CEN - Practice Exam
A 10-month-old infant who has a sudden onset of wheezing, cough, and stridor
should immediately be assessed for
A. presence of abdominal breathing.
B. unequal breath sounds.
C. axillary subcutaneous emphysema on palpation.
D. a history of bronchodilator use. - ------------ANS: B. unequal breath sounds.
A 14-year-old patient whose airway is obstructed is conscious and unable to speak.
The nurse should FIRST
A. encourage the patient to cough.
B. administer back blows.
C. remove the obstruction with Magill forceps.
D. administer abdominal thrusts - ------------ANS: D. administer abdominal thrusts
A 175-lb (80-kg) adult patient who sustained electrical burns is administered an IV
solution of lactated Ringer's containing sodium bicarbonate. Fluid administration is
deemed adequate if the patient's
A. urine output is 75 to 100 mL/h.
B. serum pH is 7.25.
C. cardiac monitor shows only rare premature ventricular contractions.
D. urine is pink-tinged. - ------------ANS: A. urine output is 75 to 100 mL/h.
A 3-year-old child who has acute respiratory distress is admitted to the emergency
department. The child is sitting forward and drooling, and the neck is extended.
These findings support the diagnosis of
A. epiglottitis.
,B. bronchiolitis.
C. croup.
D. aspiration of a foreign body. - ------------ANS: A. epiglottitis
A 4-year-old patient is brought to the emergency department the day after having a
tonsillectomy. The patient is diaphoretic, tachycardic, and crying, and has obvious
oral bleeding. The nurse should FIRST
A. place the patient on continuous cardiac monitoring.
B. suction bloody secretions from the mouth.
C. administer oxygen via nonrebreather mask.
D. initiate an IV of lactated Ringer's solution at 50 mL/h. - ------------ANS: B. suction
bloody secretions from the mouth.
A 6-month-old presents to the emergency department with report from the parents of
intermittent abdominal distension and bloody mucus in the stools. The nurse
suspects:
A. rotavirus.
B. gastroenteritis.
C. pyloric stenosis.
D. intussusception. - ------------ANS: D. intussusception.
A child with an extremity fracture is being prepared for admission prior to surgery.
The child has a low-grade fever and may have been exposed to chickenpox. The
nurse should
A. isolate the patient in a negative-pressure room.
B. anticipate administering diphenhydramine (Benadryl).
C. advise the receiving nurse to initiate isolation if vesicles develop.
,D. anticipate administering methylprednisolone (SoluMedrol). - ------------ANS: A.
isolate the patient in a negative-pressure room.
A man who briefly lost consciousness after a motor vehicle crash is alert and
oriented upon arrival at the emergency department. The patient states that he is fine
except for an abrasion where his head hit the door frame of the vehicle. The patient
complains of blurred vision 1 hour later. The nurse should FIRST
A. repeat the neurologic assessment.
B. obtain orthostatic vital signs.
C. assess visual acuity.
D. obtain blood glucose measurement. - ------------ANS: A. repeat the neurologic
assessment.
A man who weighs 165 lb (75 kg) arrives at the emergency department immediately
after sustaining a 40% partial-thickness burn. Using the formula 4 mL/kg multiplied
by the percent of body surface area burned, IV fluids should be administered at what
rate during the first 8 hours?
A. 1000 mL/h
B. 750 mL/h
C. 375 mL/h
D. 500 mL/h - ------------ANS: B. 750 mL/h
A nebulized bronchodilator is administered to a 6-year-old child with severe asthma.
Treatment may be deemed effective if the patient has
A. a respiratory rate that has decreased to 14 breaths/min.
B. a prolonged expiratory phase.
C. an increased peak expiratory flow rate.
D. diminished breath sounds bilaterally. - ------------ANS: C. an increased peak
expiratory flow rate.
, A nurse is assessing a patient who is tachycardic and tachypneic. The patient has
recently traveled cross country on an airplane. The nurse should be MOST
concerned that the patient may have:
A. a pleural effusion
B. a pneumothorax
C. pneumonia
D. a pulmonary embolism - ------------ANS: D. a pulmonary embolism
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
A. 20% to 25% over 4 to 6 hours.
B. 20% to 25% over 1 to 2 hours.
C. 10% to 15% over 2 to 4 hours.
D. 10% to 15% over 30 to 60 minutes. - ------------ANS: B. 20% to 25% over 1 to 2
hours.
A patient becomes increasingly agitated after receiving 2 mg lorazepam (Ativan).
The nurse should recognize that this response is
A. unexpected, since the condition is exacerbated.
B. expected, since this is a typical side effect.
C. expected, and the patient needs to be restrained.
D. unexpected, and the patient needs more lorazepam (Ativan). - ------------ANS: A.
unexpected, since the condition is exacerbated.
A patient complains of chest pain that worsens with inspiration or lying supine and
lessens by leaning forward. The nurse should suspect
A. endocarditis.
A 10-month-old infant who has a sudden onset of wheezing, cough, and stridor
should immediately be assessed for
A. presence of abdominal breathing.
B. unequal breath sounds.
C. axillary subcutaneous emphysema on palpation.
D. a history of bronchodilator use. - ------------ANS: B. unequal breath sounds.
A 14-year-old patient whose airway is obstructed is conscious and unable to speak.
The nurse should FIRST
A. encourage the patient to cough.
B. administer back blows.
C. remove the obstruction with Magill forceps.
D. administer abdominal thrusts - ------------ANS: D. administer abdominal thrusts
A 175-lb (80-kg) adult patient who sustained electrical burns is administered an IV
solution of lactated Ringer's containing sodium bicarbonate. Fluid administration is
deemed adequate if the patient's
A. urine output is 75 to 100 mL/h.
B. serum pH is 7.25.
C. cardiac monitor shows only rare premature ventricular contractions.
D. urine is pink-tinged. - ------------ANS: A. urine output is 75 to 100 mL/h.
A 3-year-old child who has acute respiratory distress is admitted to the emergency
department. The child is sitting forward and drooling, and the neck is extended.
These findings support the diagnosis of
A. epiglottitis.
,B. bronchiolitis.
C. croup.
D. aspiration of a foreign body. - ------------ANS: A. epiglottitis
A 4-year-old patient is brought to the emergency department the day after having a
tonsillectomy. The patient is diaphoretic, tachycardic, and crying, and has obvious
oral bleeding. The nurse should FIRST
A. place the patient on continuous cardiac monitoring.
B. suction bloody secretions from the mouth.
C. administer oxygen via nonrebreather mask.
D. initiate an IV of lactated Ringer's solution at 50 mL/h. - ------------ANS: B. suction
bloody secretions from the mouth.
A 6-month-old presents to the emergency department with report from the parents of
intermittent abdominal distension and bloody mucus in the stools. The nurse
suspects:
A. rotavirus.
B. gastroenteritis.
C. pyloric stenosis.
D. intussusception. - ------------ANS: D. intussusception.
A child with an extremity fracture is being prepared for admission prior to surgery.
The child has a low-grade fever and may have been exposed to chickenpox. The
nurse should
A. isolate the patient in a negative-pressure room.
B. anticipate administering diphenhydramine (Benadryl).
C. advise the receiving nurse to initiate isolation if vesicles develop.
,D. anticipate administering methylprednisolone (SoluMedrol). - ------------ANS: A.
isolate the patient in a negative-pressure room.
A man who briefly lost consciousness after a motor vehicle crash is alert and
oriented upon arrival at the emergency department. The patient states that he is fine
except for an abrasion where his head hit the door frame of the vehicle. The patient
complains of blurred vision 1 hour later. The nurse should FIRST
A. repeat the neurologic assessment.
B. obtain orthostatic vital signs.
C. assess visual acuity.
D. obtain blood glucose measurement. - ------------ANS: A. repeat the neurologic
assessment.
A man who weighs 165 lb (75 kg) arrives at the emergency department immediately
after sustaining a 40% partial-thickness burn. Using the formula 4 mL/kg multiplied
by the percent of body surface area burned, IV fluids should be administered at what
rate during the first 8 hours?
A. 1000 mL/h
B. 750 mL/h
C. 375 mL/h
D. 500 mL/h - ------------ANS: B. 750 mL/h
A nebulized bronchodilator is administered to a 6-year-old child with severe asthma.
Treatment may be deemed effective if the patient has
A. a respiratory rate that has decreased to 14 breaths/min.
B. a prolonged expiratory phase.
C. an increased peak expiratory flow rate.
D. diminished breath sounds bilaterally. - ------------ANS: C. an increased peak
expiratory flow rate.
, A nurse is assessing a patient who is tachycardic and tachypneic. The patient has
recently traveled cross country on an airplane. The nurse should be MOST
concerned that the patient may have:
A. a pleural effusion
B. a pneumothorax
C. pneumonia
D. a pulmonary embolism - ------------ANS: D. a pulmonary embolism
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
A. 20% to 25% over 4 to 6 hours.
B. 20% to 25% over 1 to 2 hours.
C. 10% to 15% over 2 to 4 hours.
D. 10% to 15% over 30 to 60 minutes. - ------------ANS: B. 20% to 25% over 1 to 2
hours.
A patient becomes increasingly agitated after receiving 2 mg lorazepam (Ativan).
The nurse should recognize that this response is
A. unexpected, since the condition is exacerbated.
B. expected, since this is a typical side effect.
C. expected, and the patient needs to be restrained.
D. unexpected, and the patient needs more lorazepam (Ativan). - ------------ANS: A.
unexpected, since the condition is exacerbated.
A patient complains of chest pain that worsens with inspiration or lying supine and
lessens by leaning forward. The nurse should suspect
A. endocarditis.
