A 58-year-old man presents with crushing substernal chest pain radiating to the left arm, diaphoresis, and nausea for the past 45 minutes. His 12-lead ECG shows ST-segment elevation greater than 1 mm in leads II, III, and aVF. Which diagnosis is most likely?

A patient with chest pain has an initial troponin I level within normal limits. Which action is the most appropriate next step regarding troponin testing?

A 68-year-old patient with a history of stroke is brought to the ED after vomiting and inhaling gastric contents. The nurse anticipates that the chemical injury to lung tissue from aspiration of gastric acid most commonly leads to which immediate response?

Which patient characteristic places an individual at the HIGHEST risk for aspiration of gastric contents?

A 34-year-old patient presents with ascending bilateral leg weakness that began two weeks after a gastrointestinal illness. Deep tendon reflexes are absent in both lower extremities. Which condition is most consistent with this presentation?

A patient with known Guillain-Barre syndrome is admitted to the emergency department with progressive dyspnea. Which assessment finding most urgently indicates the need for intubation?

A 19-year-old male presents with pain that began around the umbilicus 12 hours ago and has since migrated to the right lower quadrant. He has a low-grade fever of 38.1 C and nausea. Which finding on physical examination is most consistent with acute appendicitis?

A nurse is caring for a patient suspected of having appendicitis. The physician asks the nurse to assess for Rovsing’s sign. Which technique correctly elicits this sign?

A 24-year-old woman presents with dysuria, urinary frequency, and suprapubic discomfort for two days. She is afebrile with no costovertebral angle (CVA) tenderness. Urinalysis shows pyuria and bacteriuria. Which treatment is most appropriate for uncomplicated cystitis in a nonpregnant adult woman?

A 32-year-old pregnant woman at 20 weeks gestation is found to have asymptomatic bacteriuria on routine prenatal screening. Which of the following best explains why treatment is recommended in this population?

A patient in the emergency department becomes increasingly agitated, pacing and shouting at staff. Which initial de-escalation action is most appropriate?

When positioning during a verbal de-escalation encounter with an agitated patient, the emergency nurse should:

A patient arrives with urticaria, throat tightness, and hypotension after eating shellfish. Which medication is the first priority intervention?

The preferred injection site for epinephrine administration in anaphylaxis is:

A patient with a tibial fracture reports increasing pain that is not relieved by opioids, along with a feeling of tightness in the lower leg. Which assessment finding most strongly supports a diagnosis of acute compartment syndrome?

A patient with a forearm crush injury has a compartment pressure measured at 38 mmHg and a diastolic blood pressure of 60 mmHg. Which clinical decision is most appropriate at this time?

A 42-year-old patient presents with sudden onset of right-sided facial drooping that began this morning. She cannot fully close her right eye, has decreased taste on the right side of her tongue, and reports no limb weakness. Which finding best distinguishes Bell palsy from a central (upper motor neuron) facial nerve lesion?

A 55-year-old patient is diagnosed with Bell palsy. His eye will not fully close, leaving a 3 mm gap. Which intervention is the highest priority to prevent corneal injury?

A 30-year-old male sustains partial-thickness burns to both arms (anterior and posterior surfaces) and the entire anterior trunk after a house fire. Using the Rule of Nines, what percentage of total body surface area (TBSA) is burned?

A nurse is calculating the Parkland formula for fluid resuscitation in a burn patient. The patient weighs 80 kg and has 25% TBSA partial-thickness burns. How much lactated Ringer solution should be administered in the first 8 hours after injury?

A 7-year-old arrives at triage crying and holding the right arm after falling off a bicycle. Vital signs are within normal limits for age. The child is alert and interactive, and the arm appears deformed at the forearm. Which acuity level is most appropriate when the anticipated workup includes imaging plus procedural splinting and parenteral pain control?

An adult presents to triage with an uncomplicated ingrown toenail, no signs of infection, and stable vital signs. The anticipated plan is a focused examination and possibly a prescription, with no labs or imaging expected. Which acuity level best fits this presentation?