CEN EXAM 2 HIGH COMPREHENSIVE CERTIFIED EMERGENCY NURSE STUDY GUIDE 2026

CEN EXAM 2 HIGH-YIELD TRAUMA CARE,
CARDIAC EMERGENCIES, AND CRITICAL
DECISION-MAKING SUMMARY 2026

◉ cushing's triad.
Answer: widened pulse pressure, bradycardia, and irregular
respirations
(indicative of increased ICP)


◉ chronotropes.
Answer: affect the heart rate at the SA node (cardizem)


◉ inotropes.
Answer: affect contractility (dopamine)


◉ dromotropes.
Answer: affect automaticity of the heart


◉ ACE inhibitors adverse effects.
Answer: dry cough, angioedema, renal impairment

,◉ ARB (sartans).
Answer: block angiotensin 2 receptors, resulting in vasodilation


◉ antidote for vasopressor extravasation.
Answer: phentolamine (regitine)


◉ Prinzmetal angina.
Answer: -episodic CP unrelated to exertion
-ST elevation is variant and resolves when vasospasm resolves


◉ inferior MI ST elevation.
Answer: leads II, III AVF


◉ Lateral MI ST elevation.
Answer: I, AVL, V5, V6


◉ Anterior ST elevation.
Answer: V1-V4


◉ inferior MI vessel involvement.
Answer: RCA (feeds SA and AV nodes)

,◉ inferior MI presentation.
Answer: Epigastric pain
bradycardia and heart blocks


◉ anterior MI vessel involvement.
Answer: LAD (supplies L ventricle)


◉ anterior MI presentation.
Answer: crushing CP
"I can't breathe"
Ventricular failure and arrhythmias


◉ right ventricle-involved MI.
Answer: -get right sided ekg
-NO nitro or morphine`


◉ tx for MI.
Answer: oxygen
aspirin
nitroglycerin
PCI within 90 mins
beta-blockers for HTN

, **reperfusion dysrhythmias are a good sign with PCI


◉ aortic dissection BP.
Answer: difference of 20 mmHg or more in SBP b/t arms


◉ aortic dissection tx.
Answer: #1 priority is 2 large bore IV's


maintain HR of 60-80 (beta blocker)
maintain BP of 100-120 (nitro)


◉ post ROSC.
Answer: keep O2 sat 90%
CO2 35-45
SBP >90
TTM at 32-36 celsius


◉ medications that cause prolonged QT interval.
Answer: erythromycin, levofloxacin, cipro
haldol
tricyclic antidepressants