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ESI Levels Competency Exam 2026/2027 – Complete Questions and Verified Solutions – Instant Download

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This document contains the complete ESI Levels Competency exam for 2026/2027, with verified questions, detailed solutions, and clinical reasoning for triage and emergency department cases. It covers ESI Levels 1–5, including immediate lifesaving interventions, high-risk pediatric and adult cases, procedural prioritization, pain management, and multi-resource assessment. Each scenario includes step-by-step guidance on patient evaluation, vital signs interpretation, and appropriate interventions, making it an essential resource for nursing students, emergency care professionals, and healthcare providers preparing for ESI competency exams and real-world emergency triage.

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ESI LEVELS COMPETENCY SET EXAM QUESTIONS AND ANSWERS

WITH COMPLETE SOLUTIONS VERIFIED LATEST UPDATE GRADED

A+ 2026/2027



"I think I picked up a bug ESI level 3: Two or more resources. From

overseas," reports a 34-year- the patient's history, he will require labs

old male who presented in and IV fluid replacement—two

the emergency resources.

department

complaining of frequent

watery stools and abdominal

cramping. "I think I am

getting dehydrated." T 98°F,

RR 22, HR 112, BP 120/80,

SpO2 100%. Pain 6/10.

When asked why she came to ESI level 3: Two or more resources. It

the emergency looks as though this patient has a

department, the 18-year-old displaced fracture and will need a

,college student begins to closed reduction prior to casting or
cry. She tells the triage splinting. At a
nurse that she was minimum, he needs x-rays and an
sexually orthopedic consult. This patient may also
assaulted last night at an off- require procedural sedation. However,

campus party. there are already two or more

resources, so it is

not necessary to be overly concerned

about counting resources beyond two.

"I don't know what's wrong ESI level 1: Requires immediate lifesaving

with my baby girl," cries a intervention; possible aggressive fluid

young mother. She reports resuscitation.

that her 2-week-old baby is

not acting right and is

not interested in eating.

As you begin to undress

the baby, you notice that

she is listless and her skin

is mottled.

,"My pain medications are ESI level 2: Severe pain or distress. This

not working anymore. Last patient needs aggressive pain

night I couldn't sleep management with IV medications. There is

because the pain was so nothing the triage nurse can do to

bad," reports a 47-year- decrease the patient's pain level. The
old female with metastatic answer to "Would you give your last
ovarian cancer. "My open bed to this patient?" should be
husband called my yes.
oncologist, and he told me

to come to the emergency

department." The patient

rates her pain as 9/10. Vital

signs are within normal

limits.

, A 48-year-old male tells ESI level 3: Two or more resources. The

you that he has a history patient is presenting with signs and

of kidney stones and thinks symptoms of another kidney stone. At a

he has another one. He has minimum, he will need a urinalysis and CT

right costovertebral angle scan. If his pain increases, he may need

pain that radiates around IV pain medication. At a minimum, two

to the resources are required. If the pain level

front and into his groin. He was 7/10 or greater and the triage

is nauseous but tells you he nurse could not manage the pain at

took a pain pill, and right triage, the patient could meet level-

now he has minimal pain. 2 criteria.

He denies vomiting. T 98°F,

RR 16, HR 80, BP 136/74,

SpO2 100%. Pain 3/10.

"After my pediatrician saw ESI level 2: High risk. Rashes are

my son's rash, he said I had difficult to triage, but the presence of

to bring him to the petechiae is always a high-risk

emergency department situation. Even if the patient looks

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