Original DHA nursing questions on emergency & critical care, with explanations.
Short answer: 10 original multiple-choice practice questions on emergency & critical care for nurses preparing for the DHA licensing exam, each with the correct answer and a full explanation. This is a Meddex topic, not a DHA heading. They are original and are not real exam items.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
What emergency care covers
Resuscitation, shock, trauma, sepsis and poisoning.
Recognise, call for help and start the first treatment together. Do not let a step that can wait delay adrenaline, oxygen, fluids or compressions when the stem says life is at risk.
Where it fits in the exam
DHA lists four coverage headings for Registered Nurse and publishes no weights. Emergency & Critical Care is one of ten Meddex domains, so it is a Meddex grouping and not a DHA heading. Its questions can appear under more than one DHA heading.
DHA does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Emergency & Critical CareMedium
At a major incident, a nurse uses the START triage method. Which casualty is tagged immediate (red)?
AOption A: A woman who is not breathing after her airway has been opened
BOption B: A woman who cannot walk, breathes 34 times a minute and is awake
COption C: A man who walks to the treatment area while shouting that he has a sore wrist
DOption D: A man who cannot walk, breathes 20 times a minute, has a radial pulse and obeys commands
Show answer for question 1
Correct answer: B. A woman who cannot walk, breathes 34 times a minute and is awake
In START, walking casualties are tagged minor (green). In those who cannot walk, a casualty who is not breathing after the airway is opened is tagged expectant (black). A breathing casualty is tagged immediate (red) if the respiratory rate is above 30, perfusion is poor (no radial pulse or capillary refill over 2 seconds) or he cannot obey simple commands. The woman breathing 34 times a minute is red, and the man with normal findings is delayed (yellow).
Why A is wrong. A casualty not breathing after airway opening is tagged black in this system.
Why C is wrong. A walking casualty is tagged green.
Why D is wrong. A normal rate, a radial pulse and obeying commands make him delayed (yellow).
Topic: Triage: START at a major incident. Reference: Radiation Emergency Medical Management (CHEMM), US Department of Health and Human Services. START adult triage algorithm; Benson M, Koenig KL, Schultz CH. Disaster triage: START, then SAVE. Prehosp Disaster Med 1996;11:117-124
Question 2
Emergency & Critical CareEasy
A visitor has a generalised convulsive seizure in the waiting area. What should the nurse do?
AOption A: Give him a drink of water as soon as the movements stop to help him recover
BOption B: Hold his limbs firmly to stop the jerking so that he does not injure himself
COption C: Note the time, cushion his head, clear hazards and turn him on his side when the jerking stops
DOption D: Place a spoon between his teeth to protect his tongue while he is fitting
Show answer for question 2
Correct answer: C. Note the time, cushion his head, clear hazards and turn him on his side when the jerking stops
The aim is to keep him safe until the seizure ends. The nurse notes the time, cushions the head, moves hazards away, does not restrain him and does not put anything in his mouth. When the jerking stops he is placed in the recovery position and watched closely. An emergency response is called if the seizure lasts more than 5 minutes, if one follows another without recovery, if he is injured or has trouble breathing, or if it is his first seizure.
Why A is wrong. Fluid in a drowsy patient raises the risk of choking.
Why B is wrong. Restraint can cause injury to the patient and the helper.
Why D is wrong. Objects in the mouth can break teeth and obstruct the airway.
Topic: Seizure: first aid for a generalised tonic-clonic seizure. Reference: NICE NG217 Epilepsies in children, young people and adults; Epilepsy Society. First aid for tonic-clonic seizures
Question 3
Emergency & Critical CareMedium
A carpenter has a metal shard embedded in his left eye. The eye is painful and bleeding. What should the nurse do?
AOption A: Irrigate the eye with large volumes of water to try to flush the shard out of it
BOption B: Place a firm pressure patch over the eye and let him walk to the eye clinic himself
COption C: Leave the shard in, protect the eye with a rigid shield that rests on bone without pressure, and call ophthalmology
DOption D: Pull the shard out gently with clean forceps before it can move deeper into the eye
Show answer for question 3
Correct answer: C. Leave the shard in, protect the eye with a rigid shield that rests on bone without pressure, and call ophthalmology
An embedded object suggests an open globe injury. Pressure, irrigation or removal can push out the contents of the eye or cause further damage. The eye is protected with a rigid shield resting on the bony orbit, with no pressure on the globe, the patient is kept calm and still with vomiting prevented (antiemetic as prescribed), and urgent ophthalmology review is arranged.
Why A is wrong. Irrigation can force fluid and the shard into an open globe.
Why B is wrong. A pressure patch compresses the globe and can extrude its contents.
Why D is wrong. Removing an embedded object can cause bleeding and loss of eye contents.
Topic: Trauma: penetrating eye injury. Reference: Defence Medical Services. Clinical guidelines for operations: globe injury (ophthalmology)
Question 4
Emergency & Critical CareMedium
A 15-year-old boy has had sudden severe left testicular pain for 2 hours with vomiting. The testis is high-riding and tender, and the cremasteric reflex is absent. How should the nurse triage him?
AOption A: As urgent but not time-critical: offer an appointment at the next day's clinic
BOption B: As an emergency: nil by mouth, analgesia and immediate review by the surgical team
COption C: As routine: send a urine sample and wait for the result before he is seen by anyone
DOption D: As low priority: give an anti-inflammatory and advise rest and scrotal support
Show answer for question 4
Correct answer: B. As an emergency: nil by mouth, analgesia and immediate review by the surgical team
Sudden severe testicular pain with vomiting, a high-riding testis and an absent cremasteric reflex in a teenager is torsion until proved otherwise. Outcomes are best when surgery is done ideally within 4 to 6 hours of onset, and they worsen afterwards. He is made nil by mouth for theatre, given analgesia and seen at once by the surgical team. Waiting for tests or ultrasound must not delay exploration.
Why A is wrong. Waiting until the next day would almost certainly lose the testis.
Why C is wrong. Waiting for a urine test wastes time that the testis may not have.
Why D is wrong. Rest and an anti-inflammatory would leave a twisted testis without blood supply.
Topic: Acute scrotum: triage of suspected testicular torsion. Reference: European Association of Urology. Guidelines on paediatric urology: acute scrotum (testicular torsion is an emergency; Doppler ultrasound must not delay surgery)
Question 5
Emergency & Critical CareMedium
On a surgical ward, a nurse is told of four patients. Which one needs urgent review first?
AOption A: A patient on day 1 after laparotomy with pain 6/10, temperature 37.9 degrees C and HR 96/min
BOption B: A patient with a new stroke, BP 170/95 mmHg, alert and awaiting a swallow screen
COption C: A patient with diabetes whose capillary glucose is 15 mmol/L and who has no symptoms today
DOption D: A patient after thyroidectomy with a swelling neck, hoarse voice and noisy breathing
Show answer for question 5
Correct answer: D. A patient after thyroidectomy with a swelling neck, hoarse voice and noisy breathing
A rapidly expanding neck haematoma after thyroidectomy can compress the airway within minutes, and a hoarse voice with noisy breathing is an early sign of obstruction. Airway threats are the first priority, and the team should prepare to open the wound.
Why A is wrong. Early post-laparotomy pain with a mild temperature needs assessment, but it does not threaten the airway.
Why B is wrong. A stable stroke patient with a moderately raised BP is not an immediate threat to life.
Why C is wrong. Asymptomatic hyperglycaemia is a lower priority than a threatened airway.
Topic: Airway priority after neck surgery. Reference: Resuscitation Council UK ABCDE approach; Difficult Airway Society, BAETS and ENT UK consensus guideline: Management of haematoma after thyroid surgery
Question 6
Emergency & Critical CareMedium
Two hours after hip surgery, a 66-year-old man using morphine by PCA is difficult to rouse. RR is 6/min, SpO2 86% on room air and his pupils are pinpoint. What should the nurse do first?
AOption A: Reduce the PCA bolus and recheck his respiratory rate in fifteen minutes
BOption B: Stop the PCA, call urgently for help and support breathing with oxygen
COption C: Give flumazenil intravenously to reverse the opioid sedation
DOption D: Give naloxone 400 micrograms IM as a single dose and then leave him to rest
Show answer for question 6
Correct answer: B. Stop the PCA, call urgently for help and support breathing with oxygen
Opioid-induced respiratory depression is treated by stopping the opioid, calling for help and supporting airway and breathing with oxygen, using bag-mask ventilation if needed. Naloxone is then given in small titrated doses under medical direction.
Why A is wrong. Reducing the bolus and waiting is unsafe with a rate of 6/min and hypoxaemia.
Why C is wrong. Flumazenil reverses benzodiazepines and not opioids.
Why D is wrong. A large single naloxone dose can precipitate severe pain and pulmonary oedema, and leaving the patient unobserved is unsafe.
Topic: Opioid overdose: postoperative respiratory depression. Reference: Royal College of Anaesthetists and Faculty of Pain Medicine: Opioids Aware; Resuscitation Council UK ABCDE approach
Question 7
Emergency & Critical CareEasy
A 72-year-old woman with new left-sided weakness after an ischaemic stroke is alert and hungry. She asks for tea and lunch, and no swallow screen has been done. What should the nurse do?
AOption A: Offer thickened fluids and soft food and watch closely while she eats
BOption B: Sit her upright and let her eat cut-up lunch slowly with supervision
COption C: Give her a few sips of water and stop at once if she coughs or chokes
DOption D: Keep her nil by mouth, including drugs, until her swallow is screened
Show answer for question 7
Correct answer: D. Keep her nil by mouth, including drugs, until her swallow is screened
Dysphagia is common after stroke and aspiration causes pneumonia. Nothing is given by mouth, including oral medicines, until a swallow screen by a trained professional has been completed, usually within 4 hours of admission.
Why A is wrong. Altered consistency still risks aspiration if the swallow has not been screened.
Why B is wrong. Good positioning reduces but does not remove the risk when her swallow has not been assessed.
Why C is wrong. A sip test by an untrained person is unreliable, and silent aspiration may not provoke a cough.
Topic: Stroke: swallow screening and aspiration risk. Reference: National Clinical Guideline for Stroke (Royal College of Physicians); AHA/ASA Guidelines for the Early Management of Patients with Acute Ischaemic Stroke
Question 8
Emergency & Critical CareMedium
A woman has taken prednisolone 10 mg daily for polymyalgia rheumatica for three years. She is nil by mouth before a major bowel resection, and her usual tablets are on the chart for 08:00. What should the nurse do?
AOption A: Withhold the dose and record that she will restart her tablets when she goes home after the operation
BOption B: Omit the tablets because she is nil by mouth and the operation will remove the need for further steroid
COption C: Give half the dose, because she will not be eating and is having major surgery
DOption D: Give the usual dose with a sip of water, as local policy allows, and ask the anaesthetist about parenteral hydrocortisone
Show answer for question 8
Correct answer: D. Give the usual dose with a sip of water, as local policy allows, and ask the anaesthetist about parenteral hydrocortisone
Long-term glucocorticoid treatment suppresses the adrenal glands, which then cannot mount a stress response to surgery. Omitting the steroid, even briefly, can lead to adrenal crisis with hypotension, vomiting and hypoglycaemia during or after the operation. The usual dose is continued with sips of water allowed, and the anaesthetist or prescriber arranges parenteral hydrocortisone cover for major surgery or if she cannot take oral medicines. Unexplained hypotension is treated as possible adrenal crisis.
Why A is wrong. Withholding until discharge leaves her without cover during surgery.
Why B is wrong. Omitting the steroid leaves her unable to respond to surgical stress and risks adrenal crisis.
Why C is wrong. Half the dose gives inadequate cover for the stress response.
Topic: Steroid cover to prevent adrenal crisis. Reference: Association of Anaesthetists and Society for Endocrinology guidance on perioperative glucocorticoid replacement; Endocrine Society guideline on primary adrenal insufficiency
Question 9
Emergency & Critical CareMedium
A teenager dives from the poolside into the shallow end and is pulled out by a lifeguard, unresponsive and not breathing normally. A nurse bystander kneels beside him and the lifeguard asks what to do about his neck. What is the most appropriate approach?
AOption A: Tilt his head fully back and lift the chin, whatever the mechanism of injury
BOption B: Roll him onto his side and leave him there until the ambulance arrives
COption C: Support the neck in line and use a jaw thrust, without delaying rescue breaths
DOption D: Wait for a rigid collar and spinal board to arrive before giving any rescue breaths
Show answer for question 9
Correct answer: C. Support the neck in line and use a jaw thrust, without delaying rescue breaths
Spinal injury is uncommon in drowning overall, but a diving mechanism makes it possible, so routine immobilisation is not needed for every casualty while this history calls for care. Hypoxia caused the arrest, so airway and ventilation come first. The neck is held in line manually and a jaw thrust is used where it opens the airway, and if it does not, the airway is opened with head tilt and chin lift. Rescue breaths must not be delayed for equipment.
Why A is wrong. Full neck extension ignores a diving mechanism that makes a cervical injury possible.
Why B is wrong. A casualty who is not breathing needs ventilation, and lying on his side provides none.
Why D is wrong. Waiting for equipment leaves a hypoxic casualty without ventilation, and the arrest is caused by lack of oxygen.
Topic: Basic life support: drowning with suspected spinal injury. Reference: Resuscitation Council UK: Special circumstances guidelines, drowning; European Resuscitation Council Guidelines: Cardiac arrest in special circumstances
Question 10
Emergency & Critical CareMedium
During a cardiac arrest, the monitor shows ventricular fibrillation and the defibrillator pads are in place. The team leader asks for a shock. Which action is the nurse's priority before the shock is delivered?
AOption A: Keep chest compressions going until the second the shock is delivered
BOption B: Check that everyone is clear and oxygen equipment is moved away from the chest
COption C: Leave a glyceryl trinitrate patch under the pads so that the drug is not lost
DOption D: Pour water on the chest around the pads to improve electrical conduction
Show answer for question 10
Correct answer: B. Check that everyone is clear and oxygen equipment is moved away from the chest
Before delivering a shock, the team must ensure that nobody is touching the patient or the bed and that oxygen equipment is moved at least a metre from the chest to reduce fire risk. Compressions continue while the defibrillator charges, then pause briefly for the shock. Medicated patches are removed and wet skin is dried.
Why A is wrong. Compressions must stop for the shock itself, because touching the patient exposes the rescuer to the current.
Why C is wrong. Medicated patches can cause burns or block current and should be removed before the shock.
Why D is wrong. Water can divert current across the skin and cause burns or reduce energy delivery.
Topic: Cardiac arrest: safe defibrillation. Reference: Resuscitation Council UK: Adult advanced life support guidelines
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Frequently asked questions
DHA does not publish how many questions come from each topic. It lists four coverage headings for Registered Nurse with no weights. Meddex groups its questions into ten domains of its own.
No. They are original practice questions written by Meddex for exam preparation. DHA does not publish sample questions, and its Assessment Manual says sharing assessment questions is not allowed, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.