CEN Exam Challenge Questions: Advanced Emergency Nursing Practice Test with Answers &
Rationales
2. "I need you to stay in this room and someone will stay here with you"
With Mania, keep sentences brief and direct. Do not encourage the pt to speak and avoid
rambling. - ✔✔A patient presents to the ED in the manic phase of a bipolar affective disorder.
Which of the following statements made by the ER Nurse, is most therapeutic for a patient with
this diagnosis?
1. "I want you to ell me what you are feeling right now"
2. "I need you to stay in this room and someone will stay here with you"
3. "Tell me what is going on in your life right now that may have made you feel out of control for
the past few days"
4. "We are worried that you may be a danger to yourself of others in your present state, so we
are going to have someone from psychiatry come down and discuss with you what you are
feeling".
2. Poison mushrooms
OD on certain mushrooms=Cholinergic effect, Atropine is an Anti-Cholinergic drug.
Antihistamines are their own toxindrome, LSD is sympathomimetic, Jimson week is an
anticholinergic substance. - ✔✔Atropine is effective for overdoses caused by:
1. antihistamines
2. posion mushrooms
3. lysergic acid diethylamide (LSD)
4. the seeds of the Jimson weed plant.
1. Digoxin
,this is the only option that will cause heart block in particular. - ✔✔The ED nurse notices 3rd
Degree Heart Block on telemetry...
Which of the following substances did this patient most likely overdose on?
1. Digoxin
2. Lorazepam
3. Ethylene glycol
4. Acetaminophen
2. serum pH above normal
GOAL is a pH of 7.5-5.5, Pts who OD on this substance already have wide QTs and are already
hypotensive. Pupils are irrelevant. - ✔✔Effective Treatment for an overdose on tricyclic
antidepressants should cause
1. widening QT interval
2. serum pH above normal.
3. decreasing BP
4. Dilation of pupils
4. a core body temperature of 102F (38.9C).
shivering heats the body back up, sweating helps with heat loss through evaporation, main goal
is to decrease the body temp!! - ✔✔Effective treatment for heat stroke should result in:
1. the onset of shivering
2. the cessation of sweating
, 3. A GCS above 8.
4. a core body temperature of 102F (38.9C).
2. ABGs
due to the neurotoxic effects this can decrease respiratory drive and cause hypoxia. Coag.
studies great for Crotalid envenomation. Hematology/renal function not useful for either. -
✔✔Which of the following lab studies is most likely to be altered in the hours after
envenomation by coral snakes?
1. Coag studies
2. ABGs
3. Hematology studies
4. Renal function tests
1. encephalitis causing fear of air currents and water.
This is the pathology of the rabies virus, once this stage of disease progression is reached, death
is imminent. - ✔✔A patient, bitten by a bat, asks what may happen if they refuse prophylaxis
for rabies. The emergency nurse explains that infection by the rabies virus can lead to:
1. encephalitis causing fear of air currents and water.
2. a descending paralysis leading to respiratory failure.
3. cardiomyopathies requiring treatment with a pacemaker.
4. An inflammatory response causing fluid shifting and hypotension.
2. reddened, painful, purulent lesion with a yellow center. - ✔✔A wound infected with MRSA is
mostly likely to present as a:
Rationales
2. "I need you to stay in this room and someone will stay here with you"
With Mania, keep sentences brief and direct. Do not encourage the pt to speak and avoid
rambling. - ✔✔A patient presents to the ED in the manic phase of a bipolar affective disorder.
Which of the following statements made by the ER Nurse, is most therapeutic for a patient with
this diagnosis?
1. "I want you to ell me what you are feeling right now"
2. "I need you to stay in this room and someone will stay here with you"
3. "Tell me what is going on in your life right now that may have made you feel out of control for
the past few days"
4. "We are worried that you may be a danger to yourself of others in your present state, so we
are going to have someone from psychiatry come down and discuss with you what you are
feeling".
2. Poison mushrooms
OD on certain mushrooms=Cholinergic effect, Atropine is an Anti-Cholinergic drug.
Antihistamines are their own toxindrome, LSD is sympathomimetic, Jimson week is an
anticholinergic substance. - ✔✔Atropine is effective for overdoses caused by:
1. antihistamines
2. posion mushrooms
3. lysergic acid diethylamide (LSD)
4. the seeds of the Jimson weed plant.
1. Digoxin
,this is the only option that will cause heart block in particular. - ✔✔The ED nurse notices 3rd
Degree Heart Block on telemetry...
Which of the following substances did this patient most likely overdose on?
1. Digoxin
2. Lorazepam
3. Ethylene glycol
4. Acetaminophen
2. serum pH above normal
GOAL is a pH of 7.5-5.5, Pts who OD on this substance already have wide QTs and are already
hypotensive. Pupils are irrelevant. - ✔✔Effective Treatment for an overdose on tricyclic
antidepressants should cause
1. widening QT interval
2. serum pH above normal.
3. decreasing BP
4. Dilation of pupils
4. a core body temperature of 102F (38.9C).
shivering heats the body back up, sweating helps with heat loss through evaporation, main goal
is to decrease the body temp!! - ✔✔Effective treatment for heat stroke should result in:
1. the onset of shivering
2. the cessation of sweating
, 3. A GCS above 8.
4. a core body temperature of 102F (38.9C).
2. ABGs
due to the neurotoxic effects this can decrease respiratory drive and cause hypoxia. Coag.
studies great for Crotalid envenomation. Hematology/renal function not useful for either. -
✔✔Which of the following lab studies is most likely to be altered in the hours after
envenomation by coral snakes?
1. Coag studies
2. ABGs
3. Hematology studies
4. Renal function tests
1. encephalitis causing fear of air currents and water.
This is the pathology of the rabies virus, once this stage of disease progression is reached, death
is imminent. - ✔✔A patient, bitten by a bat, asks what may happen if they refuse prophylaxis
for rabies. The emergency nurse explains that infection by the rabies virus can lead to:
1. encephalitis causing fear of air currents and water.
2. a descending paralysis leading to respiratory failure.
3. cardiomyopathies requiring treatment with a pacemaker.
4. An inflammatory response causing fluid shifting and hypotension.
2. reddened, painful, purulent lesion with a yellow center. - ✔✔A wound infected with MRSA is
mostly likely to present as a:
