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CEN EXAM QUESTIONS AND ANSWERS
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CEN EXAM QUESTIONS AND ANSWERS
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CEN EXAM QUESTIONS AND ANSWERSThe most common symptom of a patient who has a pinworm infection is
A. diarrhea
B. anorexia
C. abdominal pain
D. perianal pruritus - Answers-D. Perianal pruritus
Pinworms are the most common cause of anal pruritus in children
A patient is being discharged with a presumptive diagnosis of primary herpes simplex
viral infection. the patient understands discharge instructions if she states,
A. "Acyclovir will cure my herpes"
B. "My boyfriend will not get this if he uses a condom"
C. "If I get pregnant, I can pass the disease to my baby."
D. "I know that this first episode will last only 4 or 5 days." - Answers-C. "If I get
pregnant, I can pass the disease to my baby."
The greatest risk to the fetus occurs when overt HSV infection is present at the time of
delivery. In this situation, the principal mechanism of infection is direct contact with the
infected vesicles during the process of vaginal birth.
A patient comes to the emergency department 30 minutes after an insect bite to the leg.
The wound is erythematous, swollen, and indurated. The emergency nurse should first
A. Perform an Allen's test.
B. Examine the inguinal lymph nodes.
C. Check the pulses proximal to the wound.
D. Evaluate inspiratory and expiratory breath sounds. - Answers-D. Evaluate inspiratory
and expiratory breath sounds.
Patients with insect bites are at risk for anaphylactic reactions. In assessing for systemic
reactions, ABC's are a priority. Assessment for breathing includes evaluating breath
sounds.
A patient who has been in a motorcycle crash is awake, alert, and oriented, but
complains of severe neck pain. A cross-table lateral radiograph demonstrates a fracture
of the second and third cervical vertebrae. Shortly after the radiograph is taken, the
patient experiences respiratory arrest appropriate initial management of the airway
should consist of
A. endotracheal intubation
B. administration of oxygen via nasal cannula
C. Jaw thrust maneuver and ventilation with a bag-mask device
,D. head-tilt maneuver and placement of an oropharyngeal airway. - Answers-C. Jaw-
thrust maneuver and ventilation with a bag-mask device.
The jaw thrust maneuver should be used as the basic airway management in any
patient with a suspected cervical spine injury without tilting the head. Endotracheal
intubation will be done, but it is not the first action to be taken.
Which of the following statements should be included in discharge instructions for a
patient who has undergone treatment for epistaxis?
A. "Drink plenty of hot fluids"
B. "Open your mouth while sneezing."
C. "Avoid humidity in the environment"
D. "Reduce sodium intake" - Answers-B. "Open your mouth while sneezing"
Sneezing with the mouth closed will force air through the nasal passages, possibly
dislodging the clot; therefore starting the bleeding again.
An alert patient sustains blunt trauma to the abdomen in a MVC. The patient refuses to
allow invasive treatments. Initial assessment reveals and ecchymotic area in the left
upper quadrant. The ER nurse should
A. Allow the patient to leave after signing a medical release form.
B. Request an order to sedate patient
C. assess the patients neurological status
D. obtain consent from a relative treatment. - Answers-C. Assess the patients
neurological status.
A rational, competent adult can refuse any treatment. The first step is to establish the
patients ability to understand the consequences of refusing treatment. Due to the
mechanism of injury, the patient should be evaluated for the presence of a head injury.
The best indication of adequate tissue perfusion in a patient in shock is
A. a urine output of 30mL/hr
B. An oxygen saturation of > 70%
C. A central venous pressure of 10 cm H2O
D. A capillary refill time of greater than 2 seconds. - Answers-A. A urine output of
30mL/hr
Urine output is the best indicator of adequate tissue perfusion. It is desired to have an
oxygen saturation of much greater than 70% and a capillary refill time of LESS than 2
seconds.
Which of the following is the most common finding in pulmonary embolism?
A. Dyspnea
B. Crackles (rales)
C. Fever
D. Hemoptysis - Answers-A. Dyspnea
, With pulmonary embolus, common signs and symptoms include shortness of breath,
tachypnea, tachycardia, and sudden-onset pleuritic chest pain that increases with
respirations. Dyspnea is the most common sign of pulmonary embolism. Crackles and
hemoptysis are likely to be associated with pulmonary edema. Fever is a possible
finding in patients with a pulmonary, but it is not common.
Assessment of a patient with severe acute pancreatitis reveals ascites and diminished
breath sounds in the right lower lobe. Vital signs are: BP 109/70, HR 110, and RR 38.
The emergency nurse should suspect that the patient has developed
A. Pneumonia
B. A pneumothorax
C. Pleural effusion.
D. A diaphragmatic hernia. - Answers-C. Pleural effusion.
Pleural effusion is an excess of fluid trapped in the intrapleural space of the lugs. In
pancreatitis, this occurs because fluid associated with ascites moves from the periotenal
space into the pleural space through lymph channels. Seventy percent of pleural
effusions occur on the right side.
A confused elderly woman has a blood glucose level of 1175 mg/dL (65mmol/L). Serum
ketones are negative and arterial blood gases show a pH of 7.25. The emergency nurse
should anticipate an order to administer which of the following first?
A. Sodium bicarbonate
B. Potassium chloride
C. High-dose insulin
D. Large volumes of IV fluids - Answers-D. Large volumes of IV fluids
Increased glucose, negative keytones, and acidosis are signs and symptoms of
hyperosmolar hyperglycemic non ketotic coma. In the treatment of this state, the goals
are rehydration and correcting electrolyte imbalances before potassium replacement
and insulin.
During quality review, the quality improvement committee identify a variance from the
standard of nursing care of two patient with chest pain. Which of the following is the
most appropriate recommendation by the committee?
A. Schedule a nursing inservice on the standard of care for chest pain
B. Design a new flow sheet for cardiac documentation
C. Request the nurse manager to discipline the nurses involved.
D. Conduct a random audit and determine the frequency of the problem. - Answers-D.
Conduct a random audit and determine the frequency of the problem.
Conducting a random audit is most appropriate in this scenario. The quality
improvement committee needs to determine whether these two cases are isolated
incidents or if there is an ongoing deficiency in the standard of care delivered.
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