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
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
