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CEN Final Exam 5 Questions and Answers 2025
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CEN Final Exam 5 Questions and Answers 2025
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CEN Final Exam 5 Questions and Answers 20251. A pt presents to the ED experiencing an anterior ST segment elevation MI.
The pts vital signs are normal. The hospital is not equipped with a cardaic
catheterization lab. The pt can be transferred to a cardaic catheterization lab
within 60 mins. Which of the following would you anticipate for this pt?:
A. A bolus of tissue plasminogen activator, followed by an infusion for
fibrinolytic therapy
B. Immediate transfer to the hospital with a cardiac catheterization lab for
percutaneous coronary intervention
C. A single bolus of tenecteplase (Tnkase) for fibrinolytic therapy
D. A bolus of reteplase (Retavase), followed by a second bolus of reteplase 30
mins later for fibrinolytic therapy
Ans- B. Immediate transfer to the hospital with a cardiac catheterization lab
for percutaneous coronary intervention
,In adult pts presenting with a STEMI of a hospital that does not have PCI
capability, it is recommended that the pt be transferred immediately without
fibrinolytics to a PCI center, instead of immediate fibrinolysis at the intial
hospital with transfer onlu for ischemia driven PCI
2. An anxious pt arrives by ambulance following an acute onset of difficulty
breathing. The pt is diaphoretic and denies chest pain. High-flow O2 by non-
rebreather mask has been applied. Vitals: BP 210/140, HR 130, RR 32, SpO2
88%. In addition to initiating noninvasive ventilation to treat the pts difficulty
breathing, the nurse anticipates the administration of which medication to
further treat the pts symptoms?:
A. Morphine (Morphine sulfate)
B. Furosemide (Lasix)
C. Initation of a continuous nitroglycerin infusion
D. Acetylsalicylic acid (Aspirin)
Ans- C. Initation of a continuous nitroglycerin infusion
,Pts who present with acute pulmonary edema are typically markedly
hypertensive and in acute respiratory distress. Rapid initiation of appropriate
treatment is vital to reversing the neurohormonal surge and rescuing pts from
respiratory and complete cardiac failure. Nitroglycerin is the most important
first line medication in treatment of acute pulmonary edema and respiratory
distress. The initation of continuous NTG infusion at low doses acts as a
vasodilator, leading to decreased preload: at higher doses ( >100mcg/min) acts
as a potent afterload reducer
3. An unrestrained driver is brought to the ED following a motor vehicle
collision. The pt reports hitting their chest on the steering wheel and is
complaining of chest pain across the front of their chest. There are no vital sign
abnormalities and no other complaints of pain. The diagnosis of blunt cardiac
injury is considered. The nurse anticipates an order for which of the following?:
A. EKG
B. Cardiac marker evaluation (CK or Troponin)
C. Cardiac monitoring
D. Chest radiograph
Ans- B. Cardiac marker evaluation (CK or Troponin)
, Not all trauma pts with blunt cardiac injury will have acute alterations in cardiac
markers, and other organ injury may cause release of creatinine kinase and
confound the diagnosis of blunt cardiac injury
4. Which of the following is a form of distributive shock?:
A. Neurogenic
B. Metabolic
C. Respiratory
D. Obstructive
Ans- A. Neurogenic
5. A pt presents following an acute onset of chest pain, dyspnea and severe
diaphoresis, with near syncope. Assessment shows a pt in severe distress, with
HR 110, BP 60/40 and RR 36 with bilateral rales. An EKG reveals ST segment
elevation across the precordial leads. A diagnosis of acute MI with cardiogenic
shock is made, and the pt is being prepared for transfer to the cardiac cath lab.
The vasopressor of choice, based on this pts degree of hypotension is:
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