CEN Practice Test questions with
correct answers
A 12-year-old patient is brought to the emergency department by his parents after accidentally swallowing a disk battery while changing the
battery in his watch. A chest x-ray reveals that the battery is in the patient's esophagus. He is able to swallow and breathe without difficulty. The
most appropriate intervention for this patient is to:
a. Prepare the patient and his family for emergent endoscopy to remove the battery.
b. Allow the patient clear liquids until repeat x-rays show that the battery has moved into the stomach.
c. Discharge the patient to home with instructions to check his stools until the battery passes.
d. Prepare to administer polyethylene glycol. - CORRECT ANSWER-a. Prepare the patient and his family for emergent endoscopy to remove the
battery.
Emergent endoscopy is indicated for any obstruction: when a patient is unable to manage secretions, when a patient swallows a sharp-pointed
object, or when a patient swallows a disk battery. Any of these ingestions may constitute an emergency and the patient and family should be
prepared for possible emergent endoscopy.
A 16-year-old boy is brought to the ED by his parents. They state that he awoke from sleep with nausea, vomiting, and pain in his scrotum. The
nurse notes that the boy's scrotum is swollen and he has a low-grade fever. His urinalysis is normal. The physician suspects a testicular torsion.
The definitive treatment for this boy is:
a. Antibiotics
b. Bed rest for several days
c. Anti-emetic and pain medication
d. Surgery - CORRECT ANSWER-d. Surgery
The nurse should recognize that these signs and symptoms in a teenage boy may be indicative of testicular torsion. Although all of the treatments
may be used, surgery is the definitive treatment for this condition.
A 24-year-old woman is seen in the emergency department complaining of urinary frequency, pain with urination and urgency. Vital signs are
stable and within normal limits. When you obtain a urine specimen, you note that it is cloudy and foul smelling. You should prepare the patient for:
a. Admission for acute renal failure
b. Discharge with antibiotic therapy
c. Admission for lithotripsy
d. Discharge without medications - CORRECT ANSWER-b. Discharge with antibiotic therapy
The symptoms of dysuria, urgency and frequency are classic indicators of a urinary tract infection. Urinary tract infections are very common in
women and can almost always be treated on an outpatient basis with a course of antibiotics.
A 36-year-old African American man presented to the emergency department with burns to his hands that were suffered when his car radiator
boiled over onto his hands. He has run cool water over his hands but he is still experiencing what he describes as "horrible" pain. He does not
have burns on any other area of his body. How should this burn be classified according to the American Burn Association's guidelines?
a. First degree
b. Second degree
c. Third degree
d. Fourth degree - CORRECT ANSWER-b. Second degree
Minor shallow or deep partial thickness burns on less than 15% of an adult's body less than 40 years of age can be treated on an outpatient
basis. Because the burns are on his hands, the patient may be admitted as an observation patient since there is a functional risk to his hands.The
American Burn Association's guidelines are as follows:
First Degree (partial thickness) - superficial, red, sometimes painful
Second Degree (partial thickness) - red, blistered, swollen, very painful
Third Degree (full thickness) - whitish, charred or translucent, no pin prick sensation
A baseball coach calls the emergency department after a 15-year-old boy had a tooth knocked out during a baseball game. The baseball coach
found the intact tooth on the ground and has rinsed off the dirt. What should the coach be advised to do?
a. The tooth and boy should go to the dentist in the morning.
b. You cannot give any advice over the telephone.
c. If the child is alert and oriented, put the tooth under his tongue and bring him to the ED.
, d. Wrap the tooth in a clean shirt and bring the boy and tooth to the ED. - CORRECT ANSWER-c. If the child is alert and oriented, put the tooth
under his tongue and bring him to the ED.
Many times, an avulsed tooth can be reimplanted if the tooth is out of the socket for less than 60 minutes. After that time, the periodontal
ligaments begin to die. An avulsed tooth is best transported in the patient's own mouth if he is not at risk for swallowing the tooth and if there are
no other injuries. Generally, the rule of thumb is that children under the age of six should not transport the tooth in their mouth.
A nurse has inserted a nasogastric (NG) tube for the relief of nausea and vomiting. The technician working with the nurse does not have any
special training or certification. The nurse asks the technician to "take care of the patient while I go to lunch". While the nurse is out of the
department, the technician working with the patient can:
a. Do oral care
b. Irrigate the NG tube
c. Administer meds through the NG
d. All the above - CORRECT ANSWER-a. Do oral care
The only task that the nurse should delegate to the unlicensed technician is the provision of oral care.
A nurse is caring for a farmer who was bitten by a rattlesnake while working in his field. He killed the snake and brought it to the ED for positive
identification. The triage nurse notes two puncture marks on his right hand. The proper interventions for this patient may include all of the
following EXCEPT:
a. Tetanus vaccination
b. Antivenom administration
c. Positioning the patient's hand above the heart
d. Cleansing of the bite - CORRECT ANSWER-c. Positioning the patient's hand above the heart
The optimal position of the affected extremity is below the level of the heart to slow venom movement into central circulation. Tetanus vaccination
and antivenom administration should be given as medically indicated. Cleaning the puncture wounds should be done gently.
A nurse is caring for a patient with pancreatitis. Which of the following symptoms would indicate a possible life-threatening complication?
a. Abnormal bowel sounds
b. Abdominal pain
c. Nausea and vomiting
d. Increased respiratory rate - CORRECT ANSWER-d. Increased respiratory rate
Respiratory distress as evidenced by increased respiratory rate is a potentially life-threatening complication of pancreatitis. The other symptoms
are all common findings in the patient with pancreatitis. If the symptoms have not changed significantly, they should be noted but are not life-
threatening.
A patient has been admitted to the Emergency Department with persistent epistaxis. Vital signs are stable. The correct position for this patient is:
a. Sitting with head leaning forward
b. Supine with the head facing to the side
c. Left lateral recumbent
d. Prone with the head facing to the side - CORRECT ANSWER-a. Sitting with head leaning forward
The patient should be sitting up with his head leaning forward. This position helps to prevent blood from being swallowed by the patient.
Swallowing blood can cause vomiting. Pinching the nose below the bridge of the nose may help stop bleeding
A patient in the ED is diagnosed with West Nile virus. Which of the following is the mode of transmission for this disease?
a. Bite of infected tick
b. Bite of infected flea
c. Bite of infected mosquito
d. Bite of infected spider - CORRECT ANSWER-c. Bite of infected mosquito
West Nile virus is caused by the bite of a mosquito. First discovered in the US in 1999, it is believed that the virus is actually carried by infected
birds. The mosquito bites the bird and then bites a person. Mosquitoes carry the highest amount of virus in the early fall; typically, rates of the
reported disease increases in late August and early September. As mosquitoes die off in the cold weather, the incidence of disease decreases.
A patient presents to the ED with complaint of ear and jaw pain. Upon assessment, you note that his tympanic membranes are non-bulging,
pearly gray. You look in his mouth and see this: The primary diagnosis for this patient will be:
a. Acute otitis media
b. Acute otitis externa
c. Dental caries
d. None of the above - CORRECT ANSWER-c. Dental caries
The normal eardrum is pearly gray in color so this would rule out any of the ear infections. This patient has an extensive dental caries that should
be referred to a dentist. The ED provider may prescribe antibiotics and/or pain medications for this patient to clear any infection that may be
causing the ear pain.
A seventeen-year-old is brought to the emergency department complaining of leg pain after a motor vehicle crash. X-rays show a fracture of the
femur with several bone fragments at the fracture site. You note that the skin above the fracture site is intact but bruised. This type of fracture is
called:
a. Open
b. Avulsion
c. compression
d. Comminuted - CORRECT ANSWER-d. Comminuted
A comminuted fracture is one in which there are more than two portions of the fractured bone. In a comminuted fracture, you may see bone
fragments at the site of the fracture. An open fracture is one in which the skin is broken. Since the skin is intact, this fracture is a closed,
comminuted fracture of the femur.
correct answers
A 12-year-old patient is brought to the emergency department by his parents after accidentally swallowing a disk battery while changing the
battery in his watch. A chest x-ray reveals that the battery is in the patient's esophagus. He is able to swallow and breathe without difficulty. The
most appropriate intervention for this patient is to:
a. Prepare the patient and his family for emergent endoscopy to remove the battery.
b. Allow the patient clear liquids until repeat x-rays show that the battery has moved into the stomach.
c. Discharge the patient to home with instructions to check his stools until the battery passes.
d. Prepare to administer polyethylene glycol. - CORRECT ANSWER-a. Prepare the patient and his family for emergent endoscopy to remove the
battery.
Emergent endoscopy is indicated for any obstruction: when a patient is unable to manage secretions, when a patient swallows a sharp-pointed
object, or when a patient swallows a disk battery. Any of these ingestions may constitute an emergency and the patient and family should be
prepared for possible emergent endoscopy.
A 16-year-old boy is brought to the ED by his parents. They state that he awoke from sleep with nausea, vomiting, and pain in his scrotum. The
nurse notes that the boy's scrotum is swollen and he has a low-grade fever. His urinalysis is normal. The physician suspects a testicular torsion.
The definitive treatment for this boy is:
a. Antibiotics
b. Bed rest for several days
c. Anti-emetic and pain medication
d. Surgery - CORRECT ANSWER-d. Surgery
The nurse should recognize that these signs and symptoms in a teenage boy may be indicative of testicular torsion. Although all of the treatments
may be used, surgery is the definitive treatment for this condition.
A 24-year-old woman is seen in the emergency department complaining of urinary frequency, pain with urination and urgency. Vital signs are
stable and within normal limits. When you obtain a urine specimen, you note that it is cloudy and foul smelling. You should prepare the patient for:
a. Admission for acute renal failure
b. Discharge with antibiotic therapy
c. Admission for lithotripsy
d. Discharge without medications - CORRECT ANSWER-b. Discharge with antibiotic therapy
The symptoms of dysuria, urgency and frequency are classic indicators of a urinary tract infection. Urinary tract infections are very common in
women and can almost always be treated on an outpatient basis with a course of antibiotics.
A 36-year-old African American man presented to the emergency department with burns to his hands that were suffered when his car radiator
boiled over onto his hands. He has run cool water over his hands but he is still experiencing what he describes as "horrible" pain. He does not
have burns on any other area of his body. How should this burn be classified according to the American Burn Association's guidelines?
a. First degree
b. Second degree
c. Third degree
d. Fourth degree - CORRECT ANSWER-b. Second degree
Minor shallow or deep partial thickness burns on less than 15% of an adult's body less than 40 years of age can be treated on an outpatient
basis. Because the burns are on his hands, the patient may be admitted as an observation patient since there is a functional risk to his hands.The
American Burn Association's guidelines are as follows:
First Degree (partial thickness) - superficial, red, sometimes painful
Second Degree (partial thickness) - red, blistered, swollen, very painful
Third Degree (full thickness) - whitish, charred or translucent, no pin prick sensation
A baseball coach calls the emergency department after a 15-year-old boy had a tooth knocked out during a baseball game. The baseball coach
found the intact tooth on the ground and has rinsed off the dirt. What should the coach be advised to do?
a. The tooth and boy should go to the dentist in the morning.
b. You cannot give any advice over the telephone.
c. If the child is alert and oriented, put the tooth under his tongue and bring him to the ED.
, d. Wrap the tooth in a clean shirt and bring the boy and tooth to the ED. - CORRECT ANSWER-c. If the child is alert and oriented, put the tooth
under his tongue and bring him to the ED.
Many times, an avulsed tooth can be reimplanted if the tooth is out of the socket for less than 60 minutes. After that time, the periodontal
ligaments begin to die. An avulsed tooth is best transported in the patient's own mouth if he is not at risk for swallowing the tooth and if there are
no other injuries. Generally, the rule of thumb is that children under the age of six should not transport the tooth in their mouth.
A nurse has inserted a nasogastric (NG) tube for the relief of nausea and vomiting. The technician working with the nurse does not have any
special training or certification. The nurse asks the technician to "take care of the patient while I go to lunch". While the nurse is out of the
department, the technician working with the patient can:
a. Do oral care
b. Irrigate the NG tube
c. Administer meds through the NG
d. All the above - CORRECT ANSWER-a. Do oral care
The only task that the nurse should delegate to the unlicensed technician is the provision of oral care.
A nurse is caring for a farmer who was bitten by a rattlesnake while working in his field. He killed the snake and brought it to the ED for positive
identification. The triage nurse notes two puncture marks on his right hand. The proper interventions for this patient may include all of the
following EXCEPT:
a. Tetanus vaccination
b. Antivenom administration
c. Positioning the patient's hand above the heart
d. Cleansing of the bite - CORRECT ANSWER-c. Positioning the patient's hand above the heart
The optimal position of the affected extremity is below the level of the heart to slow venom movement into central circulation. Tetanus vaccination
and antivenom administration should be given as medically indicated. Cleaning the puncture wounds should be done gently.
A nurse is caring for a patient with pancreatitis. Which of the following symptoms would indicate a possible life-threatening complication?
a. Abnormal bowel sounds
b. Abdominal pain
c. Nausea and vomiting
d. Increased respiratory rate - CORRECT ANSWER-d. Increased respiratory rate
Respiratory distress as evidenced by increased respiratory rate is a potentially life-threatening complication of pancreatitis. The other symptoms
are all common findings in the patient with pancreatitis. If the symptoms have not changed significantly, they should be noted but are not life-
threatening.
A patient has been admitted to the Emergency Department with persistent epistaxis. Vital signs are stable. The correct position for this patient is:
a. Sitting with head leaning forward
b. Supine with the head facing to the side
c. Left lateral recumbent
d. Prone with the head facing to the side - CORRECT ANSWER-a. Sitting with head leaning forward
The patient should be sitting up with his head leaning forward. This position helps to prevent blood from being swallowed by the patient.
Swallowing blood can cause vomiting. Pinching the nose below the bridge of the nose may help stop bleeding
A patient in the ED is diagnosed with West Nile virus. Which of the following is the mode of transmission for this disease?
a. Bite of infected tick
b. Bite of infected flea
c. Bite of infected mosquito
d. Bite of infected spider - CORRECT ANSWER-c. Bite of infected mosquito
West Nile virus is caused by the bite of a mosquito. First discovered in the US in 1999, it is believed that the virus is actually carried by infected
birds. The mosquito bites the bird and then bites a person. Mosquitoes carry the highest amount of virus in the early fall; typically, rates of the
reported disease increases in late August and early September. As mosquitoes die off in the cold weather, the incidence of disease decreases.
A patient presents to the ED with complaint of ear and jaw pain. Upon assessment, you note that his tympanic membranes are non-bulging,
pearly gray. You look in his mouth and see this: The primary diagnosis for this patient will be:
a. Acute otitis media
b. Acute otitis externa
c. Dental caries
d. None of the above - CORRECT ANSWER-c. Dental caries
The normal eardrum is pearly gray in color so this would rule out any of the ear infections. This patient has an extensive dental caries that should
be referred to a dentist. The ED provider may prescribe antibiotics and/or pain medications for this patient to clear any infection that may be
causing the ear pain.
A seventeen-year-old is brought to the emergency department complaining of leg pain after a motor vehicle crash. X-rays show a fracture of the
femur with several bone fragments at the fracture site. You note that the skin above the fracture site is intact but bruised. This type of fracture is
called:
a. Open
b. Avulsion
c. compression
d. Comminuted - CORRECT ANSWER-d. Comminuted
A comminuted fracture is one in which there are more than two portions of the fractured bone. In a comminuted fracture, you may see bone
fragments at the site of the fracture. An open fracture is one in which the skin is broken. Since the skin is intact, this fracture is a closed,
comminuted fracture of the femur.
