CEN Exam 1 Study Guide: Emergency Nursing Certification Practice Questions, Key Topics &
High-Yield Review
B: First-degree atrioventricular block is diagnosed partially by an EKG showing a PR interval of
greater than 0.20 seconds. - ANS ✔✔Which dysrhythmia would be identified on an ECG/EKG six-
second strip by a heart rate of 76 and a PR interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm
C: An elevated WBC count would be indicative of infection or inflammation. The WBC count of
5.0 is normal. The HCT and BS levels listed would also be considered within normal limits. - ANS
✔✔Which blood test may indicate infection or inflammation and would need to be used as part
of the clinical picture with diagnosing and treating abdominal pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74
A: Ureteral calculi are a quite common cause of acute emergency evaluation, usually causing
flank pain with radiation to the back and/or groin. About 75% of these are calcium oxalate or
phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or ultrasound may
show the stone, helical CT is now the preferred diagnostic method. Additional workup includes
CBC, chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical
analysis. Nursing attention should be directed to intravenous hydration with input and output
recording and narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some
patients may be discharged with analgesics and instructions for hydration and calculus capture.
Testicular torsion is most common in adolescents and usually presents with testicular and groin
pain with abdominal radiation; increasing pain by lifting the scrotum to the lev - ANS ✔✔A 30-
year-old man comes to the emergency department with the acute onset of left flank pain
, radiating to the groin. Microscopic hematuria is present on urinalysis. What is the most likely
diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis
C: Domestic violence, nearly always perpetrated against women, is a major problem confronted
by the emergency nurse. Screening for possible cases should include answers A, B and D.
Interestingly, victims of intimate partner violence often present with a medical ailment, not
trauma. These include back, abdominal, or pelvic pain, headaches, urinary infections, sexually
transmitted disease, or symptoms consistent with posttraumatic stress disorder (PTSD).
Sometimes evidence of old trauma such as healing fractures or cosmetically concealed bruises
may point toward the presence of domestic violence. Many victims will deny it but sometimes
compassionate questioning in a private setting will elicit a positive response. The nurse may
then offer advice, refer to a social agency or shelter, or ask for a consultation by the hospital
social worker. - ANS ✔✔Which of the following is NOT appropriate for screening for domestic
violence by the emergency department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so,
by whom
b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the emergency department for
a medical ailment, not trauma
d.asking if there is a partner from a previous relationship that makes the individual feel unsafe
D: Mechanical ventilation requires diligent observation of the patient and ventilator by the
emergency nurse. Modern ventilators usually come with alarms that indicate high or low airway
pressure. High pressure may be caused by endotracheal tube obstruction with sputum or kinks
or inadvertent endobronchial displacement. The airway should be suctioned and tube
placement checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse,
worsening of the underlying disease, and bronchospasm are also causes of elevated pressure.
High-Yield Review
B: First-degree atrioventricular block is diagnosed partially by an EKG showing a PR interval of
greater than 0.20 seconds. - ANS ✔✔Which dysrhythmia would be identified on an ECG/EKG six-
second strip by a heart rate of 76 and a PR interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm
C: An elevated WBC count would be indicative of infection or inflammation. The WBC count of
5.0 is normal. The HCT and BS levels listed would also be considered within normal limits. - ANS
✔✔Which blood test may indicate infection or inflammation and would need to be used as part
of the clinical picture with diagnosing and treating abdominal pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74
A: Ureteral calculi are a quite common cause of acute emergency evaluation, usually causing
flank pain with radiation to the back and/or groin. About 75% of these are calcium oxalate or
phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or ultrasound may
show the stone, helical CT is now the preferred diagnostic method. Additional workup includes
CBC, chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical
analysis. Nursing attention should be directed to intravenous hydration with input and output
recording and narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some
patients may be discharged with analgesics and instructions for hydration and calculus capture.
Testicular torsion is most common in adolescents and usually presents with testicular and groin
pain with abdominal radiation; increasing pain by lifting the scrotum to the lev - ANS ✔✔A 30-
year-old man comes to the emergency department with the acute onset of left flank pain
, radiating to the groin. Microscopic hematuria is present on urinalysis. What is the most likely
diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis
C: Domestic violence, nearly always perpetrated against women, is a major problem confronted
by the emergency nurse. Screening for possible cases should include answers A, B and D.
Interestingly, victims of intimate partner violence often present with a medical ailment, not
trauma. These include back, abdominal, or pelvic pain, headaches, urinary infections, sexually
transmitted disease, or symptoms consistent with posttraumatic stress disorder (PTSD).
Sometimes evidence of old trauma such as healing fractures or cosmetically concealed bruises
may point toward the presence of domestic violence. Many victims will deny it but sometimes
compassionate questioning in a private setting will elicit a positive response. The nurse may
then offer advice, refer to a social agency or shelter, or ask for a consultation by the hospital
social worker. - ANS ✔✔Which of the following is NOT appropriate for screening for domestic
violence by the emergency department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so,
by whom
b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the emergency department for
a medical ailment, not trauma
d.asking if there is a partner from a previous relationship that makes the individual feel unsafe
D: Mechanical ventilation requires diligent observation of the patient and ventilator by the
emergency nurse. Modern ventilators usually come with alarms that indicate high or low airway
pressure. High pressure may be caused by endotracheal tube obstruction with sputum or kinks
or inadvertent endobronchial displacement. The airway should be suctioned and tube
placement checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse,
worsening of the underlying disease, and bronchospasm are also causes of elevated pressure.
