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CEN EXAM FINAL QUESTIONS WITH CORRECT ANSWERS 2026/2027 COMBINED VERSION OF CEN EXAM WITH VERIFIED SOLUTIONS | LATEST UPDATE 2026/2027 | GRADED A+.

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CEN EXAM FINAL QUESTIONS WITH CORRECT ANSWERS 2026/2027 COMBINED VERSION OF CEN EXAM WITH VERIFIED SOLUTIONS | LATEST UPDATE 2026/2027 | GRADED A+. 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 -- ANSWER--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. A 7-year-old child is brought to the emergency department after multiple bee stings about 30 minutes previously. He complains of itching, swollen lips, and difficulty breathing. Wheezing and stridor are heard. What is the most immediate treatment required? a. epinephrine 0.1 mg intramuscularly b. intravenous corticosteroid c. intravenous antihistamine d. broad-spectrum antibiotic -- ANSWER--Answer: A The clinical picture of this patient is that of an anaphylactic reaction to bee stings which is potentially life-threatening. The onset of symptoms within 1 hour after exposure to the allergen is particularly worrisome as are the laryngeal and pulmonary signs. The airway must be established with intubation often necessary; high-flow oxygen, cardiac monitoring, and intravenous fluids are basics. Epinephrine given intramuscularly is the most rapidly acting agent and should be given as soon as possible after the diagnosis of anaphylaxis and every 5 Page 2 to 15 minutes thereafter as needed. Steroids and antihistamines are slower acting than epinephrine but are often given to alleviate itching, angioedema, and hives. There is no indication for antibiotics in this clinical situation unless further signs and symptoms develop. Which statement best describes acute respiratory distress syndrome (ARDS)? a.ARDS is caused by trauma only. b.ARDS is sudden, progressive, and severe. c.ARDS is caused by an illness only. d.ARDS never results in lung scarring. -- ANSWER--Answer: B ARDS is sudden, progressive, and severe, and can even lead to death. 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? ral calcium oxalate calculus ral cystine calculus cular torsion tis -- ANSWER--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 Page 3 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 level of the pubic symphysis causes exacerbation of the pain (Prehn sign). Cystitis may be infectious or drug-induced, but cystitis usually causes dysuria and pyuria and shows positive urine cultures. A cancer patient is seen in the emergency department with high fevers and malaise for 2 days. She received chemotherapy about 10 days ago. Her physical exam is not revealing but her temperature is 103°F. A CBC shows a hemoglobin of 10 g/dL, WBC 4000 with 10% polys, 5% bands, 70% lymphs, 10% monos, and 5% other white or unidentified cells. Platelets are 60,000/mm3. Which of the following is NOT immediately appropriate? cultures from different sites rolytes, liver and renal function tests if she has been receiving granulocyte colony-stimulating factor (G-CSF) blood cell transfusion -- ANSWER--Answer: D This patient has fever and neutropenia after chemotherapy. Neutropenia is defined as an absolute neutrophil count (ANC) under 1000/mm3, and a severe neutropenia less than 500/mm3 is particularly dangerous. These patients must be worked up quickly and antibiotic and possibly additional therapy started as soon as possible since the situation may be lifethreatening. While myelosuppressive drugs differ in the length of time between administration and the nadir of the ANC, 10 to 14 days is typical. Multiple cultures from different possible sites of origin for sepsis must be done along with chest x-ray and other Page 4 imaging as indicated by examination. Broad-spectrum antibiotics, such as ceftazidime or imipenem/cilastatin, should be started after cultures are obtained. She should be asked if she has been receiving G-CSF (Neupogen, Neulasta). WBC transfusions are rarely used today since they have a very short shelf life, do not last long in the circulation, and may cause allergic reactions. After an auto accident, x-rays of the patient's leg show a transverse fracture of the midfemur with several bone fragments surrounding the fracture site. The skin of the leg is intact. This type fracture is called: ession fracture nuted fracture ion fracture fracture -- ANSWER--Answer: B A fracture is a break or disruption in a bone, generally divided into closed (no break in the skin) and open (protrusion of the bone through the skin). Fractures may take different anatomic patterns, depending on the bone location, the nature of the trauma and the bone density (may be diminished with osteoporosis). Compression fractures are most common in the spine in which a fracture of one or more vertebral bodies leads to a collapse of the spine at that location. An avulsion fracture reflects a forceful contraction of muscle mass, which pulls a bone fragment to break away at the tendon's insertion site. This type of fracture is often seen with severe joint strains. This patient has a comminuted fracture in which the trauma causes more than two separated portions of the bone. Often, several small bony fragments are seen at the site of the break. Page 5 A 2-year-old is brought to the emergency department with mild fever, persistent restlessness, crying, and pulling his left ear. He has had a cold for about a week. Examination of the ear reveals a distorted light reflex and slight bulging of the tympanic membrane. What is the proper diagnosis and treatment? s externa and antibiotics s media and antibiotics s media and myringotomy labyrinthitis and antivertigo drug -- ANSWER--B: Ear infections may cause severe and persistent pain, especially in children in the 6-month to 3-year age group and are a frequent cause of emergency department visits. Loss or distortion of the light reflex and bulging of the tympanic membrane are cardinal signs of otitis media, usually caused by bacteria such as Streptococcus Influenza or Haemophilus Influenza. Sinusitis and purulent rhinitis may accompany the otitis. Antibiotics to cover these organisms, topical warmed otic analgesics, and antipyretics are the usual treatment modalities. Otitis externa or swimmer's ear also causes otalgia and frequently follows swimming in contaminated water or a foreign body in the ear. Keeping the ear dry and using otic analgesics and antibiotics are indicated. Ear plugs while swimming or ear drying agents after swimming or showering are the usual preventive measures. Myringotomy is a surgical procedure to keep the middle ear draining in chronic otitis media and hopefully prevent such complications as mastoiditis, meningitis, ruptured tympanic membrane, or permanent hearing loss. Labyrinthitis is an infection of the inner ear and usually causes severe vertigo, most commonly in adults. Page 6 Thank you for Purchasing this exam Study Guide. We provide high-quality academic materials to help students excel in exams. Our other Services include but not limited to: academic research, University & College assignments writing, essay writing, Online Classes, and research projects. Our services are reliable, affordable, and plagiarism-free. All the Best in your Exam. For more information; Contact us at: or 0R +254

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Page 1




CEN EXAM FINAL QUESTIONS WITH CORRECT
ANSWERS 2026/2027 COMBINED VERSION OF CEN EXAM
WITH VERIFIED SOLUTIONS | LATEST UPDATE 2026/2027 |
GRADED A+.


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 -- ANSWER--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.



A 7-year-old child is brought to the emergency department after multiple bee stings about 30
minutes previously. He complains of itching, swollen lips, and difficulty breathing. Wheezing
and stridor are heard. What is the most immediate treatment required?

a. epinephrine 0.1 mg intramuscularly

b. intravenous corticosteroid

c. intravenous antihistamine

d. broad-spectrum antibiotic -- ANSWER--Answer: A

The clinical picture of this patient is that of an anaphylactic reaction to bee stings which is
potentially life-threatening. The onset of symptoms within 1 hour after exposure to the
allergen is particularly worrisome as are the laryngeal and pulmonary signs. The airway must
be established with intubation often necessary; high-flow oxygen, cardiac monitoring, and
intravenous fluids are basics. Epinephrine given intramuscularly is the most rapidly acting
agent and should be given as soon as possible after the diagnosis of anaphylaxis and every 5

, Page 2




to 15 minutes thereafter as needed. Steroids and antihistamines are slower acting than
epinephrine but are often given to alleviate itching, angioedema, and hives. There is no
indication for antibiotics in this clinical situation unless further signs and symptoms develop.



Which statement best describes acute respiratory distress syndrome (ARDS)?

a.ARDS is caused by trauma only.

b.ARDS is sudden, progressive, and severe.

c.ARDS is caused by an illness only.

d.ARDS never results in lung scarring. -- ANSWER--Answer: B

ARDS is sudden, progressive, and severe, and can even lead to death.




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 -- ANSWER--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

, Page 3




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 level of the pubic symphysis causes exacerbation
of the pain (Prehn sign). Cystitis may be infectious or drug-induced, but cystitis usually
causes dysuria and pyuria and shows positive urine cultures.




A cancer patient is seen in the emergency department with high fevers and malaise for 2 days.
She received chemotherapy about 10 days ago. Her physical exam is not revealing but her
temperature is 103°F. A CBC shows a hemoglobin of 10 g/dL, WBC 4000 with 10% polys,
5% bands, 70% lymphs, 10% monos, and 5% other white or unidentified cells. Platelets are
60,000/mm3. Which of the following is NOT immediately appropriate?

a.blood cultures from different sites

b.electrolytes, liver and renal function tests

c.eask if she has been receiving granulocyte colony-stimulating factor (G-CSF)

d.white blood cell transfusion -- ANSWER--Answer: D

This patient has fever and neutropenia after chemotherapy. Neutropenia is defined as an
absolute neutrophil count (ANC) under 1000/mm3, and a severe neutropenia less than
500/mm3 is particularly dangerous. These patients must be worked up quickly and antibiotic
and possibly additional therapy started as soon as possible since the situation may be
lifethreatening. While myelosuppressive drugs differ in the length of time between
administration and the nadir of the ANC, 10 to 14 days is typical. Multiple cultures from
different possible sites of origin for sepsis must be done along with chest x-ray and other

, Page 4




imaging as indicated by examination. Broad-spectrum antibiotics, such as ceftazidime or
imipenem/cilastatin, should be started after cultures are obtained. She should be asked if she
has been receiving G-CSF (Neupogen, Neulasta). WBC transfusions are rarely used today
since they have a very short shelf life, do not last long in the circulation, and may cause
allergic reactions.




After an auto accident, x-rays of the patient's leg show a transverse fracture of the midfemur
with several bone fragments surrounding the fracture site. The skin of the leg is intact. This
type fracture is called:

a.compression fracture

b.comminuted fracture

c.avulsion fracture

d.open fracture -- ANSWER--Answer: B

A fracture is a break or disruption in a bone, generally divided into closed (no break in the
skin) and open (protrusion of the bone through the skin). Fractures may take different
anatomic patterns, depending on the bone location, the nature of the trauma and the bone
density (may be diminished with osteoporosis). Compression fractures are most common in
the spine in which a fracture of one or more vertebral bodies leads to a collapse of the spine
at that location. An avulsion fracture reflects a forceful contraction of muscle mass, which
pulls a bone fragment to break away at the tendon's insertion site. This type of fracture is
often seen with severe joint strains. This patient has a comminuted fracture in which the
trauma causes more than two separated portions of the bone. Often, several small bony
fragments are seen at the site of the break.

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