NCLEX Emergency Nursing & Triage Exam Questions and Answers

170 Questions and Answers

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In emergency settings, nurses must act quickly, think critically, and prioritize care efficiently. This NCLEX Emergency Nursing & Triage Exam Questions and Answers resource is specifically designed to prepare nursing students and professionals for the high-stakes decisions and rapid-response scenarios frequently assessed on the NCLEX-RN exam.

This practice exam focuses on key concepts in emergency care, including the principles of triage, prioritization of care, airway-breathing-circulation (ABC) assessments, trauma response, and emergency interventions. It covers both medical and surgical emergencies—ranging from myocardial infarction and stroke to sepsis, shock, burns, and respiratory failure.

You’ll encounter real-world scenario-based questions that challenge you to recognize life-threatening conditions, apply critical thinking, and determine the most appropriate nursing actions. The questions reinforce knowledge of emergency protocols, such as the Emergency Severity Index (ESI), disaster management, mass casualty triage, and crisis communication.

The test also explores the use of rapid assessment tools, delegation in high-pressure settings, and the ethical responsibilities involved in emergency care. Emphasis is placed on safe medication administration during emergencies, patient stabilization, and communication within interdisciplinary teams.

Designed to simulate the complexity of clinical emergencies, this exam resource strengthens your ability to prioritize patients, anticipate complications, and provide safe, efficient care under pressure. It’s especially beneficial for learners preparing for the NCLEX and those pursuing careers in emergency departments, urgent care clinics, critical care units, or trauma centers.

Whether you’re building foundational skills or refreshing your emergency nursing knowledge, this practice test offers a high-yield, exam-focused approach that supports success on test day and in real clinical environments.

By mastering the content in this practice exam, you’ll be better prepared to face urgent situations with clarity, speed, and sound clinical judgment—hallmarks of an exceptional emergency nurse.

Sample Questions and Answers

  1. A 60-year-old patient arrives at the emergency department (ED) with chest pain radiating to the left arm. Which action should the nurse take first?
  • A. Obtain a complete medical history.
  • B. Administer sublingual nitroglycerin.
  • C. Apply oxygen via nasal cannula.
  • D. Perform a 12-lead ECG.
    Answer: D. Perform a 12-lead ECG.
  1. What is the most appropriate intervention for a patient experiencing hypoglycemia?
  • A. Administer glucagon IM.
  • B. Provide a high-protein snack.
  • C. Administer 1 ampule of D50 IV.
  • D. Give 500 mL of D5W.
    Answer: C. Administer 1 ampule of D50 IV.
  1. A triage nurse should prioritize which of the following patients?
  • A. A 25-year-old with a swollen ankle after a fall.
  • B. A 40-year-old with shortness of breath and diaphoresis.
  • C. A 50-year-old with a minor hand laceration.
  • D. A 10-year-old with a minor nosebleed.
    Answer: B. A 40-year-old with shortness of breath and diaphoresis.
  1. In emergency triage, what does the “red tag” signify?
  • A. Deceased.
  • B. Minor injury.
  • C. Immediate attention required.
  • D. Delayed treatment.
    Answer: C. Immediate attention required.
  1. A patient with suspected spinal cord injury should be managed by which of the following interventions?
  • A. Perform a head-to-toe physical exam.
  • B. Immobilize the spine.
  • C. Perform a Glasgow Coma Scale (GCS) assessment.
  • D. Place the patient in a semi-Fowler’s position.
    Answer: B. Immobilize the spine.
  1. A burn patient presents with blisters and severe pain. Which type of burn does the patient likely have?
  • A. Superficial.
  • B. Full-thickness.
  • C. Partial-thickness.
  • D. Fourth-degree.
    Answer: C. Partial-thickness.
  1. During cardiac arrest, which rhythm is most appropriate for defibrillation?
  • A. Asystole.
  • B. Ventricular fibrillation.
  • C. Sinus bradycardia.
  • D. Atrial fibrillation.
    Answer: B. Ventricular fibrillation.
  1. What is the initial treatment for a patient with an open chest wound?
  • A. Cover the wound with a sterile dressing.
  • B. Apply a three-sided occlusive dressing.
  • C. Administer high-flow oxygen.
  • D. Place the patient in a prone position.
    Answer: B. Apply a three-sided occlusive dressing.
  1. In a patient with suspected sepsis, which of the following is the nurse’s priority?
  • A. Administer broad-spectrum antibiotics.
  • B. Draw blood cultures.
  • C. Start fluid resuscitation.
  • D. Monitor urine output.
    Answer: C. Start fluid resuscitation.
  1. What is the most critical nursing intervention during a hypertensive crisis?
  • A. Administer antihypertensive medication.
  • B. Insert a Foley catheter.
  • C. Elevate the patient’s legs.
  • D. Provide high-flow oxygen.
    Answer: A. Administer antihypertensive medication.
  1. A patient presents with acute anaphylaxis. What is the priority intervention?
  • A. Establish an airway.
  • B. Administer IV fluids.
  • C. Provide diphenhydramine.
  • D. Administer epinephrine IM.
    Answer: D. Administer epinephrine IM.
  1. Which medication is most appropriate for a patient with acute opioid overdose?
  • A. Naloxone.
  • B. Flumazenil.
  • C. Atropine.
  • D. Activated charcoal.
    Answer: A. Naloxone.
  1. In assessing a patient with head trauma, which finding requires immediate intervention?
  • A. Vomiting.
  • B. Glasgow Coma Scale (GCS) of 15.
  • C. Unequal pupil size.
  • D. Headache.
    Answer: C. Unequal pupil size.
  1. A patient arrives with frostbite on both feet. What is the priority intervention?
  • A. Rub the affected areas vigorously.
  • B. Immerse the feet in warm water (37–40°C).
  • C. Administer pain medication.
  • D. Apply ice packs to the area.
    Answer: B. Immerse the feet in warm water (37–40°C).
  1. Which lab finding is most concerning for a patient with trauma?
  • A. Hemoglobin of 14 g/dL.
  • B. Platelet count of 90,000/mm³.
  • C. White blood cell count of 11,000/mm³.
  • D. Serum sodium of 140 mEq/L.
    Answer: B. Platelet count of 90,000/mm³.
  1. The nurse identifies which of the following as a symptom of carbon monoxide poisoning?
  • A. Cyanosis.
  • B. Cherry-red skin.
  • C. Jaundice.
  • D. Petechiae.
    Answer: B. Cherry-red skin.
  1. In managing a patient with a tension pneumothorax, the nurse should prepare for which intervention?
  • A. Chest tube insertion.
  • B. Bronchoscopy.
  • C. Endotracheal intubation.
  • D. Needle decompression.
    Answer: D. Needle decompression.
  1. A patient in the ED exhibits signs of acute stroke. What is the priority intervention?
  • A. Administer aspirin.
  • B. Perform a CT scan of the head.
  • C. Check blood glucose levels.
  • D. Administer tissue plasminogen activator (tPA).
    Answer: B. Perform a CT scan of the head.
  1. Which intervention is most critical for a patient with a snakebite?
  • A. Elevate the affected limb.
  • B. Apply a tourniquet.
  • C. Immobilize the affected limb.
  • D. Administer corticosteroids.
    Answer: C. Immobilize the affected limb.
  1. For a patient with heatstroke, what is the initial nursing intervention?
  • A. Administer antipyretics.
  • B. Initiate rapid cooling measures.
  • C. Provide oral fluids.
  • D. Place the patient in a Trendelenburg position.
    Answer: B. Initiate rapid cooling measures.

 

  1. A patient arrives at the ED with a suspected stroke. Which time-sensitive intervention is most critical?
  • A. Start IV fluids.
  • B. Perform a head CT scan without contrast.
  • C. Draw blood for coagulation studies.
  • D. Administer aspirin immediately.
    Answer: B. Perform a head CT scan without contrast.
  1. A patient presents to triage with complaints of abdominal pain rated 9/10, accompanied by hypotension and tachycardia. What is the nurse’s priority?
  • A. Initiate IV fluids.
  • B. Administer pain medication.
  • C. Obtain a urine sample.
  • D. Prepare for an ultrasound.
    Answer: A. Initiate IV fluids.
  1. Which finding suggests airway obstruction in a patient?
  • A. Stridor.
  • B. Wheezing.
  • C. Crackles.
  • D. Rhonchi.
    Answer: A. Stridor.
  1. A nurse triaging during a mass casualty event assigns which priority level to a patient with a minor laceration on the arm?
  • A. Red tag.
  • B. Yellow tag.
  • C. Green tag.
  • D. Black tag.
    Answer: C. Green tag.
  1. In a patient with severe sepsis, which lab result would concern the nurse the most?
  • A. Elevated white blood cell count.
  • B. Blood glucose of 120 mg/dL.
  • C. Serum lactate of 5 mmol/L.
  • D. Platelet count of 250,000/mm³.
    Answer: C. Serum lactate of 5 mmol/L.
  1. What is the appropriate nursing intervention for a patient with a suspected cervical spine injury?
  • A. Perform a chin-lift maneuver.
  • B. Logroll the patient when moving.
  • C. Remove the cervical collar to assess.
  • D. Elevate the head of the bed to 45 degrees.
    Answer: B. Logroll the patient when moving.
  1. A patient is admitted with diabetic ketoacidosis (DKA). What is the first intervention the nurse should implement?
  • A. Administer IV insulin.
  • B. Start fluid resuscitation.
  • C. Check blood glucose.
  • D. Administer potassium supplements.
    Answer: B. Start fluid resuscitation.
  1. A nurse suspects a tension pneumothorax in a trauma patient. Which clinical sign supports this suspicion?
  • A. Bilateral crackles.
  • B. Tracheal deviation to the unaffected side.
  • C. Bradycardia.
  • D. Hyperresonance on the affected side.
    Answer: B. Tracheal deviation to the unaffected side.
  1. A child presents with a febrile seizure in the ED. What is the nurse’s priority action?
  • A. Administer antipyretics.
  • B. Ensure a patent airway.
  • C. Apply seizure precautions.
  • D. Start an IV for fluid resuscitation.
    Answer: B. Ensure a patent airway.
  1. A patient with suspected meningitis requires which intervention first?
  • A. Administer IV antibiotics.
  • B. Perform a lumbar puncture.
  • C. Start seizure precautions.
  • D. Assess the patient’s Glasgow Coma Scale (GCS).
    Answer: A. Administer IV antibiotics.

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