PROPHECY EMERGENCY DEPARTMENT RN A PRACTICE
EXAM 2026 | Questions & Answers | Verified Answers | 75
Questions w/ Detailed Rationales | Comprehensive Prep |
Pass Guaranteed - A+ Graded
SECTION 1: TRIAGE AND PRIORITIZATION (Questions 1-8)
Q1: Four patients arrive simultaneously in the emergency department. Which patient
should be assigned the highest priority (ESI Level 1 or 2)?
A. 45-year-old with chest pain, normal vital signs, pain rating 6/10, EKG shows sinus
rhythm
B. 28-year-old with ankle sprain, normal vital signs, pain rating 7/10
C. 62-year-old with altered mental status, respiratory rate 28, SpO2 88% on room air,
hypotensive (BP 78/42). [CORRECT]
D. 35-year-old with abdominal pain, vomiting x2, normal vital signs, pain rating 8/10
Correct Answer: C
Rationale: Patient C meets ESI Level 1 criteria requiring immediate life-saving
intervention. Altered mental status with hypoxemia (SpO2 88%) and hypotension (SBP
<90) indicates shock and respiratory failure, requiring immediate airway management,
oxygenation, and hemodynamic support. Patient A has chest pain but is
hemodynamically stable (ESI 2 or 3). Patient B is a stable extremity injury (ESI 4).
Patient D has significant symptoms but normal vital signs (ESI 3). ESI Level 1 requires
immediate physician intervention and life-saving measures. The combination of altered
mental status + respiratory failure + hypotension creates a "triple threat" requiring
immediate resuscitation.
,Q2: During a mass casualty incident using the START triage system, which patient
would receive a RED (Immediate) tag?
A. 30-year-old walking and talking, minor abrasions
B. 50-year-old with respiratory rate 28, capillary refill 3 seconds, unable to follow
commands. [CORRECT]
C. 25-year-old with no respirations after airway repositioning, no pulse
D. 40-year-old with respiratory rate 18, capillary refill <2 seconds, follows commands
Correct Answer: B
Rationale: START (Simple Triage and Rapid Treatment) uses RPM (Respiration,
Perfusion, Mental status). RED (Immediate) criteria include: RR >30 or <10, capillary refill
>2 seconds, or unable to follow simple commands. Patient B meets two criteria (RR 28
approaching threshold, cap refill 3 seconds, altered mental status). Patient A is GREEN
(Minor/Walking Wounded). Patient C is BLACK (Deceased/Expectant) after airway
repositioning without spontaneous respirations. Patient D is YELLOW (Delayed) with
normal parameters. The inability to follow commands indicates significant
hypoperfusion or brain injury requiring immediate intervention. Capillary refill >2
seconds indicates poor perfusion consistent with shock.
Q3: Using the SALT triage method, which action is appropriate for a patient with
spontaneous respirations but inadequate respiratory effort?
A. Assign BLACK tag and move to collection point
B. Assign RED tag and provide lifesaving intervention. [CORRECT]
C. Assign YELLOW tag and delay treatment
D. Assign GREEN tag and expectant care
Correct Answer: B
,Rationale: SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) prioritizes
patients who need lifesaving interventions (LSI) to survive. Inadequate respiratory effort
requires immediate airway management or ventilatory support (RED tag). SALT differs
from START by incorporating LSI decisions before final categorization. BLACK
(Expectant) is for those unlikely to survive despite resources. YELLOW (Delayed) can
wait for treatment. GREEN (Minimal) has minor injuries. The key SALT principle is "if you
can do something lifesaving quickly, do it"—inadequate respirations meets this criterion.
Q4: Five patients are waiting in the emergency department. Which should the nurse
assess FIRST?
A. 55-year-old with 8/10 chest pain, normal vital signs, waiting 2 hours
B. 22-year-old with 6/10 migraine, photophobia, waiting 1 hour
C. 38-year-old with sore throat, fever 101.2°F, waiting 3 hours
D. 68-year-old with new-onset atrial fibrillation, heart rate 154, BP 98/64, mild dyspnea.
[CORRECT]
Correct Answer: D
Rationale: Patient D has an unstable dysrhythmia with hemodynamic compromise
(hypotension, tachycardia, dyspnea) requiring immediate intervention. New-onset A-fib
with RVR and hypotension can precipitate cardiovascular collapse, stroke, or heart
failure. While Patient A has chest pain, normal vital signs indicate stability. Migraine (B)
and sore throat (C) are lower acuity. The ABC approach and hemodynamic stability
assessment prioritize the patient with dysrhythmia + instability. Heart rate >150 with
hypotension (SBP <100) indicates poor perfusion requiring immediate cardioversion or
rate control.
Q5: Which patient presentation requires IMMEDIATE physician evaluation at triage?
, A. 25-year-old with wrist fracture, neurovascular intact, pain 7/10
B. 40-year-old with abdominal pain, stable vital signs, last meal 6 hours ago
C. 58-year-old with thunderclap headache, BP 220/118, altered mental status.
[CORRECT]
D. 33-year-old with ankle injury, able to bear weight, swelling present
Correct Answer: C
Rationale: Thunderclap headache with severe hypertension and altered mental status
suggests intracranial hemorrhage (subarachnoid or intracerebral), hypertensive
emergency, or increased intracranial pressure—conditions requiring immediate
physician assessment and intervention. This represents a "don't pass go" presentation
at triage. The other patients have stable conditions that, while requiring evaluation, do
not pose immediate threat to life or neurological function. The combination of sudden
severe headache + neurological deficit + severe hypertension constitutes a neurological
emergency.
Q6: In a mass casualty incident with limited resources, which patient would be triaged
as YELLOW (Delayed)?
A. Open airway, respiratory rate 32, capillary refill 4 seconds
B. Severe head injury, unresponsive, agonal respirations
C. Open femur fracture, distal pulses present, controlled bleeding, alert and oriented.
[CORRECT]
D. Minor lacerations, ambulatory, refuses treatment
Correct Answer: C
Rationale: YELLOW (Delayed) patients require medical care but can wait hours without
immediate life threat. Patient C has a significant injury (open femur fracture) but is
hemodynamically stable with intact circulation and normal mental status—can wait for
definitive care. Patient A is RED (Immediate) with respiratory distress and poor
EXAM 2026 | Questions & Answers | Verified Answers | 75
Questions w/ Detailed Rationales | Comprehensive Prep |
Pass Guaranteed - A+ Graded
SECTION 1: TRIAGE AND PRIORITIZATION (Questions 1-8)
Q1: Four patients arrive simultaneously in the emergency department. Which patient
should be assigned the highest priority (ESI Level 1 or 2)?
A. 45-year-old with chest pain, normal vital signs, pain rating 6/10, EKG shows sinus
rhythm
B. 28-year-old with ankle sprain, normal vital signs, pain rating 7/10
C. 62-year-old with altered mental status, respiratory rate 28, SpO2 88% on room air,
hypotensive (BP 78/42). [CORRECT]
D. 35-year-old with abdominal pain, vomiting x2, normal vital signs, pain rating 8/10
Correct Answer: C
Rationale: Patient C meets ESI Level 1 criteria requiring immediate life-saving
intervention. Altered mental status with hypoxemia (SpO2 88%) and hypotension (SBP
<90) indicates shock and respiratory failure, requiring immediate airway management,
oxygenation, and hemodynamic support. Patient A has chest pain but is
hemodynamically stable (ESI 2 or 3). Patient B is a stable extremity injury (ESI 4).
Patient D has significant symptoms but normal vital signs (ESI 3). ESI Level 1 requires
immediate physician intervention and life-saving measures. The combination of altered
mental status + respiratory failure + hypotension creates a "triple threat" requiring
immediate resuscitation.
,Q2: During a mass casualty incident using the START triage system, which patient
would receive a RED (Immediate) tag?
A. 30-year-old walking and talking, minor abrasions
B. 50-year-old with respiratory rate 28, capillary refill 3 seconds, unable to follow
commands. [CORRECT]
C. 25-year-old with no respirations after airway repositioning, no pulse
D. 40-year-old with respiratory rate 18, capillary refill <2 seconds, follows commands
Correct Answer: B
Rationale: START (Simple Triage and Rapid Treatment) uses RPM (Respiration,
Perfusion, Mental status). RED (Immediate) criteria include: RR >30 or <10, capillary refill
>2 seconds, or unable to follow simple commands. Patient B meets two criteria (RR 28
approaching threshold, cap refill 3 seconds, altered mental status). Patient A is GREEN
(Minor/Walking Wounded). Patient C is BLACK (Deceased/Expectant) after airway
repositioning without spontaneous respirations. Patient D is YELLOW (Delayed) with
normal parameters. The inability to follow commands indicates significant
hypoperfusion or brain injury requiring immediate intervention. Capillary refill >2
seconds indicates poor perfusion consistent with shock.
Q3: Using the SALT triage method, which action is appropriate for a patient with
spontaneous respirations but inadequate respiratory effort?
A. Assign BLACK tag and move to collection point
B. Assign RED tag and provide lifesaving intervention. [CORRECT]
C. Assign YELLOW tag and delay treatment
D. Assign GREEN tag and expectant care
Correct Answer: B
,Rationale: SALT (Sort, Assess, Lifesaving Interventions, Treatment/Transport) prioritizes
patients who need lifesaving interventions (LSI) to survive. Inadequate respiratory effort
requires immediate airway management or ventilatory support (RED tag). SALT differs
from START by incorporating LSI decisions before final categorization. BLACK
(Expectant) is for those unlikely to survive despite resources. YELLOW (Delayed) can
wait for treatment. GREEN (Minimal) has minor injuries. The key SALT principle is "if you
can do something lifesaving quickly, do it"—inadequate respirations meets this criterion.
Q4: Five patients are waiting in the emergency department. Which should the nurse
assess FIRST?
A. 55-year-old with 8/10 chest pain, normal vital signs, waiting 2 hours
B. 22-year-old with 6/10 migraine, photophobia, waiting 1 hour
C. 38-year-old with sore throat, fever 101.2°F, waiting 3 hours
D. 68-year-old with new-onset atrial fibrillation, heart rate 154, BP 98/64, mild dyspnea.
[CORRECT]
Correct Answer: D
Rationale: Patient D has an unstable dysrhythmia with hemodynamic compromise
(hypotension, tachycardia, dyspnea) requiring immediate intervention. New-onset A-fib
with RVR and hypotension can precipitate cardiovascular collapse, stroke, or heart
failure. While Patient A has chest pain, normal vital signs indicate stability. Migraine (B)
and sore throat (C) are lower acuity. The ABC approach and hemodynamic stability
assessment prioritize the patient with dysrhythmia + instability. Heart rate >150 with
hypotension (SBP <100) indicates poor perfusion requiring immediate cardioversion or
rate control.
Q5: Which patient presentation requires IMMEDIATE physician evaluation at triage?
, A. 25-year-old with wrist fracture, neurovascular intact, pain 7/10
B. 40-year-old with abdominal pain, stable vital signs, last meal 6 hours ago
C. 58-year-old with thunderclap headache, BP 220/118, altered mental status.
[CORRECT]
D. 33-year-old with ankle injury, able to bear weight, swelling present
Correct Answer: C
Rationale: Thunderclap headache with severe hypertension and altered mental status
suggests intracranial hemorrhage (subarachnoid or intracerebral), hypertensive
emergency, or increased intracranial pressure—conditions requiring immediate
physician assessment and intervention. This represents a "don't pass go" presentation
at triage. The other patients have stable conditions that, while requiring evaluation, do
not pose immediate threat to life or neurological function. The combination of sudden
severe headache + neurological deficit + severe hypertension constitutes a neurological
emergency.
Q6: In a mass casualty incident with limited resources, which patient would be triaged
as YELLOW (Delayed)?
A. Open airway, respiratory rate 32, capillary refill 4 seconds
B. Severe head injury, unresponsive, agonal respirations
C. Open femur fracture, distal pulses present, controlled bleeding, alert and oriented.
[CORRECT]
D. Minor lacerations, ambulatory, refuses treatment
Correct Answer: C
Rationale: YELLOW (Delayed) patients require medical care but can wait hours without
immediate life threat. Patient C has a significant injury (open femur fracture) but is
hemodynamically stable with intact circulation and normal mental status—can wait for
definitive care. Patient A is RED (Immediate) with respiratory distress and poor
