CEN Practice Questions: Emergency Nursing Certification MCQs with Answers & Rationales
(Exam Prep Guide)
A patient complains of CP, dyspnea, and diaphoresis. Which of the following assessment factors
would indicate a possible diagnosis of acute coronary syndrome?
A. Pleuritic chest pain
B. Positional chest pain
C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in
the left shoulder
D. Pain reproducible with chest wall palpation - ✔✔C.
Rationale:
Chest pain that radiates to BOTH shoulders has a likelihood ratio of 7.1 and a pain that radiates
to the right shoulder has a stronger likelihood ration of 2.9 of predicting ACS, compared w/ pain
that radiates only to the left shoulder
Which of the following human compensatory mechanisms to the presence of shock triggers
glycogenolysis?
A. Chemoreceptor activation
B. Clotting cascade activation
C. Cerebral autoregulation stimulation
D. Adrenal gland stimulation - ✔✔D. Adrenal gland stimulation
A patient presents to the ED with abdominal pain and "ripping" back pain. Which condition
places the patient at risk for abdominal aortic dissection?
A. Down Syndrome
, B. Romano-Ward Syndrome
C. Jervell and Lange Nielsen Syndrome
D. Ehler-Danlos Syndrome - ✔✔D. Ehler-Danlos Syndrome
Rationale:
Patients with Ehler-Danos syndrome may be identified by hypermobile joints and skin that is
hyper-extensible, has a soft velvety-like appearance, is fragile and tears or bruises easily. Ehler-
Danlos syndrome is a connective tissue disorder that places patients at risk for the presence of
aortic aneurysm and dissection.
What is Romano-Ward syndrome? - ✔✔inherited cardiac disorder that causes long QT
syndrome. Patients with this syndrome may have sudden death resulting from a dysrhythmia
What is Jervell and Lange Nielsen Syndrome? - ✔✔a condition that causes profound hearing
loss from birth and also long QT syndrome. Pt's with this syndrome may have sudden death
resulting from a dysrhythmia
An end-tidal carbon dioxide level reading less than 10% after 20 minutes of high-quality CPR
indicates what? - ✔✔a low ETCO2 level indicates a lack of both end cellular perfusion and
adenosine triphosphate production, resulting in cellular death.
termination of the resuscitation efforts should be considered at this point
What EKG reading would you anticipate in a patient who has overdosed on tricyclic
antidepressants? - ✔✔Sinus tachycardia with both a widened QRS interval and a prolonged QT
interval.
QRS widening occurs as a result of sodium channel blockade which may also present on the EKG
as a right bundle branch block
(Exam Prep Guide)
A patient complains of CP, dyspnea, and diaphoresis. Which of the following assessment factors
would indicate a possible diagnosis of acute coronary syndrome?
A. Pleuritic chest pain
B. Positional chest pain
C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in
the left shoulder
D. Pain reproducible with chest wall palpation - ✔✔C.
Rationale:
Chest pain that radiates to BOTH shoulders has a likelihood ratio of 7.1 and a pain that radiates
to the right shoulder has a stronger likelihood ration of 2.9 of predicting ACS, compared w/ pain
that radiates only to the left shoulder
Which of the following human compensatory mechanisms to the presence of shock triggers
glycogenolysis?
A. Chemoreceptor activation
B. Clotting cascade activation
C. Cerebral autoregulation stimulation
D. Adrenal gland stimulation - ✔✔D. Adrenal gland stimulation
A patient presents to the ED with abdominal pain and "ripping" back pain. Which condition
places the patient at risk for abdominal aortic dissection?
A. Down Syndrome
, B. Romano-Ward Syndrome
C. Jervell and Lange Nielsen Syndrome
D. Ehler-Danlos Syndrome - ✔✔D. Ehler-Danlos Syndrome
Rationale:
Patients with Ehler-Danos syndrome may be identified by hypermobile joints and skin that is
hyper-extensible, has a soft velvety-like appearance, is fragile and tears or bruises easily. Ehler-
Danlos syndrome is a connective tissue disorder that places patients at risk for the presence of
aortic aneurysm and dissection.
What is Romano-Ward syndrome? - ✔✔inherited cardiac disorder that causes long QT
syndrome. Patients with this syndrome may have sudden death resulting from a dysrhythmia
What is Jervell and Lange Nielsen Syndrome? - ✔✔a condition that causes profound hearing
loss from birth and also long QT syndrome. Pt's with this syndrome may have sudden death
resulting from a dysrhythmia
An end-tidal carbon dioxide level reading less than 10% after 20 minutes of high-quality CPR
indicates what? - ✔✔a low ETCO2 level indicates a lack of both end cellular perfusion and
adenosine triphosphate production, resulting in cellular death.
termination of the resuscitation efforts should be considered at this point
What EKG reading would you anticipate in a patient who has overdosed on tricyclic
antidepressants? - ✔✔Sinus tachycardia with both a widened QRS interval and a prolonged QT
interval.
QRS widening occurs as a result of sodium channel blockade which may also present on the EKG
as a right bundle branch block
