CEN Practice Test
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. - ANS-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 - ANS-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 - ANS-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 - ANS-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. - ANS-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
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. - ANS-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 - ANS-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 - ANS-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 - ANS-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. - ANS-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
