BCEN Triage Systems 4

Question 1

The Manchester Triage System (MTS) assigns a maximum waiting time of 10 minutes to which acuity level?

Accepted Answer

Urgent

Answer

In MTS, Urgent (orange) patients have a maximum wait time of 10 minutes before clinical assessment.

Question 2

During a mass casualty incident, which principle guides the decision to tag a patient as Expectant (Black) rather than Immediate (Red)?

Accepted Answer

Severity of injuries relative to available resources

Answer

Expectant tagging is resource-based; injuries that would consume disproportionate resources with low survival probability are classified Black to maximize overall survivor count.

Question 3

A patient triaged as ESI level 3 is reassessed after 30 minutes in the waiting room and now has altered mental status and hypotension. The appropriate action is:

Accepted Answer

Immediately upgrade to ESI 1 and initiate resuscitation

Answer

Deterioration to altered mental status and hypotension indicates immediate life-threatening instability requiring ESI-1 reclassification and urgent intervention.

Question 4

Which of the following correctly describes a limitation of the START triage system?

Accepted Answer

It may under-triage pediatric patients and those with chronic disabilities

Answer

START was designed for adults and may under-triage children (different normal respiratory rates) and patients whose chronic conditions affect baseline neurological status.

Question 5

In ESI triage, a patient with a minor rash, no fever, and no vital sign abnormalities who requires only a prescription renewal is best assigned:

Accepted Answer

ESI 5

Answer

ESI level 5 applies to patients who are stable, not high risk, and require only one resource or none — a prescription renewal with no acute findings qualifies.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Triage Systems 4