Certified Emergency Nurse (CEN) Practice
Questions – Updated 2025
A patient complains of CP, dyspnea, and diaphoresis. Which of the following assessment factors would
indicate a possible diagnosis of acute coronary syndrome?
A. Pleuritic chest pain
B. Positional chest pain
C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in the left
shoulder
D. Pain reproducible with chest wall palpation -ANSWER ✨✔---C.
Rationale:
Chest pain that radiates to BOTH shoulders has a likelihood ratio of 7.1 and a pain that radiates to the
right shoulder has a stronger likelihood ration of 2.9 of predicting ACS, compared w/ pain that radiates
only to the left shoulder
Which of the following human compensatory mechanisms to the presence of shock triggers
glycogenolysis?
A. Chemoreceptor activation
B. Clotting cascade activation
, C. Cerebral autoregulation stimulation
D. Adrenal gland stimulation -ANSWER ✨✔---D. Adrenal gland stimulation
A patient presents to the ED with abdominal pain and "ripping" back pain. Which condition places the
patient at risk for abdominal aortic dissection?
A. Down Syndrome
B. Romano-Ward Syndrome
C. Jervell and Lange Nielsen Syndrome
D. Ehler-Danlos Syndrome -ANSWER ✨✔---D. Ehler-Danlos Syndrome
Rationale:
Patients with Ehler-Danos syndrome may be identified by hypermobile joints and skin that is hyper-
extensible, has a soft velvety-like appearance, is fragile and tears or bruises easily. Ehler-Danlos
syndrome is a connective tissue disorder that places patients at risk for the presence of aortic aneurysm
and dissection.
What is Romano-Ward syndrome? -ANSWER ✨✔---inherited cardiac disorder that causes long QT
syndrome. Patients with this syndrome may have sudden death resulting from a dysrhythmia
What is Jervell and Lange Nielsen Syndrome? -ANSWER ✨✔---a condition that causes profound
hearing loss from birth and also long QT syndrome. Pt's with this syndrome may have sudden death
resulting from a dysrhythmia
An end-tidal carbon dioxide level reading less than 10% after 20 minutes of high-quality CPR indicates
what? -ANSWER ✨✔---a low ETCO2 level indicates a lack of both end cellular perfusion and
adenosine triphosphate production, resulting in cellular death.
termination of the resuscitation efforts should be considered at this point
What EKG reading would you anticipate in a patient who has overdosed on tricyclic antidepressants? -
ANSWER ✨✔---Sinus tachycardia with both a widened QRS interval and a prolonged QT interval.
Questions – Updated 2025
A patient complains of CP, dyspnea, and diaphoresis. Which of the following assessment factors would
indicate a possible diagnosis of acute coronary syndrome?
A. Pleuritic chest pain
B. Positional chest pain
C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in the left
shoulder
D. Pain reproducible with chest wall palpation -ANSWER ✨✔---C.
Rationale:
Chest pain that radiates to BOTH shoulders has a likelihood ratio of 7.1 and a pain that radiates to the
right shoulder has a stronger likelihood ration of 2.9 of predicting ACS, compared w/ pain that radiates
only to the left shoulder
Which of the following human compensatory mechanisms to the presence of shock triggers
glycogenolysis?
A. Chemoreceptor activation
B. Clotting cascade activation
, C. Cerebral autoregulation stimulation
D. Adrenal gland stimulation -ANSWER ✨✔---D. Adrenal gland stimulation
A patient presents to the ED with abdominal pain and "ripping" back pain. Which condition places the
patient at risk for abdominal aortic dissection?
A. Down Syndrome
B. Romano-Ward Syndrome
C. Jervell and Lange Nielsen Syndrome
D. Ehler-Danlos Syndrome -ANSWER ✨✔---D. Ehler-Danlos Syndrome
Rationale:
Patients with Ehler-Danos syndrome may be identified by hypermobile joints and skin that is hyper-
extensible, has a soft velvety-like appearance, is fragile and tears or bruises easily. Ehler-Danlos
syndrome is a connective tissue disorder that places patients at risk for the presence of aortic aneurysm
and dissection.
What is Romano-Ward syndrome? -ANSWER ✨✔---inherited cardiac disorder that causes long QT
syndrome. Patients with this syndrome may have sudden death resulting from a dysrhythmia
What is Jervell and Lange Nielsen Syndrome? -ANSWER ✨✔---a condition that causes profound
hearing loss from birth and also long QT syndrome. Pt's with this syndrome may have sudden death
resulting from a dysrhythmia
An end-tidal carbon dioxide level reading less than 10% after 20 minutes of high-quality CPR indicates
what? -ANSWER ✨✔---a low ETCO2 level indicates a lack of both end cellular perfusion and
adenosine triphosphate production, resulting in cellular death.
termination of the resuscitation efforts should be considered at this point
What EKG reading would you anticipate in a patient who has overdosed on tricyclic antidepressants? -
ANSWER ✨✔---Sinus tachycardia with both a widened QRS interval and a prolonged QT interval.
