CEN Practice Exam Questions And
Answers Verified 100% Correct |Latest
Updates
The PRIORITY nursing intervention for a patient who has frostbite is to
admin ordered pain meds
use friction massage to rapidly warm affected extremity
maintain moistened dressing on affected area
prepare for STAT escharotomy - ANSWER -admin ordered pain meds -- Frostbite
is very painful during re-warming, so pain management is a priority.
A patient who sustained a leg laceration from a chainsaw is unsure if he has ever
received a tetanus immunization. The patient should receive - ANSWER -250 U of
tetanus immune globulin and 0.5 mL of tetanus, diphtheria toxoids, and pertussis
vaccine. --
The nurse is caring for a patient who has a high fever, central nervous system
dysfunction and tachycardia. The nurse should recognize that the patient may be
experiencing - ANSWER -Thyroid Storm -- The classic triad of thyroid storm is
high fever, central nervous system dysfunction or cerebral encephalopathy and
exaggerated tachycardia out of proportion to fever.
The treatment of choice for a patient presenting with headache in the right
temporal region and jaw pain is - ANSWER -dexamethasone (Decadron) IV --
Temporal arteritis is an inflammatory condition, so a steroid is the first-line
treatment to prevent vision loss.
A nebulized bronchodilator is administered to a 6-year-old child with severe
asthma. Treatment may be deemed effective if the patient has
RR decreased to 14 breaths/min
a prolonged expiratory phase
diminished breath sounds bilaterally
an increased peak expiratory flow rate - ANSWER -an increased peak expiratory
flow rate. -- The hallmark of asthma diagnosis is spirometry before and after
bronchodilator therapy to document reversibility of airway narrowing, usually by
peak expiratory flow rates.
, A patient who is trembling, sweating, and hyperventilating is having an anxiety
attack. Arterial blood gas analysis is likely to show which of the following?
pH < 7.35
HCO3 > 26
o2 sat < 96%
PaCO2 < 33 mm Hg - ANSWER -PaCO2 < 33 mm Hg -- With the increased
respiratory rate that occurs with anxiety, carbon dioxide is blown off, which results
in a low PaCO2
A patient has a regular, narrow complex tachycardia with a heart rate of 200
beats/min and a blood pressure of 90/60 mm Hg. An IV of D5W has been initiated
and adenosine (Adenocard), 6 mg IV, is ordered. The nurse should - ANSWER -
administer the adenosine undiluted in the port closest to the insertion site.
A patient who has a serum potassium level of 2.6 mEq/L should be MOST closely
monitored for
carpopedal spasm
edema of the extremities
increased neuromuscular irritability
weakness of the respiratory muscles - ANSWER -weakness of the respiratory
muscles -- Respiratory muscle weakness related to hypokalemia may lead to
respiratory failure or death.
The earliest indication of increased intracranial pressure is - ANSWER -altered
LOC -- Early signs and symptoms of increased intracranial pressure are changes in
the level of consciousness and restlessness. Vital sign changes are a late sign of
increased intracranial pressure.
A patient admitted in hypertensive emergency is given a nicardipine (Cardene)
drip. Treatment has been effective if the patient's mean arterial pressure decreases
by - ANSWER -20% to 25% over 1 to 2 hours -- The therapeutic intervention
should be limiting the decrease in blood pressure to 25% within the first 2 hours of
treatment. Rapid reduction of blood pressure slows the progression of end organ
damage.
A trauma patient complains of shoulder pain, but has no history or evidence of
shoulder injury. The patient should be examined for possible
pneumothorax
visceral injury
,damage to ulnar nerve
injury to the cervical spine - ANSWER -Visceral Injury -- Injury to the spleen can
manifest itself with pain that is referred to the left shoulder (Kehr's sign). A
visceral injury may be the cause of the referred pain, secondary to stimulation of
the phrenic nerve due to abdominal distention or irritation of the diaphragm.
A patient reports weakness, fatigue, nausea and vomiting. On assessment, the
nurse notes hyperpigmentation of the knuckles and elbows. The nurse should
suspect - ANSWER -Addisonian crisis --
The following patient symptoms of weakness, fatigue, nausea and vomiting cause
Addisonian crisis.
Describe Addison's crisis - ANSWER -Addison's (adrenal) crisis -- not enough
adrenal function/hormone. Decreased glucose, low sodium, elevated potassium (d/t
low Na); presents with dehydration (weakness, fatigue, hypotension).
Can occur when pt goes "cold turkey" from chronic prednisone use
Addison's crisis tx - ANSWER -Treat the sx -- hypovolemia (fluids, o2,
vasopressors)
Hyperkalemia (tele, kayexalate, IV insulin/dextrose); Hyponatremia (IV NS),
hypoglycemia (amp D50), aldosterone/cortisol (IV steroids)
Define Cushing's syndrome - labs, appearance - ANSWER -Too much adrenal
function/hormone -- high glucose, high Na, low K (d/t high Na)
Cushingoid appearance (moon face, buffalo hump, immunocompromised, poor
wound healing
caused by prednisone use
A patient complains of lower abdominal discomfort and is only able to urinate a
small amount at a time. The patient's bladder is distended. What is the FIRST
intervention that the nurse should take? - ANSWER -Insert indwelling urinary cath
-- In a patient with urinary retention, an indwelling urinary catheter should be
inserted for immediate relief.
Narrow pulse pressure indicative of - ANSWER -Hypovolemic Shock
*As vascular volume drops:
*Sympathetic Nervous System stimulated - Adrenergic System ("Fight or Flight")
Alpha Receptors: Vasoconstriction (elevated BP, **narrowing pulse pressure),
glycogenolysis (elevated blood sugar), Diaphoresis (clammy/cool skin)
, Beta-one receptors (heart); Increased HR, contractility, automaticity
Beta-two receptors (lungs): Increased RR, Bronchodilation
Widened pulse pressure indicative of - ANSWER -Increased intracranial pressure
(late sign)
Cushing's Triad - ANSWER -Triad of sx associated with increased intracranial
pressure. (late signs)
1 - profound bradycardia
2 - Abnml Res pattern
3 - Widened pulse press
Testicular torsion is usually associated with scrotal pain that has a:
sudden onset associated with nausea.
gradual onset and an associated fever.
sudden onset that resolves after urination.
gradual onset that radiates into the lower abdomen. - ANSWER -Sudden Onset Ass
w/ Nausea -- A sudden onset of scrotal pain results from twisting of the spermatic
cord. This results in cessation of blood flow and, ultimately, tissue necrosis if not
diagnosed and treated rapidly
Which of the following statements regarding concussions indicates patient
discharge teaching has been effective?
"I may have memory problems over the next year."
"I should avoid solid food for the next 24 hours."
"I'll try to stay awake for the next 12 hours."
"I expect to be back to normal after 2 days." - ANSWER -"I may have memory
problems over the next year." -- Post-concussive syndrome may occur immediately
after a head injury or may not appear until several days or months after the head
trauma. Symptoms typically resolve within several weeks but have been known to
persist for extended periods of time. Signs and symptoms may include a persistent
headache, memory loss, impaired judgment, and irritability.
Results of laboratory studies for a patient with disseminated intravascular
coagulation are MOST likely to reveal
- normal fibrinogen levels.
- decreased clotting time.
- elevation of fibrin split products.
Answers Verified 100% Correct |Latest
Updates
The PRIORITY nursing intervention for a patient who has frostbite is to
admin ordered pain meds
use friction massage to rapidly warm affected extremity
maintain moistened dressing on affected area
prepare for STAT escharotomy - ANSWER -admin ordered pain meds -- Frostbite
is very painful during re-warming, so pain management is a priority.
A patient who sustained a leg laceration from a chainsaw is unsure if he has ever
received a tetanus immunization. The patient should receive - ANSWER -250 U of
tetanus immune globulin and 0.5 mL of tetanus, diphtheria toxoids, and pertussis
vaccine. --
The nurse is caring for a patient who has a high fever, central nervous system
dysfunction and tachycardia. The nurse should recognize that the patient may be
experiencing - ANSWER -Thyroid Storm -- The classic triad of thyroid storm is
high fever, central nervous system dysfunction or cerebral encephalopathy and
exaggerated tachycardia out of proportion to fever.
The treatment of choice for a patient presenting with headache in the right
temporal region and jaw pain is - ANSWER -dexamethasone (Decadron) IV --
Temporal arteritis is an inflammatory condition, so a steroid is the first-line
treatment to prevent vision loss.
A nebulized bronchodilator is administered to a 6-year-old child with severe
asthma. Treatment may be deemed effective if the patient has
RR decreased to 14 breaths/min
a prolonged expiratory phase
diminished breath sounds bilaterally
an increased peak expiratory flow rate - ANSWER -an increased peak expiratory
flow rate. -- The hallmark of asthma diagnosis is spirometry before and after
bronchodilator therapy to document reversibility of airway narrowing, usually by
peak expiratory flow rates.
, A patient who is trembling, sweating, and hyperventilating is having an anxiety
attack. Arterial blood gas analysis is likely to show which of the following?
pH < 7.35
HCO3 > 26
o2 sat < 96%
PaCO2 < 33 mm Hg - ANSWER -PaCO2 < 33 mm Hg -- With the increased
respiratory rate that occurs with anxiety, carbon dioxide is blown off, which results
in a low PaCO2
A patient has a regular, narrow complex tachycardia with a heart rate of 200
beats/min and a blood pressure of 90/60 mm Hg. An IV of D5W has been initiated
and adenosine (Adenocard), 6 mg IV, is ordered. The nurse should - ANSWER -
administer the adenosine undiluted in the port closest to the insertion site.
A patient who has a serum potassium level of 2.6 mEq/L should be MOST closely
monitored for
carpopedal spasm
edema of the extremities
increased neuromuscular irritability
weakness of the respiratory muscles - ANSWER -weakness of the respiratory
muscles -- Respiratory muscle weakness related to hypokalemia may lead to
respiratory failure or death.
The earliest indication of increased intracranial pressure is - ANSWER -altered
LOC -- Early signs and symptoms of increased intracranial pressure are changes in
the level of consciousness and restlessness. Vital sign changes are a late sign of
increased intracranial pressure.
A patient admitted in hypertensive emergency is given a nicardipine (Cardene)
drip. Treatment has been effective if the patient's mean arterial pressure decreases
by - ANSWER -20% to 25% over 1 to 2 hours -- The therapeutic intervention
should be limiting the decrease in blood pressure to 25% within the first 2 hours of
treatment. Rapid reduction of blood pressure slows the progression of end organ
damage.
A trauma patient complains of shoulder pain, but has no history or evidence of
shoulder injury. The patient should be examined for possible
pneumothorax
visceral injury
,damage to ulnar nerve
injury to the cervical spine - ANSWER -Visceral Injury -- Injury to the spleen can
manifest itself with pain that is referred to the left shoulder (Kehr's sign). A
visceral injury may be the cause of the referred pain, secondary to stimulation of
the phrenic nerve due to abdominal distention or irritation of the diaphragm.
A patient reports weakness, fatigue, nausea and vomiting. On assessment, the
nurse notes hyperpigmentation of the knuckles and elbows. The nurse should
suspect - ANSWER -Addisonian crisis --
The following patient symptoms of weakness, fatigue, nausea and vomiting cause
Addisonian crisis.
Describe Addison's crisis - ANSWER -Addison's (adrenal) crisis -- not enough
adrenal function/hormone. Decreased glucose, low sodium, elevated potassium (d/t
low Na); presents with dehydration (weakness, fatigue, hypotension).
Can occur when pt goes "cold turkey" from chronic prednisone use
Addison's crisis tx - ANSWER -Treat the sx -- hypovolemia (fluids, o2,
vasopressors)
Hyperkalemia (tele, kayexalate, IV insulin/dextrose); Hyponatremia (IV NS),
hypoglycemia (amp D50), aldosterone/cortisol (IV steroids)
Define Cushing's syndrome - labs, appearance - ANSWER -Too much adrenal
function/hormone -- high glucose, high Na, low K (d/t high Na)
Cushingoid appearance (moon face, buffalo hump, immunocompromised, poor
wound healing
caused by prednisone use
A patient complains of lower abdominal discomfort and is only able to urinate a
small amount at a time. The patient's bladder is distended. What is the FIRST
intervention that the nurse should take? - ANSWER -Insert indwelling urinary cath
-- In a patient with urinary retention, an indwelling urinary catheter should be
inserted for immediate relief.
Narrow pulse pressure indicative of - ANSWER -Hypovolemic Shock
*As vascular volume drops:
*Sympathetic Nervous System stimulated - Adrenergic System ("Fight or Flight")
Alpha Receptors: Vasoconstriction (elevated BP, **narrowing pulse pressure),
glycogenolysis (elevated blood sugar), Diaphoresis (clammy/cool skin)
, Beta-one receptors (heart); Increased HR, contractility, automaticity
Beta-two receptors (lungs): Increased RR, Bronchodilation
Widened pulse pressure indicative of - ANSWER -Increased intracranial pressure
(late sign)
Cushing's Triad - ANSWER -Triad of sx associated with increased intracranial
pressure. (late signs)
1 - profound bradycardia
2 - Abnml Res pattern
3 - Widened pulse press
Testicular torsion is usually associated with scrotal pain that has a:
sudden onset associated with nausea.
gradual onset and an associated fever.
sudden onset that resolves after urination.
gradual onset that radiates into the lower abdomen. - ANSWER -Sudden Onset Ass
w/ Nausea -- A sudden onset of scrotal pain results from twisting of the spermatic
cord. This results in cessation of blood flow and, ultimately, tissue necrosis if not
diagnosed and treated rapidly
Which of the following statements regarding concussions indicates patient
discharge teaching has been effective?
"I may have memory problems over the next year."
"I should avoid solid food for the next 24 hours."
"I'll try to stay awake for the next 12 hours."
"I expect to be back to normal after 2 days." - ANSWER -"I may have memory
problems over the next year." -- Post-concussive syndrome may occur immediately
after a head injury or may not appear until several days or months after the head
trauma. Symptoms typically resolve within several weeks but have been known to
persist for extended periods of time. Signs and symptoms may include a persistent
headache, memory loss, impaired judgment, and irritability.
Results of laboratory studies for a patient with disseminated intravascular
coagulation are MOST likely to reveal
- normal fibrinogen levels.
- decreased clotting time.
- elevation of fibrin split products.
