Pam Bartley CEN Study Set: Emergency Nursing Certification Review Questions, Key Concepts
& Exam Prep Guide
How do you calculate a mean arterial pressure (MAP)? - correct answer ✔✔SBP + 2(DBP) /3
What test is performed before inserting a radial arterial line? - correct answer ✔✔Allen's test
Allen's test (modified) - correct answer ✔✔The hand is elevated and the patient is asked to
clench their fist for about 30 seconds.
Ulnar and the radial arteries are occluded
Still elevated, the hand is then opened (it should appear blanched)
Ulnar pressure is released while radial pressure is maintained; color should return within 5 to 15
seconds.
How do you assess BP in patient with a ventricular assist device (VAD)? - correct answer ✔✔Via
arterial line
Ankle-brachial index (ABI) - correct answer ✔✔A ratio derived by dividing the ankle blood
pressure by the brachial blood pressure; this calculation is used to assess the vascular status of
the lower extremities. To obtain the ABI, a blood pressure cuff is applied to the lower
extremities just above the malleoli. The systolic pressure is measured by Doppler ultrasound at
both the dorsalis pedis and posterior tibial pulses. The higher of these two pressures is then
divided by the higher of the two brachial pulses.
What is a normal ankle-brachial index (ABI)? - correct answer ✔✔1.0-1.4
What do you hear on percussion in air-leak syndrome? - correct answer ✔✔hyperresonance
,What ECG change do you see in carbon monoxide (CO) toxicity? - correct answer ✔✔sinus
tachycardia, ST depression
What is the difference between complete and incomplete cord syndromes? - correct answer
✔✔Complete: no function below level of the injury
Incomplete: some function below level of the injury
Why do you use a barium enema in the treatment of intussusception? - correct answer ✔✔The
barium can push the intestine back into place in 90% of cases
In DKA, when is the insulin infusion discontinued? - correct answer ✔✔When the patient is
alert, oriented, eating and drinking normally, SC insulin can be resumed
Leave the IV insulin running for 30-60 min after first SC injection
What ECG change may you see in acute adrenal insufficiency? - correct answer ✔✔Peaked T
waves, widened QRS (due to hyperkalemia)
What is the purpose of permissive hypotension in pelvic fracture? - correct answer ✔✔To
prevent disruption of clot formation
What causes the dark urine in rhabdomyolysis? - correct answer ✔✔Myoglobin (muscle
breakdown product) secreted by the kidney
Why is creatine kinase (CK) elevated in rhabdomyolysis? - correct answer ✔✔CK is an enzyme
found in skeletal muscle; it is released as muscle tissue is damaged by rhabdo
What is a common complication seen in stage 2 of Lyme disease? - correct answer ✔✔neuro
complications (numbness, pain, weakness, Bell's palsy)
,How do you treat a patient with circumferential torso burn when you are unable to ventilate
with BVM? - correct answer ✔✔Sit patient up if appropriate
escharotomy
Why is pulse oximetry high during hypoxemia from carbon monoxide exposure? - correct
answer ✔✔Pulse oximetry does not differentiate between O2 and CO attached to hemoglobin
Why does hydroxocobalamin in the Cyanokit turn urine red? - correct answer ✔✔It gives a
harmless and transient reddish colour to the skin and urine
Why is calcium required in hydrofluoric acid burn? - correct answer ✔✔Calcium gluconate binds
with the fluorine ion, preventing further penetration/damage of bone and tissue
Why is activated charcoal NOT effective in Iron ingestion? - correct answer ✔✔Activated
charcoal does not bind to iron
Which nursing ethical principle is EMTALA is based on? - correct answer ✔✔Justice? Can't find a
definitve answer to this anywhere!
Reporting suspected child maltreatment is practicing which ethical principle? - correct answer
✔✔Nonmaleficence? Can't find a definitive answer to this anywhere!
How is JumpStart different from START disaster triage? - correct answer ✔✔The JumpSTART
pediatric triage MCI triage tool (usually shortened to JumpSTART) is a variation of the simple
triage and rapid treatment (START) triage system; JumpSTART was designed specifically for
triaging children in disaster settings
Body packers - correct answer ✔✔Whole bowel irrigation
, Deferoxamine - correct answer ✔✔Vin rose urine
Stimulants - correct answer ✔✔mydriasis
Opioids - correct answer ✔✔myosis
Cholinergic crisis - correct answer ✔✔SLUDGE
Ethylene glycol - correct answer ✔✔Fomepizole
Digoxin - correct answer ✔✔yellow green vision
Beta blocker toxicity - correct answer ✔✔glucagon
acetaminiophen - correct answer ✔✔N-acetylcysteine
salicylates - correct answer ✔✔urine alkalination
sulfonylureas - correct answer ✔✔Octreotide
Phencyclidine (PCP) - correct answer ✔✔Combative behavior
Autonomy - correct answer ✔✔Right to make own health decisions & have their choices
respected
Beneficence - correct answer ✔✔Oath to help others - Including helping unresponsive pts
& Exam Prep Guide
How do you calculate a mean arterial pressure (MAP)? - correct answer ✔✔SBP + 2(DBP) /3
What test is performed before inserting a radial arterial line? - correct answer ✔✔Allen's test
Allen's test (modified) - correct answer ✔✔The hand is elevated and the patient is asked to
clench their fist for about 30 seconds.
Ulnar and the radial arteries are occluded
Still elevated, the hand is then opened (it should appear blanched)
Ulnar pressure is released while radial pressure is maintained; color should return within 5 to 15
seconds.
How do you assess BP in patient with a ventricular assist device (VAD)? - correct answer ✔✔Via
arterial line
Ankle-brachial index (ABI) - correct answer ✔✔A ratio derived by dividing the ankle blood
pressure by the brachial blood pressure; this calculation is used to assess the vascular status of
the lower extremities. To obtain the ABI, a blood pressure cuff is applied to the lower
extremities just above the malleoli. The systolic pressure is measured by Doppler ultrasound at
both the dorsalis pedis and posterior tibial pulses. The higher of these two pressures is then
divided by the higher of the two brachial pulses.
What is a normal ankle-brachial index (ABI)? - correct answer ✔✔1.0-1.4
What do you hear on percussion in air-leak syndrome? - correct answer ✔✔hyperresonance
,What ECG change do you see in carbon monoxide (CO) toxicity? - correct answer ✔✔sinus
tachycardia, ST depression
What is the difference between complete and incomplete cord syndromes? - correct answer
✔✔Complete: no function below level of the injury
Incomplete: some function below level of the injury
Why do you use a barium enema in the treatment of intussusception? - correct answer ✔✔The
barium can push the intestine back into place in 90% of cases
In DKA, when is the insulin infusion discontinued? - correct answer ✔✔When the patient is
alert, oriented, eating and drinking normally, SC insulin can be resumed
Leave the IV insulin running for 30-60 min after first SC injection
What ECG change may you see in acute adrenal insufficiency? - correct answer ✔✔Peaked T
waves, widened QRS (due to hyperkalemia)
What is the purpose of permissive hypotension in pelvic fracture? - correct answer ✔✔To
prevent disruption of clot formation
What causes the dark urine in rhabdomyolysis? - correct answer ✔✔Myoglobin (muscle
breakdown product) secreted by the kidney
Why is creatine kinase (CK) elevated in rhabdomyolysis? - correct answer ✔✔CK is an enzyme
found in skeletal muscle; it is released as muscle tissue is damaged by rhabdo
What is a common complication seen in stage 2 of Lyme disease? - correct answer ✔✔neuro
complications (numbness, pain, weakness, Bell's palsy)
,How do you treat a patient with circumferential torso burn when you are unable to ventilate
with BVM? - correct answer ✔✔Sit patient up if appropriate
escharotomy
Why is pulse oximetry high during hypoxemia from carbon monoxide exposure? - correct
answer ✔✔Pulse oximetry does not differentiate between O2 and CO attached to hemoglobin
Why does hydroxocobalamin in the Cyanokit turn urine red? - correct answer ✔✔It gives a
harmless and transient reddish colour to the skin and urine
Why is calcium required in hydrofluoric acid burn? - correct answer ✔✔Calcium gluconate binds
with the fluorine ion, preventing further penetration/damage of bone and tissue
Why is activated charcoal NOT effective in Iron ingestion? - correct answer ✔✔Activated
charcoal does not bind to iron
Which nursing ethical principle is EMTALA is based on? - correct answer ✔✔Justice? Can't find a
definitve answer to this anywhere!
Reporting suspected child maltreatment is practicing which ethical principle? - correct answer
✔✔Nonmaleficence? Can't find a definitive answer to this anywhere!
How is JumpStart different from START disaster triage? - correct answer ✔✔The JumpSTART
pediatric triage MCI triage tool (usually shortened to JumpSTART) is a variation of the simple
triage and rapid treatment (START) triage system; JumpSTART was designed specifically for
triaging children in disaster settings
Body packers - correct answer ✔✔Whole bowel irrigation
, Deferoxamine - correct answer ✔✔Vin rose urine
Stimulants - correct answer ✔✔mydriasis
Opioids - correct answer ✔✔myosis
Cholinergic crisis - correct answer ✔✔SLUDGE
Ethylene glycol - correct answer ✔✔Fomepizole
Digoxin - correct answer ✔✔yellow green vision
Beta blocker toxicity - correct answer ✔✔glucagon
acetaminiophen - correct answer ✔✔N-acetylcysteine
salicylates - correct answer ✔✔urine alkalination
sulfonylureas - correct answer ✔✔Octreotide
Phencyclidine (PCP) - correct answer ✔✔Combative behavior
Autonomy - correct answer ✔✔Right to make own health decisions & have their choices
respected
Beneficence - correct answer ✔✔Oath to help others - Including helping unresponsive pts
