ENP — Emergency Nurse Practitioner Certification
1. According to the Emergency Severity Index (ESI), a patient presenting with
active seizure activity should be triaged as which level?
A. ESI Level 2
B. ESI Level 3
C. ESI Level 1
D. ESI Level 4
2. In the primary survey of a trauma patient, which assessment takes priority after
airway with cervical spine protection?
A. Disability/neurologic status
B. Exposure and environmental control
C. Circulation with hemorrhage control
D. Breathing and ventilation
3. A patient arrives with a Glasgow Coma Scale score of 8. This finding most
appropriately warrants which intervention?
A. Oral airway placement only
B. Definitive airway management
C. Observation for one hour
D. Discharge with neuro checks
4. Which vital sign trend is the earliest and most sensitive indicator of
compensated shock in an adult?
A. Narrowed pulse pressure alone
B. Hypotension
C. Bradycardia
D. Tachycardia
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, ENP — Emergency Nurse Practitioner Certification
5. Using the START triage method in a mass casualty incident, a victim who is not
breathing after airway repositioning is categorized as which color?
A. Yellow (delayed)
B. Red (immediate)
C. Black (deceased/expectant)
D. Green (minor)
6. A patient with a respiratory rate of 32, capillary refill of 3 seconds, and unable to
follow commands is triaged under START as which category?
A. Red (immediate)
B. Green (minor)
C. Black (expectant)
D. Yellow (delayed)
7. Which of the following is the most reliable initial indicator of adequate tissue
perfusion in the ED?
A. Mental status and skin perfusion
B. Pulse oximetry alone
C. Heart rate alone
D. Systolic blood pressure alone
8. The AVPU scale is primarily used in emergency assessment to rapidly evaluate
which parameter?
A. Airway patency
B. Peripheral perfusion
C. Ventilatory effort
D. Level of consciousness
9. In a patient with suspected sepsis, which single finding should prompt
immediate ESI Level 2 triage?
A. Mild tachycardia in a well-appearing patient
B. Lactate concerning for organ dysfunction with abnormal vital signs
C. Reported chills without objective fever
D. Isolated low-grade fever without other symptoms
10. The correct order of the primary trauma survey is best represented by which
mnemonic sequence?
A. B-A-C-D-E
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, ENP — Emergency Nurse Practitioner Certification
B. D-A-B-C-E
C. A-B-C-D-E
D. C-A-B-D-E
11. A pregnant trauma patient beyond 20 weeks gestation should be positioned
how during the primary survey to prevent supine hypotensive syndrome?
A. Supine with legs elevated
B. Left lateral tilt or manual uterine displacement
C. Trendelenburg position
D. Right lateral tilt
12. Which triage tool is specifically validated for use in pediatric emergency
patients to estimate weight and guide resuscitation?
A. SALT triage
B. Broselow tape
C. START triage
D. CTAS scale
13. A patient reports chest pain radiating to the jaw with diaphoresis. What is the
appropriate ESI acuity level?
A. ESI Level 3
B. ESI Level 2
C. ESI Level 4
D. ESI Level 5
14. During the secondary survey, obtaining a AMPLE history refers to gathering
which categories of information?
A. Age, Mechanism, Pain, Level of consciousness, Exposure
B. Allergies, Mobility, Past surgeries, Labs, Exam
C. Allergies, Medications, Past history, Last meal, Events
D. Airway, Mobility, Pulse, Level, Exposure
15. Which of the following best describes the purpose of the disability component
(D) in the primary survey?
A. Assessment of musculoskeletal disability
B. Determining discharge disposition
C. Evaluating psychiatric status
D. Rapid neurologic assessment including GCS and pupils
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, ENP — Emergency Nurse Practitioner Certification
16. A patient with an isolated closed fracture of the wrist, normal vital signs, and
pain rated 4/10 is most appropriately triaged as which ESI level?
A. ESI Level 3
B. ESI Level 1
C. ESI Level 4
D. ESI Level 2
17. Jump START, a pediatric-specific mass casualty triage tool, differs from adult
START primarily in its approach to which assessment?
A. Pediatric patients bypass respiratory assessment entirely
B. Capillary refill is not assessed in children
C. Apneic pediatric patients receive rescue breaths before being classified
as deceased
D. Pediatric patients are always triaged green
18. In the exposure/environment component of the primary survey, which action is
essential after fully undressing a trauma patient?
A. Applying ice packs to all extremities
B. Leaving the patient uncovered for full team visualization indefinitely
C. Preventing hypothermia with warming measures
D. Delaying warming until after CT imaging
19. A patient with a heart rate of 130, systolic BP of 85, and confusion is classified
in which class of hemorrhagic shock?
A. Class III
B. Class I
C. Class II
D. Class IV
20. Which statement about the Canadian Triage and Acuity Scale (CTAS) is
accurate?
A. It does not incorporate vital signs
B. It uses a 3-level scale
C. It is used exclusively for pediatric patients
D. It uses a 5-level scale similar in structure to ESI
21. A patient presents with a stab wound to the abdomen and is hemodynamically
unstable. What is the priority ED intervention?
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1. According to the Emergency Severity Index (ESI), a patient presenting with
active seizure activity should be triaged as which level?
A. ESI Level 2
B. ESI Level 3
C. ESI Level 1
D. ESI Level 4
2. In the primary survey of a trauma patient, which assessment takes priority after
airway with cervical spine protection?
A. Disability/neurologic status
B. Exposure and environmental control
C. Circulation with hemorrhage control
D. Breathing and ventilation
3. A patient arrives with a Glasgow Coma Scale score of 8. This finding most
appropriately warrants which intervention?
A. Oral airway placement only
B. Definitive airway management
C. Observation for one hour
D. Discharge with neuro checks
4. Which vital sign trend is the earliest and most sensitive indicator of
compensated shock in an adult?
A. Narrowed pulse pressure alone
B. Hypotension
C. Bradycardia
D. Tachycardia
Page 1 of 60
, ENP — Emergency Nurse Practitioner Certification
5. Using the START triage method in a mass casualty incident, a victim who is not
breathing after airway repositioning is categorized as which color?
A. Yellow (delayed)
B. Red (immediate)
C. Black (deceased/expectant)
D. Green (minor)
6. A patient with a respiratory rate of 32, capillary refill of 3 seconds, and unable to
follow commands is triaged under START as which category?
A. Red (immediate)
B. Green (minor)
C. Black (expectant)
D. Yellow (delayed)
7. Which of the following is the most reliable initial indicator of adequate tissue
perfusion in the ED?
A. Mental status and skin perfusion
B. Pulse oximetry alone
C. Heart rate alone
D. Systolic blood pressure alone
8. The AVPU scale is primarily used in emergency assessment to rapidly evaluate
which parameter?
A. Airway patency
B. Peripheral perfusion
C. Ventilatory effort
D. Level of consciousness
9. In a patient with suspected sepsis, which single finding should prompt
immediate ESI Level 2 triage?
A. Mild tachycardia in a well-appearing patient
B. Lactate concerning for organ dysfunction with abnormal vital signs
C. Reported chills without objective fever
D. Isolated low-grade fever without other symptoms
10. The correct order of the primary trauma survey is best represented by which
mnemonic sequence?
A. B-A-C-D-E
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, ENP — Emergency Nurse Practitioner Certification
B. D-A-B-C-E
C. A-B-C-D-E
D. C-A-B-D-E
11. A pregnant trauma patient beyond 20 weeks gestation should be positioned
how during the primary survey to prevent supine hypotensive syndrome?
A. Supine with legs elevated
B. Left lateral tilt or manual uterine displacement
C. Trendelenburg position
D. Right lateral tilt
12. Which triage tool is specifically validated for use in pediatric emergency
patients to estimate weight and guide resuscitation?
A. SALT triage
B. Broselow tape
C. START triage
D. CTAS scale
13. A patient reports chest pain radiating to the jaw with diaphoresis. What is the
appropriate ESI acuity level?
A. ESI Level 3
B. ESI Level 2
C. ESI Level 4
D. ESI Level 5
14. During the secondary survey, obtaining a AMPLE history refers to gathering
which categories of information?
A. Age, Mechanism, Pain, Level of consciousness, Exposure
B. Allergies, Mobility, Past surgeries, Labs, Exam
C. Allergies, Medications, Past history, Last meal, Events
D. Airway, Mobility, Pulse, Level, Exposure
15. Which of the following best describes the purpose of the disability component
(D) in the primary survey?
A. Assessment of musculoskeletal disability
B. Determining discharge disposition
C. Evaluating psychiatric status
D. Rapid neurologic assessment including GCS and pupils
Page 3 of 60
, ENP — Emergency Nurse Practitioner Certification
16. A patient with an isolated closed fracture of the wrist, normal vital signs, and
pain rated 4/10 is most appropriately triaged as which ESI level?
A. ESI Level 3
B. ESI Level 1
C. ESI Level 4
D. ESI Level 2
17. Jump START, a pediatric-specific mass casualty triage tool, differs from adult
START primarily in its approach to which assessment?
A. Pediatric patients bypass respiratory assessment entirely
B. Capillary refill is not assessed in children
C. Apneic pediatric patients receive rescue breaths before being classified
as deceased
D. Pediatric patients are always triaged green
18. In the exposure/environment component of the primary survey, which action is
essential after fully undressing a trauma patient?
A. Applying ice packs to all extremities
B. Leaving the patient uncovered for full team visualization indefinitely
C. Preventing hypothermia with warming measures
D. Delaying warming until after CT imaging
19. A patient with a heart rate of 130, systolic BP of 85, and confusion is classified
in which class of hemorrhagic shock?
A. Class III
B. Class I
C. Class II
D. Class IV
20. Which statement about the Canadian Triage and Acuity Scale (CTAS) is
accurate?
A. It does not incorporate vital signs
B. It uses a 3-level scale
C. It is used exclusively for pediatric patients
D. It uses a 5-level scale similar in structure to ESI
21. A patient presents with a stab wound to the abdomen and is hemodynamically
unstable. What is the priority ED intervention?
Page 4 of 60
