CEN ACTUAL EXAM PAPER 2026
COMPLETE QUESTIONS AND SOLUTIONS
CERTIFICATION READY
◉ You are caring for a patient in cardiogenic shock. You know that a
probable cause of this condition is:
a. Dehydration
b. Spinal cord injury
c. Congestive heart failure
d. Infection
Answer: c. Congestive heart failure
Congestive heart failure is a common cause of cardiogenic shock.
Acute myocardial infarction and other heart conditions can also
cause cardiogenic shock. Dehydration can be a cause of hypovolemic
shock. Spinal cord injury can cause neurogenic shock. Infection can
cause septic shock.
◉ You are caring for a 10-year-old child with normal blood pressure,
increased heart rate, and cool pale skin. The child is reported to have
had vomitting and diarrhea the past two days. As you perform your
,primary assessment, you note that respirations are clear and not
labored. What is the probable first intervention for this child?
a. Give 20 ml/kg bolus of saline or lactated Ringer's
b. Start an Epinephrine infusion at 0.1mg/kg
c. Give Epinephrine bolus of 0.01 mg/kg
d. Give Amiodarone 5 mg/kg IV over 60 minutes
Answer: a. Give 20 ml/kg bolus of saline or lactated Ringer's
By all indications, the child is in hypovolemic shock and the first
interventions should be a fluid bolus at 20 ml/kg of saline or
lactated Ringer's solution.
◉ You assume care for the patient in the ED. During the time she has
been in the ED, she has consistently complained of photophobia, a
stiff neck, increasing confusion, and nausea. Her history shows a
motor vehicle accident several days ago. She states the pain is the
worst headache she has ever had. You suspect she might have a:
a. Subarachnoid hemorrhage
b. Migraine headache
c. Whiplash injury
d. Sinus headache
Answer: a. Subarachnoid hemorrhage
, Given the history of the recent MVA and these classic symptoms, the
prudent nurse should have a high degree of suspicion of a
subarachnoid hemorrhage. Assessment will show neurologic deficits
and decreased eye movements. The nurse should prepare the
patient for a CT scan of the brain.
◉ To quickly evaluate a child's neurological status, all of the
following standard evaluations can be used EXCEPT:
a. The Epworth Scale.
b. The AVPU scale.
c. The Glasgow Coma Scale.
d. Pupillary responses to light.
Answer: a. The Epworth Scale.
The Epworth Scale is a measure of sleepiness and is not part of the
standard evaluation of a child's neurological exam. The AVPU and
Glasgow Coma scales can be used to evaluate a child's neuro status.
Pupillary size and response should also be checked.
◉ According to the American Heart Association stroke
recommendations, the critical goal time from arrival to the
Emergency Department to CT brain scan is:
COMPLETE QUESTIONS AND SOLUTIONS
CERTIFICATION READY
◉ You are caring for a patient in cardiogenic shock. You know that a
probable cause of this condition is:
a. Dehydration
b. Spinal cord injury
c. Congestive heart failure
d. Infection
Answer: c. Congestive heart failure
Congestive heart failure is a common cause of cardiogenic shock.
Acute myocardial infarction and other heart conditions can also
cause cardiogenic shock. Dehydration can be a cause of hypovolemic
shock. Spinal cord injury can cause neurogenic shock. Infection can
cause septic shock.
◉ You are caring for a 10-year-old child with normal blood pressure,
increased heart rate, and cool pale skin. The child is reported to have
had vomitting and diarrhea the past two days. As you perform your
,primary assessment, you note that respirations are clear and not
labored. What is the probable first intervention for this child?
a. Give 20 ml/kg bolus of saline or lactated Ringer's
b. Start an Epinephrine infusion at 0.1mg/kg
c. Give Epinephrine bolus of 0.01 mg/kg
d. Give Amiodarone 5 mg/kg IV over 60 minutes
Answer: a. Give 20 ml/kg bolus of saline or lactated Ringer's
By all indications, the child is in hypovolemic shock and the first
interventions should be a fluid bolus at 20 ml/kg of saline or
lactated Ringer's solution.
◉ You assume care for the patient in the ED. During the time she has
been in the ED, she has consistently complained of photophobia, a
stiff neck, increasing confusion, and nausea. Her history shows a
motor vehicle accident several days ago. She states the pain is the
worst headache she has ever had. You suspect she might have a:
a. Subarachnoid hemorrhage
b. Migraine headache
c. Whiplash injury
d. Sinus headache
Answer: a. Subarachnoid hemorrhage
, Given the history of the recent MVA and these classic symptoms, the
prudent nurse should have a high degree of suspicion of a
subarachnoid hemorrhage. Assessment will show neurologic deficits
and decreased eye movements. The nurse should prepare the
patient for a CT scan of the brain.
◉ To quickly evaluate a child's neurological status, all of the
following standard evaluations can be used EXCEPT:
a. The Epworth Scale.
b. The AVPU scale.
c. The Glasgow Coma Scale.
d. Pupillary responses to light.
Answer: a. The Epworth Scale.
The Epworth Scale is a measure of sleepiness and is not part of the
standard evaluation of a child's neurological exam. The AVPU and
Glasgow Coma scales can be used to evaluate a child's neuro status.
Pupillary size and response should also be checked.
◉ According to the American Heart Association stroke
recommendations, the critical goal time from arrival to the
Emergency Department to CT brain scan is:
