CEN Certified Emergency Nurse
Practice Exam Questions with Answers
and Rationales EXAM REVIEWS 2025-
2026 QUESTIONS AND CORRECT
VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
1. A trauma patient arrives after a motor vehicle collision with a
blood pressure of 82/48 mmHg, heart rate of 132 beats/min, cool
clammy skin, and altered mental status. What is the priority
nursing intervention?
A. Obtain a complete medical history
B. Insert a urinary catheter
C. Initiate rapid assessment of airway, breathing, circulation, and
begin fluid resuscitation
D. Administer pain medication
Answer: C
Rationale: According to trauma principles, airway, breathing, and
circulation (ABCs) take priority. Signs indicate hypovolemic shock
requiring immediate assessment and aggressive resuscitation.
2. Which ECG finding is most consistent with hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. Delta waves
,D. U waves
Answer: B
Rationale: Hyperkalemia typically produces tall, peaked T waves
followed by PR prolongation, QRS widening, and eventually sine-
wave patterns if untreated.
3. A patient presents with sudden onset unilateral facial droop and
right arm weakness. What is the priority nursing action?
A. Administer aspirin immediately
B. Activate the stroke protocol
C. Schedule an MRI within 24 hours
D. Administer alteplase immediately
Answer: B
Rationale: Rapid activation of the stroke team allows immediate
imaging and determination of eligibility for thrombolytic or
endovascular therapy.
4. Which patient should be seen first according to the Emergency
Severity Index (ESI)?
A. Sprained ankle with pain score 7/10
B. Fever and sore throat
C. Chest pain with diaphoresis and hypotension
D. Finger laceration requiring sutures
Answer: C
, Rationale: Chest pain accompanied by hypotension suggests
cardiogenic shock or acute myocardial infarction requiring immediate
intervention.
5. A patient with diabetic ketoacidosis (DKA) has a serum
potassium of 5.8 mEq/L. Which intervention is appropriate initially?
A. Administer potassium chloride
B. Begin IV fluids and insulin as prescribed while monitoring
potassium
C. Restrict fluids
D. Give sodium bicarbonate routinely
Answer: B
Rationale: Although serum potassium may initially be elevated, total
body potassium is depleted. Fluids and insulin are priorities while
closely monitoring potassium levels.
6. Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone competitively reverses opioid effects and rapidly
improves respiratory depression.
7. Which assessment finding indicates tension pneumothorax?
Practice Exam Questions with Answers
and Rationales EXAM REVIEWS 2025-
2026 QUESTIONS AND CORRECT
VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
1. A trauma patient arrives after a motor vehicle collision with a
blood pressure of 82/48 mmHg, heart rate of 132 beats/min, cool
clammy skin, and altered mental status. What is the priority
nursing intervention?
A. Obtain a complete medical history
B. Insert a urinary catheter
C. Initiate rapid assessment of airway, breathing, circulation, and
begin fluid resuscitation
D. Administer pain medication
Answer: C
Rationale: According to trauma principles, airway, breathing, and
circulation (ABCs) take priority. Signs indicate hypovolemic shock
requiring immediate assessment and aggressive resuscitation.
2. Which ECG finding is most consistent with hyperkalemia?
A. Prolonged QT interval
B. Tall, peaked T waves
C. Delta waves
,D. U waves
Answer: B
Rationale: Hyperkalemia typically produces tall, peaked T waves
followed by PR prolongation, QRS widening, and eventually sine-
wave patterns if untreated.
3. A patient presents with sudden onset unilateral facial droop and
right arm weakness. What is the priority nursing action?
A. Administer aspirin immediately
B. Activate the stroke protocol
C. Schedule an MRI within 24 hours
D. Administer alteplase immediately
Answer: B
Rationale: Rapid activation of the stroke team allows immediate
imaging and determination of eligibility for thrombolytic or
endovascular therapy.
4. Which patient should be seen first according to the Emergency
Severity Index (ESI)?
A. Sprained ankle with pain score 7/10
B. Fever and sore throat
C. Chest pain with diaphoresis and hypotension
D. Finger laceration requiring sutures
Answer: C
, Rationale: Chest pain accompanied by hypotension suggests
cardiogenic shock or acute myocardial infarction requiring immediate
intervention.
5. A patient with diabetic ketoacidosis (DKA) has a serum
potassium of 5.8 mEq/L. Which intervention is appropriate initially?
A. Administer potassium chloride
B. Begin IV fluids and insulin as prescribed while monitoring
potassium
C. Restrict fluids
D. Give sodium bicarbonate routinely
Answer: B
Rationale: Although serum potassium may initially be elevated, total
body potassium is depleted. Fluids and insulin are priorities while
closely monitoring potassium levels.
6. Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone competitively reverses opioid effects and rapidly
improves respiratory depression.
7. Which assessment finding indicates tension pneumothorax?
