CEN Exam 1 | Actual Questions and Answers Latest Updated
2026/2027 (Graded A+)
• Question
Which 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 Answer: B: First-degree atrioventricular block is diagnosed partially by an EKG
showing a PR interval of greater than 0.20 seconds.
• Question
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 Answer: 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?
• Question
a.ureteral calcium oxalate calculus b.ureteral cystine calculus c.testicular torsion
d.cystitis
Correct Answer: 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.
, • Question
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 Answer: 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.
• Question
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 Answer: 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 sputum or kinks or inadvertent endobronchial displacement. The
airway should be suctioned and tube placement checked. A chest x-ray is frequently
helpful in determining the cause. Lung collapse, worsening of the underlying disease,
and bronchospasm are also causes of elevated pressure. Leaks around the endotracheal
tube cuffs will cause low airway pressure. Auto-positive end-expiratory pressure
(auto-PEEP) is caused by
premature inspiratory delivery before full expiration (as in asthma or COPD patients)
and may lead to increased pressure and lung damage.
2026/2027 (Graded A+)
• Question
Which 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 Answer: B: First-degree atrioventricular block is diagnosed partially by an EKG
showing a PR interval of greater than 0.20 seconds.
• Question
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 Answer: 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?
• Question
a.ureteral calcium oxalate calculus b.ureteral cystine calculus c.testicular torsion
d.cystitis
Correct Answer: 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.
, • Question
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 Answer: 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.
• Question
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 Answer: 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 sputum or kinks or inadvertent endobronchial displacement. The
airway should be suctioned and tube placement checked. A chest x-ray is frequently
helpful in determining the cause. Lung collapse, worsening of the underlying disease,
and bronchospasm are also causes of elevated pressure. Leaks around the endotracheal
tube cuffs will cause low airway pressure. Auto-positive end-expiratory pressure
(auto-PEEP) is caused by
premature inspiratory delivery before full expiration (as in asthma or COPD patients)
and may lead to increased pressure and lung damage.
