Exam (elaborations)
CEN Exam 1: Questions With Correct Solutions
CEN Exam 1: Questions With Correct Solutions
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CEN Exam 1: Questions With Correct SolutionsWhich dysrhythmia would be identified on an ECG/EKG six-second strip by a
heart rate of 76 and a PR interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm Correct Ans - B: First-degree
atrioventricular block is diagnosed partially by an EKG showing a PR interval
of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would need to be
used as part of the clinical picture with diagnosing and treating abdominal
pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74 Correct Ans - C: An elevated WBC count
would be indicative of infection or inflammation. The WBC count of 5.0 is
normal. The HCT and BS levels listed would also be considered within normal
limits.
A 30-year-old man comes to the emergency department with the acute onset
of left flank pain radiating to the groin. Microscopic hematuria is present on
urinalysis. What is the most likely diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis Correct Ans - A: Ureteral calculi are a quite common cause of
acute emergency evaluation, usually causing flank pain with radiation to the
back and/or groin. About 75% of these are calcium oxalate or phosphate; less
common are struvite, uric acid, or cystine calculi. While KUB or ultrasound
may show the stone, helical CT is now the preferred diagnostic method.
Additional workup includes CBC, chemistry panel, urinalysis, and straining of
urine to catch a passed stone for chemical analysis. Nursing attention should
be directed to intravenous hydration with input and output recording and
narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some
, patients may be discharged with analgesics and instructions for hydration and
calculus capture. Testicular torsion is most common in adolescents and
usually presents with testicular and groin pain with abdominal radiation;
increasing pain by lifting the scrotum to the level of the pubic symphysis
causes exacerbation of the pain (Prehn sign). Cystitis may be infectious or
drug-induced, but cystitis usually causes dysuria and pyuria and shows
positive urine cultures.
Which of the following is NOT appropriate for screening for domestic violence
by the emergency department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone in
the past year; if so, by whom
b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the
emergency department for a medical ailment, not trauma
d.asking if there is a partner from a previous relationship that makes the
individual feel unsafe Correct Ans - C: Domestic violence, nearly
always perpetrated against women, is a major problem confronted by the
emergency nurse. Screening for possible cases should include answers A, B
and D. Interestingly, victims of intimate partner violence often present with a
medical ailment, not trauma. These include back, abdominal, or pelvic pain,
headaches, urinary infections, sexually transmitted disease, or symptoms
consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of
old trauma such as healing fractures or cosmetically concealed bruises may
point toward the presence of domestic violence. Many victims will deny it but
sometimes compassionate questioning in a private setting will elicit a positive
response. The nurse may then offer advice, refer to a social agency or shelter,
or ask for a consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator alarm
rings and the airway pressure is found to be elevated. Possible causes include
the following EXCEPT:
a.endotracheal tube obstruction with sputum
b.pneumothorax
c.bronchospasm
d.cuff leak Correct Ans - D: Mechanical ventilation requires diligent
observation of the patient and ventilator by the emergency nurse. Modern
ventilators usually come with alarms that indicate high or low airway
pressure. High pressure may be caused by endotracheal tube obstruction with
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