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Quizzes > Health & Medicine

ESI test: Assess your Emergency Severity Index triage skills

Quick ESI practice test with realistic triage cases. Instant feedback.

Editorial: Review CompletedCreated By: Lehlohonolo MasiloUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art icons and checklist on sky blue background for free ESI triage quiz challenge and knowledge test

Use this quiz to practice the Emergency Severity Index and triage levels so you can sort cases with more confidence. Work through short scenarios, choose an ESI level, and see instant feedback with brief explanations. For more practice, try the shock quiz and emergency nursing quiz to round out your emergency care knowledge.

What does ESI stand for in triage assessment?
Emergency Service Intervention
Evaluation and Screening Instrument
Event Safety Indicator
Emergency Severity Index
ESI stands for Emergency Severity Index, a tool used in triage to categorize patients by acuity and expected resource needs. It is widely implemented in emergency departments to improve patient flow. The term is standardized and part of most triage protocols.
How many levels are there in the Emergency Severity Index?
Five
Four
Six
Three
The ESI is a five-level triage system, ranging from Level 1 (most urgent) to Level 5 (least urgent). This structure allows quick categorization of patients based on acuity and resource needs. Five levels have been validated to improve patient flow and outcomes.
Which ESI level is assigned to patients who need immediate life-saving intervention?
Level 1
Level 3
Level 4
Level 2
ESI Level 1 is reserved for patients requiring immediate life-saving interventions, such as airway management or major resuscitation. This classification directs them to the resuscitation bay. Prompt identification is critical to patient survival.
Which level in the ESI is for high-risk patients who do not require immediate life-saving intervention?
Level 2
Level 3
Level 4
Level 1
ESI Level 2 includes high-risk patients who are not in immediate danger but might deteriorate without timely evaluation. Examples include chest pain or severe pain. This classification helps prioritize urgent cases.
Which ESI level indicates a stable patient who requires no resources?
Level 5
Level 4
Level 3
Level 2
ESI Level 5 is assigned to patients who are stable and do not require any diagnostic tests or interventions (resources) in the emergency department. They often need only a simple exam and discharge. This level optimizes resource utilization.
In the ESI triage system, how are 'resources' defined?
Diagnostic studies and interventions
Number of staff members needed
Length of patient stay
Rooms occupied
Resources in ESI refer to anticipated diagnostic tests, procedures, and interventions like labs, imaging, IV fluids, and consultations. Counting resources helps determine patient level from 3 to 5. Accurate resource estimation is central to the ESI algorithm.
Which vital sign abnormality would automatically escalate an adult patient from ESI Level 3 to Level 2?
Blood pressure of 120/80 mm Hg
Heart rate of 80 beats per minute
Systolic blood pressure of 80 mm Hg
Respiratory rate of 16 breaths per minute
A systolic blood pressure below 90 mm Hg is considered a high-risk vital sign and automatically qualifies an adult patient for ESI Level 2. This ensures prompt evaluation of potentially unstable patients. The ESI algorithm uses vital sign thresholds for acuity during triage.
What is the first step in the ESI triage algorithm?
Check patient insurance status
Measure vital signs
Assess if immediate life-saving intervention is required
Estimate expected resource needs
The initial step of the ESI algorithm is to determine if the patient needs an immediate life-saving intervention (Level 1). This rapid assessment prioritizes critical cases for resuscitation. Other steps follow only if no immediate intervention is needed.
A patient presents with chest pain, and the ED team orders an ECG, troponin level, and chest X-ray. The patient is stable and has no high-risk features. What ESI level should be assigned?
Level 4
Level 1
Level 2
Level 3
A stable chest pain patient requiring three resources (ECG, lab test, imaging) without immediate life-saving needs falls into ESI Level 3. Level 3 is defined by expected resource count of two or more with no high-risk features.
A 2-year-old child has a simple laceration on the forehead that needs suturing under local anesthesia. No other interventions or tests are needed. What is the appropriate ESI level?
Level 2
Level 5
Level 3
Level 4
Suturing a laceration is considered one resource in ESI. A patient requiring one resource and no high-risk criteria is classified as ESI Level 4. This helps allocate resources for simple procedures.
A patient arrives unresponsive with no pulse and no spontaneous breathing. What ESI level applies?
Level 1
Level 4
Level 2
Level 3
An unresponsive patient without pulse or breathing needs immediate life-saving interventions such as CPR and airway management. This scenario meets ESI Level 1 criteria. Prompt resuscitation resources are required.
Which of the following is a criterion for assigning a patient to ESI Level 2?
Needing only a physical exam
Stable vitals and zero resources
High-risk situation or probable severe condition
Major trauma requiring immediate surgery
ESI Level 2 includes patients in high-risk situations or with probable severe conditions that may deteriorate (like chest pain, signs of stroke). These patients need rapid evaluation even if they do not require immediate life-saving interventions.
Which intervention is considered one resource in the ESI system?
Providing oral medication
Measuring vital signs
Administering IV fluids
Taking a complete history
Administering IV fluids is considered one resource in the ESI algorithm. Physical exam tasks and oral medications do not count as resources. Accurate resource counting guides level determination.
Which of the following does NOT count as a resource when estimating ESI level?
Vital signs monitoring
Intravenous access
Radiology imaging
Laboratory tests
Vital signs monitoring is part of routine assessment and does not count as an ESI resource. Labs, imaging, procedures, and IV access are counted as resources for the triage algorithm.
A patient presents with an acute ankle sprain and requires only an X-ray. What ESI level is appropriate?
Level 2
Level 4
Level 5
Level 3
An ankle sprain needing one diagnostic resource (X-ray) and no high-risk features corresponds to ESI Level 4. This level is for patients requiring one resource.
A 28-year-old patient comes in for a medication refill with no acute complaints. No tests or interventions are needed. What ESI level should be assigned?
Level 3
Level 4
Level 5
Level 2
Patients requiring no resources, such as for prescription refills, are classified as ESI Level 5. They are stable and have no acute needs. This maximizes efficiency for low-acuity visits.
A 60-year-old with chest pain and a blood pressure of 80/50 mm Hg arrives in the ED. He is diaphoretic and short of breath. What ESI level applies?
Level 3
Level 4
Level 1
Level 2
Hypotension (BP <90 mm Hg) with chest pain indicates a life-threatening condition requiring immediate intervention, classifying the patient as ESI Level 1. Resuscitation and continuous monitoring are needed.
A 50-year-old with a sore throat requires only a rapid strep test and symptomatic treatment. Which ESI level is appropriate?
Level 4
Level 3
Level 5
Level 2
Needing one resource (a rapid streptococcal antigen test) places the patient in ESI Level 4 if no high-risk features are present. Symptomatic treatment does not count as an additional resource.
A 3-year-old child presents actively seizing in the waiting room. What ESI level should be assigned?
Level 4
Level 2
Level 1
Level 3
An actively seizing child requires immediate life-saving interventions such as airway support and anticonvulsants, making this ESI Level 1. Rapid care is essential to prevent complications.
A neonate under 28 days old presents with a fever of 38.5 °C but is otherwise stable. Which ESI level is correct?
Level 3
Level 4
Level 1
Level 2
Any neonate younger than 28 days with a fever is high-risk and requires prompt evaluation, classifying them as ESI Level 2. This is due to potential serious infections.
A 45-year-old with melena and signs of volume depletion requires blood transfusion and IV fluids. Which ESI level applies?
Level 1
Level 4
Level 3
Level 2
A patient who needs an immediate blood transfusion and IV fluids for GI bleeding is undergoing life-saving interventions, which is ESI Level 1. Hemodynamic instability warrants highest priority.
A 65-year-old with a suspected hip fracture needs an X-ray, IV analgesia, and splinting. What ESI level should be assigned?
Level 4
Level 3
Level 5
Level 2
Requiring three resources (imaging, IV medication, and splinting) without immediate life-threatening issues corresponds to ESI Level 3. Multiple resource needs place patients in Level 3.
In the ESI decision algorithm, what is the step immediately after determining that no immediate life-saving intervention or high-risk situation exists?
Measure pain score
Obtain insurance information
Estimate the number of resources the patient will need
Perform a full physical exam
After ruling out the need for immediate life-saving intervention (Level 1) and high-risk conditions (Level 2), the ESI algorithm directs the triage nurse to estimate resource needs to determine Level 3, 4, or 5. This resource assessment is central to the ESI structure.
According to the ESI guidelines, which systolic blood pressure threshold in an adult automatically qualifies for Level 2 assignment?
<90 mm Hg
<80 mm Hg
<120 mm Hg
<100 mm Hg
A systolic blood pressure below 90 mm Hg is a high-risk vital sign per ESI criteria and automatically places adult patients in Level 2 if immediate life-saving intervention isn't required. This ensures rapid evaluation of potentially unstable patients.
Which of the following is considered a single resource under the ESI triage system?
Prescription refill
Applying a splint or sling
Oral antibiotic prescription
Measuring vital signs
Applying a splint or sling is classified as one resource in the ESI system. Splinting is a procedural intervention that affects triage level. Routine measures like vital signs or prescriptions do not count as resources.
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Study Outcomes

  1. Understand ESI Triage Levels -

    Describe the five levels of the Emergency Severity Index and identify which patient presentations correspond to each triage category.

  2. Apply ESI Test Criteria -

    Employ the Emergency Severity Index framework to answer esis test questions and assign patients to the correct triage level.

  3. Analyze Clinical Scenarios -

    Interpret diverse case studies to determine the appropriate triage level based on essential esi test criteria.

  4. Recall Key ESI Triage Test Answers -

    Retrieve critical decision points and correct responses for common questions in an esi triage test.

  5. Evaluate Resource Allocation -

    Assess resource utilization and predict which patients will require multiple interventions in emergency settings.

  6. Improve Triage Decision-Making -

    Enhance confidence and speed in making accurate triage calls during high-pressure hospital situations.

Cheat Sheet

  1. Mastering the Five ESI Levels -

    Learn the distinct criteria for Levels 1 - 5 by using a simple mnemonic like "Critical, High”Risk, Multiple Resources, One Resource, No Resources." This framework, based on AHRQ's Emergency Severity Index handbook, ensures quick alignment with esis test questions on patient acuity. Regularly quiz yourself on sample scenarios to build confidence in picking the right level.

  2. Predicting Resource Needs -

    Count anticipated diagnostics (labs, imaging), procedures, and consultations to decide if a patient needs more than two resources - key for Level 3 assignment. This resource”estimation method comes straight from peer”reviewed emergency medicine literature and shines in esi test prep. Practice by listing resources for common presentations (e.g., abdominal pain or minor trauma).

  3. Rapid ABCDE Assessment -

    Prioritize Airway, Breathing, Circulation, Disability, Exposure to catch immediate life threats. Training from the American College of Emergency Physicians stresses this systematic check before moving to ESI triage test answers. Use timed drills to sharpen your rapid”assessment skills under pressure.

  4. Adjusting for Special Populations -

    Know pediatric and geriatric vital”sign norms - infants can be tachypneic at 50 breaths/min while seniors often mask fever. Official guidelines from the World Health Organization and emergency nursing journals highlight these tweaks for accurate Level 2 vs. Level 3 decisions. Include age”specific cases in your study routine for deeper retention.

  5. Targeted Practice with esis test questions -

    Use scenario”based quizzes from academic repositories to identify gaps in your reasoning and review official esi test rationales. Tracking your pattern of errors helps you focus on weak spots, whether it's pediatric fever or chest pain triage. Celebrate incremental improvements - every correct answer builds confidence for exam day.

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