acute distress. On arrival, vital signs are BP 118/58 mm Hg, HR 112 beats/min, RR 20 breaths/min,
SpO2 95%, T 38.8 C (101.9 F). His medical history includes human immunodeficiency virus (HIV) and
he is taking antiviral medications. Using a 5-level triage system, this patient would be triaged as
which acuity level?
Acuity Level 4 (non-urgent)
Acuity Level 2 (emergent)
Acuity Level 1 (life-threatening situation)
Acuity Level 3 (urgent) - CORRECT ANSWER-Acuity Level 2 (emergent)
An 84-year-old male with a decreased level of consciousness presents to the emergency department
from a nursing home. The patient has a history of hypertension, gout, and chronic obstructive
pulmonary disease. He is allergic to penicillin. Current medications include docusate, albuterol
,inhaler, colchicine, and metoprolol. Vital signs on arrival are BP 78/48 mm Hg, HR 60 beats/min, RR
28 breaths/min, T 35.3 C (95.6 F), and SpO2 92% without supplemental oxygen. Which type of shock
do these clinical manifestations represent?
Obstructive
Septic
Anaphylactic
Hypovolemic - CORRECT ANSWER-Septic
A 56-year-old female presents to the emergency department with complaints of abdominal pain for
5 days. The patient was involved in a motor vehicle crash, but did not feel that she needed to come
to the emergency department. Upon examination, the patient has no active bowel sounds and the
abdomen is rigid. The patient has which gastrointestinal emergency?
Peritonitis
Diverticulitis
Intestinal obstruction
Esophageal obstruction - CORRECT ANSWER-Peritonitis
A patient, who was successfully defibrillated, now has an irregular rhythm at 86 beats/min. The
patient remains unresponsive, with absent central pulses. These findings are associated with which
condition?
Ruptured aortic aneurysm
Pulseless electrical activity
Pericardial tamponade
Coarse ventricular fibrillation - CORRECT ANSWER-Pulseless electrical activity
An adolescent playing basketball felt a pop in her heel after a jump shot, and a sharp pain in her heel
as she landed. She is unable to stand on the ball of her foot. Which injury do these clinical
manifestations most likely represent?
Calcaneous fracture
Achilles tendon rupture
Ankle strain
Metatarsal fracture - CORRECT ANSWER-Achilles tendon rupture
,A patient arrives after getting a hand caught in a machine, peeling the skin away and exposing
underlying structures. What injury does this represent?
Hematoma
Avulsion
Laceration
Abrasion - CORRECT ANSWER-Avulsion
The nurse is providing discharge instructions to a patient with asthma. Which of the following
statements indicates understanding from the patient?
I should avoid air conditioning if I begin having symptoms
I'm going to wash my bed linen once a week in hot water.
To get a baseline peak expiratory flow, I'll do it right before I use my inhaler.
My son uses a spacer, but since I'm an adult and can coordinate the inhaler, I don't need one. -
CORRECT ANSWER-I'm going to wash my bed linen once a week in hot water.
Discharge instructions are given to a patient with a prescription for phenazopyridine. Which
statement by the patient indicates an understanding of the medication's side effects?
My urine will have an orange discoloration.
I can continue to take it even if I develop a rash.
This medication does not have any side effects.
I may gain weight while taking this medication. - CORRECT ANSWER-My urine will have an
orange discoloration.
A patient presents to the ED stating he had been hit in the right eye with a glass bottle two days ago.
On assessment, the eye is reddened, tearing, and there is an irregular pupil. Which ocular
emergency is associated with these assessment findings?
Retinal detachment
Hyphema
Foreign body
Iritis - CORRECT ANSWER-Iritis
A patient presents to the ED with complaints of feeling guilty and sad. He also has had decreased
appetite and sleep disturbances for the past 3 weeks. What intervention is priority for this patient?
, Performing a suicide risk assessment
Placing patient in a low stimulus area
Administering antidepressants or anxiolytics
Providing a discharge referral for support services - CORRECT ANSWER-Performing a suicide
risk assessment
An ED patient is being prepared for surgical intervention for a large bowel obstruction. The surgeon
needs to obtain a signature for informed consent. The patient is unable to sign the consent form
because of having been heavily sedated. Which advanced directive allows for a family member to
sign the consent form?
Durable power of attorney for finance
Living will
Do not resuscitate order
Durable power of attorney for healthcare - CORRECT ANSWER-Durable power of attorney for
healthcare
A male patient arrives following a motor vehicle collision. Emergency medical services report vital
signs: HR 92 beats/min, RR 20 breaths/min, BP 128/74 mm Hg, SpO2 96% with a nonrebreather at 15
L/min. They state that the airbag malfunctioned and he hit the steering wheel. The nurse assesses
the patient and finds bruising to the sternum, muffled heart tones, and the following vital signs: HR
102 beats/min, RR 18 breaths/min, BP 122/94 mm Hg, SpO2 92%. What pathophysiologic process
does the nurse recognize?
Low pulse pressure
Decrease in afterload
High pulse pressure
Cushing triad - CORRECT ANSWER-Low pulse pressure
Which inherited bleeding disorder is the most common?
Von Willebrand
Classic hemophilia
Christmas disease
Rosenthal syndrome - CORRECT ANSWER-Von Willebrand
Which complication is the most common risk for all puncture wounds?
2025–2026 COMPREHENSIVE STUDY GUIDE |170 VERIFIED NCLEX &
CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
This study guide offers a comprehensive collection of high-yield emergency
nursing and clinical scenarios with verified, exam-style questions and correct
answers, fully aligned with NCLEX, CEN, and acute care certification standards
for 2025–2026. It includes case-based reasoning for trauma, pulmonary
embolism, behavioral emergencies, endocrine disorders, infectious disease
protocols, anxiety presentations, and shock states. Perfect for nurses
preparing for NCLEX, emergency nursing certifications, or clinical rotations in
ED, ICU, or urgent care settings.
Which of the following statements made by a patient would lead the nurse to conclude that the
patient understands risk factors for pulmonary embolism?
While on a long flight, I should get up and walk to stretch my legs every hour.
Resuming my birth control pills will lower my risk of cancer and my risk of another clot.
If I drink plenty of water while driving on a long trip, this shouldn't happen again.
Switching from my regular cigarettes to the electronic ones can reduce my risk. - CORRECT
ANSWER-While on a long flight, I should get up and walk to stretch my legs every hour.
A middle-aged male patient presents to the ED with complaint of fever. He is awake, alert, and in no
acute distress. On arrival, vital signs are BP 118/58 mm Hg, HR 112 beats/min, RR 20 breaths/min,
SpO2 95%, T 38.8 C (101.9 F). His medical history includes human immunodeficiency virus (HIV) and
he is taking antiviral medications. Using a 5-level triage system, this patient would be triaged as
which acuity level?
Acuity Level 4 (non-urgent)
Acuity Level 2 (emergent)
Acuity Level 1 (life-threatening situation)
Acuity Level 3 (urgent) - CORRECT ANSWER-Acuity Level 2 (emergent)
An 84-year-old male with a decreased level of consciousness presents to the emergency department
from a nursing home. The patient has a history of hypertension, gout, and chronic obstructive
pulmonary disease. He is allergic to penicillin. Current medications include docusate, albuterol
,inhaler, colchicine, and metoprolol. Vital signs on arrival are BP 78/48 mm Hg, HR 60 beats/min, RR
28 breaths/min, T 35.3 C (95.6 F), and SpO2 92% without supplemental oxygen. Which type of shock
do these clinical manifestations represent?
Obstructive
Septic
Anaphylactic
Hypovolemic - CORRECT ANSWER-Septic
A 56-year-old female presents to the emergency department with complaints of abdominal pain for
5 days. The patient was involved in a motor vehicle crash, but did not feel that she needed to come
to the emergency department. Upon examination, the patient has no active bowel sounds and the
abdomen is rigid. The patient has which gastrointestinal emergency?
Peritonitis
Diverticulitis
Intestinal obstruction
Esophageal obstruction - CORRECT ANSWER-Peritonitis
A patient, who was successfully defibrillated, now has an irregular rhythm at 86 beats/min. The
patient remains unresponsive, with absent central pulses. These findings are associated with which
condition?
Ruptured aortic aneurysm
Pulseless electrical activity
Pericardial tamponade
Coarse ventricular fibrillation - CORRECT ANSWER-Pulseless electrical activity
An adolescent playing basketball felt a pop in her heel after a jump shot, and a sharp pain in her heel
as she landed. She is unable to stand on the ball of her foot. Which injury do these clinical
manifestations most likely represent?
Calcaneous fracture
Achilles tendon rupture
Ankle strain
Metatarsal fracture - CORRECT ANSWER-Achilles tendon rupture
,A patient arrives after getting a hand caught in a machine, peeling the skin away and exposing
underlying structures. What injury does this represent?
Hematoma
Avulsion
Laceration
Abrasion - CORRECT ANSWER-Avulsion
The nurse is providing discharge instructions to a patient with asthma. Which of the following
statements indicates understanding from the patient?
I should avoid air conditioning if I begin having symptoms
I'm going to wash my bed linen once a week in hot water.
To get a baseline peak expiratory flow, I'll do it right before I use my inhaler.
My son uses a spacer, but since I'm an adult and can coordinate the inhaler, I don't need one. -
CORRECT ANSWER-I'm going to wash my bed linen once a week in hot water.
Discharge instructions are given to a patient with a prescription for phenazopyridine. Which
statement by the patient indicates an understanding of the medication's side effects?
My urine will have an orange discoloration.
I can continue to take it even if I develop a rash.
This medication does not have any side effects.
I may gain weight while taking this medication. - CORRECT ANSWER-My urine will have an
orange discoloration.
A patient presents to the ED stating he had been hit in the right eye with a glass bottle two days ago.
On assessment, the eye is reddened, tearing, and there is an irregular pupil. Which ocular
emergency is associated with these assessment findings?
Retinal detachment
Hyphema
Foreign body
Iritis - CORRECT ANSWER-Iritis
A patient presents to the ED with complaints of feeling guilty and sad. He also has had decreased
appetite and sleep disturbances for the past 3 weeks. What intervention is priority for this patient?
, Performing a suicide risk assessment
Placing patient in a low stimulus area
Administering antidepressants or anxiolytics
Providing a discharge referral for support services - CORRECT ANSWER-Performing a suicide
risk assessment
An ED patient is being prepared for surgical intervention for a large bowel obstruction. The surgeon
needs to obtain a signature for informed consent. The patient is unable to sign the consent form
because of having been heavily sedated. Which advanced directive allows for a family member to
sign the consent form?
Durable power of attorney for finance
Living will
Do not resuscitate order
Durable power of attorney for healthcare - CORRECT ANSWER-Durable power of attorney for
healthcare
A male patient arrives following a motor vehicle collision. Emergency medical services report vital
signs: HR 92 beats/min, RR 20 breaths/min, BP 128/74 mm Hg, SpO2 96% with a nonrebreather at 15
L/min. They state that the airbag malfunctioned and he hit the steering wheel. The nurse assesses
the patient and finds bruising to the sternum, muffled heart tones, and the following vital signs: HR
102 beats/min, RR 18 breaths/min, BP 122/94 mm Hg, SpO2 92%. What pathophysiologic process
does the nurse recognize?
Low pulse pressure
Decrease in afterload
High pulse pressure
Cushing triad - CORRECT ANSWER-Low pulse pressure
Which inherited bleeding disorder is the most common?
Von Willebrand
Classic hemophilia
Christmas disease
Rosenthal syndrome - CORRECT ANSWER-Von Willebrand
Which complication is the most common risk for all puncture wounds?
