Certified Emergency Nurse (CEN)
Examination 2026–2027 | Comprehensive
Question Practice Test with Answers &
Rationales| Free Pdf Access
1. A client arrives in the emergency department with chest pain, diaphoresis,
and shortness of breath. What is the nurse's priority action?
A. Obtain a 12-lead ECG
B. Provide discharge instructions
C. Collect a urine specimen
D. Administer oral fluids
Correct Answer: A
Rationale: A 12-lead ECG should be obtained within 10 minutes for suspected acute
coronary syndrome to identify life-threatening cardiac ischemia.
2. A trauma client presents with absent breath sounds on the left side, tracheal
deviation, and severe respiratory distress. Which condition should the nurse
suspect?
A. Pulmonary embolism
B. Tension pneumothorax
,C. Cardiac tamponade
D. Asthma exacerbation
Correct Answer: B
Rationale: Tension pneumothorax causes tracheal deviation, absent breath sounds, and
severe respiratory compromise requiring immediate intervention.
3. Which client should be assessed first?
A. Client with oxygen saturation of 82%
B. Client with ankle pain
C. Client requesting food
D. Client awaiting discharge
Correct Answer: A
Rationale: Airway and breathing concerns take priority according to emergency nursing
triage principles.
4. A client with diabetic ketoacidosis (DKA) is expected to exhibit which
finding?
A. Kussmaul respirations
B. Bradycardia
C. Hypothermia
D. Hypertension
Correct Answer: A
Rationale: Kussmaul respirations are deep, rapid respirations that compensate for
metabolic acidosis.
,5. Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale: Naloxone rapidly reverses respiratory depression caused by opioid overdose.
6. A burn client has circumferential burns to the chest. Which complication is
the greatest concern?
A. Restricted ventilation
B. Hyperglycemia
C. Hypertension
D. Bradycardia
Correct Answer: A
Rationale: Circumferential chest burns can impair chest expansion and ventilation.
7. A client with suspected stroke arrives within 1 hour of symptom onset.
Which action has the highest priority?
A. Determine exact symptom onset time
B. Obtain dietary history
C. Schedule rehabilitation
D. Assess bowel function
, Correct Answer: A
Rationale: Eligibility for thrombolytic therapy depends on the time symptoms began.
8. Which ECG finding is most commonly associated with hyperkalemia?
A. Peaked T waves
B. U waves
C. ST depression
D. Prolonged QT interval
Correct Answer: A
Rationale: Peaked T waves are an early and classic sign of hyperkalemia.
9. A client with a traumatic brain injury suddenly develops unequal pupils.
What should the nurse suspect?
A. Increased intracranial pressure
B. Hypoglycemia
C. Renal failure
D. Pneumonia
Correct Answer: A
Rationale: Unequal pupils may indicate brain herniation due to increased intracranial
pressure.
10. Which intervention is appropriate for an actively seizing client?
A. Protect the client from injury
B. Insert an oral airway
Examination 2026–2027 | Comprehensive
Question Practice Test with Answers &
Rationales| Free Pdf Access
1. A client arrives in the emergency department with chest pain, diaphoresis,
and shortness of breath. What is the nurse's priority action?
A. Obtain a 12-lead ECG
B. Provide discharge instructions
C. Collect a urine specimen
D. Administer oral fluids
Correct Answer: A
Rationale: A 12-lead ECG should be obtained within 10 minutes for suspected acute
coronary syndrome to identify life-threatening cardiac ischemia.
2. A trauma client presents with absent breath sounds on the left side, tracheal
deviation, and severe respiratory distress. Which condition should the nurse
suspect?
A. Pulmonary embolism
B. Tension pneumothorax
,C. Cardiac tamponade
D. Asthma exacerbation
Correct Answer: B
Rationale: Tension pneumothorax causes tracheal deviation, absent breath sounds, and
severe respiratory compromise requiring immediate intervention.
3. Which client should be assessed first?
A. Client with oxygen saturation of 82%
B. Client with ankle pain
C. Client requesting food
D. Client awaiting discharge
Correct Answer: A
Rationale: Airway and breathing concerns take priority according to emergency nursing
triage principles.
4. A client with diabetic ketoacidosis (DKA) is expected to exhibit which
finding?
A. Kussmaul respirations
B. Bradycardia
C. Hypothermia
D. Hypertension
Correct Answer: A
Rationale: Kussmaul respirations are deep, rapid respirations that compensate for
metabolic acidosis.
,5. Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale: Naloxone rapidly reverses respiratory depression caused by opioid overdose.
6. A burn client has circumferential burns to the chest. Which complication is
the greatest concern?
A. Restricted ventilation
B. Hyperglycemia
C. Hypertension
D. Bradycardia
Correct Answer: A
Rationale: Circumferential chest burns can impair chest expansion and ventilation.
7. A client with suspected stroke arrives within 1 hour of symptom onset.
Which action has the highest priority?
A. Determine exact symptom onset time
B. Obtain dietary history
C. Schedule rehabilitation
D. Assess bowel function
, Correct Answer: A
Rationale: Eligibility for thrombolytic therapy depends on the time symptoms began.
8. Which ECG finding is most commonly associated with hyperkalemia?
A. Peaked T waves
B. U waves
C. ST depression
D. Prolonged QT interval
Correct Answer: A
Rationale: Peaked T waves are an early and classic sign of hyperkalemia.
9. A client with a traumatic brain injury suddenly develops unequal pupils.
What should the nurse suspect?
A. Increased intracranial pressure
B. Hypoglycemia
C. Renal failure
D. Pneumonia
Correct Answer: A
Rationale: Unequal pupils may indicate brain herniation due to increased intracranial
pressure.
10. Which intervention is appropriate for an actively seizing client?
A. Protect the client from injury
B. Insert an oral airway
