CEN (Certified Emergency Nurse) Practice
Exam 2 – Questions and Correct Answers
(Verified Answers) with Rationales 2025
1. A patient presents with a deviated trachea, absent breath sounds on the left,
and hypotension. What is the most likely diagnosis?
Tension pneumothorax
This is a classic triad of signs indicating a tension pneumothorax: tracheal
deviation, absent breath sounds, and hypotension.
2. Which medication is the antidote for benzodiazepine overdose?
Flumazenil
Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation
from benzodiazepines.
3. A 5-year-old presents with a barking cough and inspiratory stridor. What is
the most likely diagnosis?
Croup (laryngotracheobronchitis)
The hallmark signs of croup include a barking cough and inspiratory stridor due
to upper airway inflammation.
4. What is the preferred initial fluid for resuscitating a trauma patient with
hypovolemia?
Lactated Ringer’s
Lactated Ringer’s is an isotonic crystalloid solution commonly used in trauma
resuscitation.
,5. Which ECG finding is most indicative of hyperkalemia?
Peaked T waves
Tall, peaked T waves are a classic ECG finding in patients with elevated serum
potassium.
6. Which of the following is a contraindication for thrombolytic therapy in
stroke?
Recent intracranial hemorrhage
Patients with recent intracranial bleeding are at high risk for further
hemorrhage with thrombolytics.
7. A patient presents with pinpoint pupils, respiratory depression, and
unconsciousness. What is the suspected overdose?
Opioid overdose
The triad of pinpoint pupils, respiratory depression, and unconsciousness is
classic for opioid toxicity.
8. What is the priority action for a chemical burn to the eye?
Irrigate with copious normal saline
Immediate irrigation helps dilute and remove the chemical, preventing further
ocular damage.
9. A 25-year-old is brought in after a car crash. BP is 80/40, HR 140, RR 28.
Skin is cool and clammy. What shock is this?
Hypovolemic shock
These are typical signs of hypovolemic shock caused by fluid or blood loss.
10. What is the most sensitive indicator of early shock?
Tachycardia
Tachycardia is often the first compensatory response to shock before
hypotension sets in.
, 11. Which type of burn injury requires transfer to a burn center?
Partial-thickness burns >10% TBSA
Burn center referral criteria include partial-thickness burns exceeding 10% of
the total body surface area.
12. What is the antidote for acetaminophen overdose?
N-acetylcysteine
This medication restores hepatic glutathione and prevents liver damage.
13. What is the hallmark sign of cardiac tamponade?
Pulsus paradoxus
This is a drop in systolic BP >10 mmHg during inspiration, typical of
tamponade.
14. A patient with suspected stroke arrives with symptom onset 4 hours
ago. What is the next best step?
CT scan of the head
A head CT rules out hemorrhagic stroke before thrombolytic therapy is initiated.
15. What is the proper treatment for anaphylactic shock?
Intramuscular epinephrine
Epinephrine is the first-line treatment for anaphylaxis due to its vasoconstrictive
and bronchodilating effects.
16. Which lab value would be elevated in rhabdomyolysis?
Creatine kinase (CK)
CK levels rise due to muscle breakdown in rhabdomyolysis.
17. Which symptom is common in retinal detachment?
Seeing floaters or flashes of light
These are typical visual disturbances seen in retinal detachment.
Exam 2 – Questions and Correct Answers
(Verified Answers) with Rationales 2025
1. A patient presents with a deviated trachea, absent breath sounds on the left,
and hypotension. What is the most likely diagnosis?
Tension pneumothorax
This is a classic triad of signs indicating a tension pneumothorax: tracheal
deviation, absent breath sounds, and hypotension.
2. Which medication is the antidote for benzodiazepine overdose?
Flumazenil
Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation
from benzodiazepines.
3. A 5-year-old presents with a barking cough and inspiratory stridor. What is
the most likely diagnosis?
Croup (laryngotracheobronchitis)
The hallmark signs of croup include a barking cough and inspiratory stridor due
to upper airway inflammation.
4. What is the preferred initial fluid for resuscitating a trauma patient with
hypovolemia?
Lactated Ringer’s
Lactated Ringer’s is an isotonic crystalloid solution commonly used in trauma
resuscitation.
,5. Which ECG finding is most indicative of hyperkalemia?
Peaked T waves
Tall, peaked T waves are a classic ECG finding in patients with elevated serum
potassium.
6. Which of the following is a contraindication for thrombolytic therapy in
stroke?
Recent intracranial hemorrhage
Patients with recent intracranial bleeding are at high risk for further
hemorrhage with thrombolytics.
7. A patient presents with pinpoint pupils, respiratory depression, and
unconsciousness. What is the suspected overdose?
Opioid overdose
The triad of pinpoint pupils, respiratory depression, and unconsciousness is
classic for opioid toxicity.
8. What is the priority action for a chemical burn to the eye?
Irrigate with copious normal saline
Immediate irrigation helps dilute and remove the chemical, preventing further
ocular damage.
9. A 25-year-old is brought in after a car crash. BP is 80/40, HR 140, RR 28.
Skin is cool and clammy. What shock is this?
Hypovolemic shock
These are typical signs of hypovolemic shock caused by fluid or blood loss.
10. What is the most sensitive indicator of early shock?
Tachycardia
Tachycardia is often the first compensatory response to shock before
hypotension sets in.
, 11. Which type of burn injury requires transfer to a burn center?
Partial-thickness burns >10% TBSA
Burn center referral criteria include partial-thickness burns exceeding 10% of
the total body surface area.
12. What is the antidote for acetaminophen overdose?
N-acetylcysteine
This medication restores hepatic glutathione and prevents liver damage.
13. What is the hallmark sign of cardiac tamponade?
Pulsus paradoxus
This is a drop in systolic BP >10 mmHg during inspiration, typical of
tamponade.
14. A patient with suspected stroke arrives with symptom onset 4 hours
ago. What is the next best step?
CT scan of the head
A head CT rules out hemorrhagic stroke before thrombolytic therapy is initiated.
15. What is the proper treatment for anaphylactic shock?
Intramuscular epinephrine
Epinephrine is the first-line treatment for anaphylaxis due to its vasoconstrictive
and bronchodilating effects.
16. Which lab value would be elevated in rhabdomyolysis?
Creatine kinase (CK)
CK levels rise due to muscle breakdown in rhabdomyolysis.
17. Which symptom is common in retinal detachment?
Seeing floaters or flashes of light
These are typical visual disturbances seen in retinal detachment.
