CEN practice questions with correct answered to pass

CEN practice questions with correct answered to passPulse pressure is the difference between systolic blood pressure and diastolic blood pressure, and is widened in which of the following disorders? (A) Early hypovolemic shock (B) Increased ICP (C) Cardiac tamponade (D) Neurogenic shock - correct answer (B) Increased ICP [pulse pressure is narrow in early shock, cardiac tamponade, and aortic valve stenosis] Parents bring in their 4-week-old infant with non-bilious projectile vomiting and persistent hunger. Which of the following conditions is suspected? - correct answer (A) Pyloric stenosis [PS is characterized by non-bilious projectile vomiting and persistent hunger; volvulus has bilious vomiting] Systemic vascular resistance (SVR) is decreased in which type of shock? - correct answer (D) Distributive [Afterload (pressure) is low in distributive shock (neurogenic, septic, anaphylactic) due to vasodilation, and high in all other forms of shock due to vasoconstriction] Which is the following is the hallmark symptom of Prinzmetal's angina? - correct answer Pain at rest due to coronary vasospasm; may be seen with stimulant use ST segment elevation in ECG leads II, III and aVF indicates injury to which area of the heart? - correct answer Inferior wall [V1-V4 look at the anterior wall; I, aVL, V5, V6 look at the lateral wall of the left ventricle] A 40F who is 36-weeks pregnant presents to the ED with painless bright red vaginal bleeding. The nurse knows a pelvic exam is contraindicated since the most likely cause of the bleeding is - correct answer Placenta previa [think P's - painless privates, placenta previa; abrupt placenta - always painful] A 14-year-old c/o lightheadedness & palpitations. Which cardiac disorder is characterized by a short PR interval and a Delta wave? - correct answer Wolff-Parkinson-White (WPW) syndrome [WPW is characterized by a short PR interval, and a slurred QRS on the upstroke, yielding a widened QRS complex; this morphology is referred to as a "Delta wave"] A 22F c/o thick, white, "cottage-cheese" like vaginal discharge, pruritus, vulvar burning and dyspareunia. The nurse suspects a diagnosis of: - correct answer Candidiasis [characterized by pruritus & thick, white, "cottage-cheese" like vaginal discharge] Which atrioventricular block is characterized by a consistent but prolonged PR interval, and a consistent R to R interval? - correct answer First degree AV block [Second degree type I has progressive elongation of PR interval; second degree type 2 has a consistent PR interval, but inconsistent R to R interval; third degree heart block has a consistent R to R interval, but the P waves get lost] Fever, bloating, and pain at the right costal margin upon palpation is associated with which disorder? - correct answer Cholecystitis [pain at the right costal margins = "Murphy's sign"] JVD, increased CVP, hepatomegaly, and peripheral edema is seen in which disorder? - correct answer Right heart failure [S&S = JVD, increased right atrial pressure (CVP), peripheral edema, ascites, hepatomegaly, and splenomegaly; left heart failure S&S = pulmonary edema] The following are signs of pericardial tamponade? - correct answer S&S: Beck's triad (hypotension, JVD, muffled heart sounds); the pressure on the heart also causes pulses paradoxus [decreased BP and pulse strength upon inspiration], and electrical alternans [low EKG amplitude] Which of the following is an early sign/symptom of left ventricular heart failure? - correct answer Paroxysmal nocturnal dyspnea & dyspnea [crackles, JVD, ascites, hepatomegaly, peripheral edema = right heart failure] Morphine is contraindicated in a right ventricular MI (RV MI) because of what drug action? - correct answer Morphine reduces preload [preload reducing agents like morphine Lasix [venodilator], and NTG are contraindicated in RV MI b/c they decrease preload] Which of the following signs/symptoms is not characteristic of Wernicke's encephalopathy? Confabulation, chronic memory loss, ataxia, nystagmus. - correct answer Chronic memory loss [Wernick's encephalopathy is characterized by confusion, confabulation, gait ataxia and nystagmus; chronic/permanent memory loss is a symptom of Korsakoff's syndrome] A patient c/o an excruciating unilateral headache with nasal congestion and excessive lacrimation on the affect side. The nurse suspects: - correct answer Cluster headache [excessive tearing/lacrimation, along with unilateral nasal congestion, are signs of a cluster HA; temporal (Giant cell) arteritis has a palpable cord-like temporal artery Which highly communicable infection is characterized by swollen salivary and parotid glands? - correct answer Mumps [Measles = Koplik spots; pertussis = "whooping cough"; diphtheria = gray pseudomembranous coating in throat] A 68F with a history of AFIB c/o sudden onset of painless, unilateral vision loss and denies any trauma. Which ocular emergency does the nurse suspect? - correct answer Central retinal artery occlusion (CRAO) [acute angle glaucoma = "tunnel vision" and halos around lights; hyphema = blood in anterior chamber of eye] Which of the following signs/symptoms should raise an index of suspicion that a patient is experiencing retinal detachment? - correct answer Photopsia and "floaters" in the visual field A hazardous vulnerability assessment is completed in which phase of disaster management? - correct answer Mitigation [disaster preparedness = stockpiling supplies, training and mutual aid agreements] A patient c/o sharp chest pain that worsens with inspiration and lying down. Which sound is commonly heard in pericarditis? - correct answer Pericardial friction rub, heard best when the patient leans forward [murmurs are audible in valve disorders] Pertussis is a highly communicable infection characterized by gagging, vomiting, and what hallmark sign? - correct answer Paroxysmal cough [inspiratory stridor = heard in upper airway obstruction, like croup; expiratory wheeze = heard early in lower airway obstruction, like asthma; drooling with respiratory distress = hallmark sign of epiglottitis]