CEN EXAM STUDY GUIDE 2026/2027
ACCURATE QUESTIONS WITH
CORRECT DETAILED SOLUTIONS |
NEWEST VERSION
Here is a 200-question MCQ revision set for the CEN (Certified Emergency Nurse)
Exam Study Guide 2026/2027.
Titles, descriptions, and keywords are bolded at the start of each section.
Correct answers are marked with ✅ and are mixed across A, B, C, D — not all the
same letter.
Title: Cardiovascular Emergencies – Acute Coronary Syndrome and Dysrhythmias
Description: Questions focus on ischemic chest pain, STEMI/NSTEMI recognition,
12-lead ECG findings, and emergency interventions.
Keywords: acute coronary syndrome, STEMI, NSTEMI, troponin, aspirin,
nitroglycerin, PCI, dysrhythmia, defibrillation
1. A patient presents with crushing substernal chest pain and ST elevation in leads II,
III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Right coronary artery ✅
C. Left circumflex
D. Left main
2. Which medication should be withheld if a patient with suspected acute coronary
syndrome has a systolic BP of 88 mm Hg?
A. Aspirin
, B. Nitroglycerin ✅
C. Heparin
D. Clopidogrel
3. A 12-lead ECG shows ST elevation in V1–V4. This indicates infarction of which
area?
A. Inferior wall
B. Lateral wall
C. Anterior wall ✅
D. Posterior wall
4. Which cardiac marker is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I ✅
D. BNP
5. A patient with STEMI is scheduled for PCI. Which medication is given to prevent
platelet aggregation?
A. Aspirin ✅
B. Furosemide
C. Metoprolol
D. Digoxin
6. Which dysrhythmia is most common immediately after an acute MI?
A. Ventricular tachycardia
B. Premature ventricular contractions ✅
C. Atrial fibrillation
D. Complete heart block
7. A patient has a heart rate of 38, BP 78/40, and cool skin. Which intervention is
priority?
A. Atropine ✅
B. Adenosine
, C. Amiodarone
D. Diltiazem
8. Which finding indicates unstable angina rather than stable angina?
A. Pain relieved by rest
B. Pain occurs with exertion only
C. Pain occurs at rest ✅
D. Pain lasts less than 2 minutes
9. A patient develops ventricular fibrillation. What is the priority action?
A. CPR and defibrillation ✅
B. Synchronized cardioversion
C. Adenosine 6 mg IV
D. Carotid massage
10. Which lead is most useful for detecting anterior wall MI?
A. V1–V4 ✅
B. II, III, aVF
C. I, aVL, V5–V6
D. V1–V2 only
Title: Respiratory Emergencies – Airway, Breathing, and Ventilation
Description: Questions cover asthma, COPD, pulmonary embolism, pneumothorax,
and ABG interpretation.
Keywords: asthma, COPD, PE, pneumothorax, ABG, oxygen, intubation, peak flow
11. A patient with asthma has wheezing and peak flow at 40% of personal best.
Which medication is priority?
A. Albuterol ✅
B. Montelukast
, C. Prednisone
D. Theophylline
12. Which ABG value indicates respiratory acidosis?
A. pH 7.50, PaCO2 30
B. pH 7.30, PaCO2 55 ✅
C. pH 7.40, PaCO2 40
D. pH 7.48, PaCO2 32
13. A patient with COPD has an SpO2 of 88%. What is the target oxygen saturation?
A. 95–100%
B. 88–92% ✅
C. 80–85%
D. 100%
14. Which sign indicates tension pneumothorax?
A. Tracheal deviation away from affected side ✅
B. Bilateral crackles
C. Bradycardia
D. Peripheral edema
15. A patient with pulmonary embolism is most likely to present with:
A. Sudden pleuritic chest pain and dyspnea ✅
B. Productive cough with green sputum
C. Wheezing relieved by inhaler
D. Bradypnea and hypothermia
16. Which intervention is priority for a patient with a tension pneumothorax?
A. Needle decompression ✅
B. Chest X-ray
C. Oxygen by nasal cannula
D. Bronchodilator
17. A patient has a respiratory rate of 6 and oxygen saturation of 82%. What is the
priority?
A. Bag-mask ventilation ✅
ACCURATE QUESTIONS WITH
CORRECT DETAILED SOLUTIONS |
NEWEST VERSION
Here is a 200-question MCQ revision set for the CEN (Certified Emergency Nurse)
Exam Study Guide 2026/2027.
Titles, descriptions, and keywords are bolded at the start of each section.
Correct answers are marked with ✅ and are mixed across A, B, C, D — not all the
same letter.
Title: Cardiovascular Emergencies – Acute Coronary Syndrome and Dysrhythmias
Description: Questions focus on ischemic chest pain, STEMI/NSTEMI recognition,
12-lead ECG findings, and emergency interventions.
Keywords: acute coronary syndrome, STEMI, NSTEMI, troponin, aspirin,
nitroglycerin, PCI, dysrhythmia, defibrillation
1. A patient presents with crushing substernal chest pain and ST elevation in leads II,
III, and aVF. Which coronary artery is most likely occluded?
A. Left anterior descending
B. Right coronary artery ✅
C. Left circumflex
D. Left main
2. Which medication should be withheld if a patient with suspected acute coronary
syndrome has a systolic BP of 88 mm Hg?
A. Aspirin
, B. Nitroglycerin ✅
C. Heparin
D. Clopidogrel
3. A 12-lead ECG shows ST elevation in V1–V4. This indicates infarction of which
area?
A. Inferior wall
B. Lateral wall
C. Anterior wall ✅
D. Posterior wall
4. Which cardiac marker is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I ✅
D. BNP
5. A patient with STEMI is scheduled for PCI. Which medication is given to prevent
platelet aggregation?
A. Aspirin ✅
B. Furosemide
C. Metoprolol
D. Digoxin
6. Which dysrhythmia is most common immediately after an acute MI?
A. Ventricular tachycardia
B. Premature ventricular contractions ✅
C. Atrial fibrillation
D. Complete heart block
7. A patient has a heart rate of 38, BP 78/40, and cool skin. Which intervention is
priority?
A. Atropine ✅
B. Adenosine
, C. Amiodarone
D. Diltiazem
8. Which finding indicates unstable angina rather than stable angina?
A. Pain relieved by rest
B. Pain occurs with exertion only
C. Pain occurs at rest ✅
D. Pain lasts less than 2 minutes
9. A patient develops ventricular fibrillation. What is the priority action?
A. CPR and defibrillation ✅
B. Synchronized cardioversion
C. Adenosine 6 mg IV
D. Carotid massage
10. Which lead is most useful for detecting anterior wall MI?
A. V1–V4 ✅
B. II, III, aVF
C. I, aVL, V5–V6
D. V1–V2 only
Title: Respiratory Emergencies – Airway, Breathing, and Ventilation
Description: Questions cover asthma, COPD, pulmonary embolism, pneumothorax,
and ABG interpretation.
Keywords: asthma, COPD, PE, pneumothorax, ABG, oxygen, intubation, peak flow
11. A patient with asthma has wheezing and peak flow at 40% of personal best.
Which medication is priority?
A. Albuterol ✅
B. Montelukast
, C. Prednisone
D. Theophylline
12. Which ABG value indicates respiratory acidosis?
A. pH 7.50, PaCO2 30
B. pH 7.30, PaCO2 55 ✅
C. pH 7.40, PaCO2 40
D. pH 7.48, PaCO2 32
13. A patient with COPD has an SpO2 of 88%. What is the target oxygen saturation?
A. 95–100%
B. 88–92% ✅
C. 80–85%
D. 100%
14. Which sign indicates tension pneumothorax?
A. Tracheal deviation away from affected side ✅
B. Bilateral crackles
C. Bradycardia
D. Peripheral edema
15. A patient with pulmonary embolism is most likely to present with:
A. Sudden pleuritic chest pain and dyspnea ✅
B. Productive cough with green sputum
C. Wheezing relieved by inhaler
D. Bradypnea and hypothermia
16. Which intervention is priority for a patient with a tension pneumothorax?
A. Needle decompression ✅
B. Chest X-ray
C. Oxygen by nasal cannula
D. Bronchodilator
17. A patient has a respiratory rate of 6 and oxygen saturation of 82%. What is the
priority?
A. Bag-mask ventilation ✅
