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ESI Practice Cases Exam/100 Questions and Answers/100% Correct
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ESI Practice Cases Exam/100 Questionsand Answers/100% Correct
"I was taking my contacts out last night, and I think I scratched my cornea,"
reports a 27-year-old female. "I'm wearing these sunglasses because the
light really bothers my eyes." Her right eye is red and tearing. She rates her
pain as 6/10. Vital signs are within normal limits. - -ESI level 5: No resources.
This patient will need an eye exam and will be discharged to home with
prescriptions and an appointment to follow up with an ophthalmologist.
-EMS presents to the ED with an 18-year-old female with a suspected
medication overdose. Her college roommates found her lethargic and "not
acting right," so they called 911. The patient has a history of depression. On
exam, you notice multiple superficial lacerations to both wrists. Her
respiratory rate is 10, and her SpO2 on room air is 86 percent. - -ESI level 1:
Requires immediate lifesaving intervention.
The patient's respiratory rate, oxygen saturation, and inability to protect her
own airway indicate the need for immediate endotracheal intubation.
-EMS arrived with an unresponsive 19-year-old male with a single self-
inflicted gunshot wound to the head. Prior to intubation, his Glasgow Coma
Scale score was 3. - -ESI level 1: Requires immediate lifesaving intervention.
The patient is unresponsive and will require immediate lifesaving
interventions to maintain airway, breathing, circulation, and neuro status;
specifically, the patient will require immediate confirmation of endotracheal
tube placement.
-"I ran out of my blood pressure medicine, and my doctor is on vacation. Can
someone here write me a prescription?" requests a 56-year-old male with a
history of HTN. Vital signs: BP 128/84, HR 76, RR 16, T 97°F. - -ESI level 5:
No resources.
The patient needs a prescription refill and has no other medical complaints.
His blood pressure is controlled with his current medication. If at triage his
blood pressure was 188/124 and he complained of a headache, then he
would meet the criteria for a high-risk situation and be assigned to ESI level
2. If this patient's BP was elevated and the patient had no complaints, he or
she would remain an ESI level 5. The blood pressure would be repeated and
would most likely not be treated in the ED or treated with PO medications.
, -A 41-year-old male involved in a bicycle accident walks into the emergency
department with his right arm in a sling. He tells you that he fell off his bike
and landed on his right arm. His is complaining of pain in the wrist area and
has a 2-centimeter laceration on his left elbow. "My helmet saved me," he
tells you. - -ESI level 3: Two or more resources.
At a minimum, this patient will require an x-ray of his right arm and suturing
of his left elbow laceration.
-A 32-year-old female presents to the emergency department complaining
of shortness of breath for several hours. No past medical history, +smoker.
Vital signs: RR 32, HR 96, BP 126/80, SpO2 93% on room air, T 98.6°F. No
allergies, current medications include vitamins and birth control pills. - -ESI
level 2: High risk.
This 32-year-old female with new-onset shortness of breath is on birth
control pills. She is a smoker and is exhibiting signs and symptoms of
respiratory distress (SpO2 and respiratory rate.) Based on history and signs
and symptoms, a pulmonary embolus, as well as other potential causes for
her respiratory distress, must be ruled out.
-"I just turned my back for a minute," cried the mother of a 4-year-old. The
child was pulled out of the family pool by a neighbor who immediately
administered mouth-to-mouth resuscitation. The child is now breathing
spontaneously but continues to be unresponsive. On arrival in the ED, vital
signs were: HR 126, RR 28, BP 80/64, SpO2 96% on a non-rebreather. - -ESI
level 1: Unresponsive.
This 4-year-old continues to be unresponsive. The patient will require
immediate lifesaving interventions to address airway, breathing, and
circulation.
-A normal healthy 7-year-old walks into the emergency department
accompanied by his father, who reports that his son woke up complaining of
a stomach ache. "He refused to walk downstairs and is not interested in
eating or playing." The child vomits at triage. Vital signs: T 100.4°F, RR 22,
HR 88, BP 84/60, SpO2100%. Pain 6/10. - -ESI level 3: Two or more
resources.
At a minimum, this child will need a workup for his abdominal pain, which
will include labs and a CT or ultrasound—two resources.
-A 6-year-old male tells you that he was running across the playground and
fell. He presents with a 3-centimeter laceration over his right knee. Healthy,
no medications and no allergies, immunizations are up to date. - -ESI level 4:
One resource.
, The laceration will need to be sutured—one resource.
-"I slipped on the ice, and I hurt my wrist," reports a 58-year-old female with
a history of migraines. There is no obvious deformity. Vital signs are within
normal limits, and she rates her pain as 5/10. - -ESI level 4: One resource.
This patient needs an x-ray to rule out a fracture. A splint is not a resource.
-A 4-year-old female is transported to the ED following a fall off the jungle
gym at a preschool. A fall of 4 feet. A witness reports that the child hit her
head and was unconscious for a couple of minutes. On arrival you notice that
the child is crying and asking for her mother. Her left arm is splinted. Vital
signs: HR 162, RR 38. - -ESI level 2: High-risk situation.
This 4-year-old had a witnessed fall with loss of consciousness and presents
to the ED with a change in level of consciousness. She needs to be rapidly
evaluated and closely monitored.
-A 60-year-old man requests to see a doctor because his right foot hurts. On
exam the great toe and foot skin is red, warm, swollen, and tender to touch.
He denies injury. past medical history includes type 2 diabetes, and
psoriasis. Vital signs: T 99.4°F, RR 18, HR 82, BP 146/70, SpO2 99%. - -ESI
level 3: Two or more resources.
This patient has a significant medical history, and based on his presentation,
he will require two or more resources, which could include labs and IV
antibiotics.
-A 52-year-old female requests to see a doctor for a possible urinary tract
infection (UTI). She is complaining of dysuria and frequency. She denies
abdominal pain or vaginal discharge. No allergies, takes vitamins, and has no
significant past medical history. Vital signs: T 97.4°F, HR 78, RR 14, BP
142/70. - -ESI level 4: One resource.
She will need one resource—lab, which will include a urinalysis and urine
culture. She most likely has a UTI that will be treated with oral medications.
-"I called my pediatrician, and she told me to bring him in because of his
fever," reports the mother of a 2-week-old. Vital signs: T 101°F, HR 154, RR
42, SpO2 100%. Uncomplicated, vaginal delivery. The baby is acting
appropriately. - -ESI level 2: High risk.
A temperature higher than 100.4°F (38.0°C) in an infant less than 28 days
old is considered high risk no matter how good the infant looks. Infants in
this age range are at a high risk for bacteremia.
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