CEN EXAM VERSION 1
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: The nurse is caring for a patient with an obvious femur
fracture and bleeding from the urethra. The nurse should question
which of the following orders?
A. viscoelastrometric testing
B. traction splint
C. ankle-brachial index
D. elevation of extremity
Answer:
B
Question 2: The nurse should be suspicious of a possible pelvic
injury with urethral bleeding. Traction is contraindicated in the
presence of a pelvic injury. The other interventions are appropriate
for this patient's injuries. The emergency nurse is treating a patient
who was rescued from a burning building. The patient is restless,
intermittently confused, and nauseated. The nurse understands the
MOST likely cause of this presentation is?
A. decreased carbon dioxide.
B. increased carboxyhemoglobin.
C. increased carbon dioxide
D. decreased carboxyhemoglobin.
Answer:
B
,Question 3: Carbon monoxide poisoning is the most immediate
threat to life in survivors of inhalation injury. Because carbon
monoxide binds readily to hemoglobin, the most likely cause of the
patient's symptoms is increased carboxyhemoglobin. The other
options do not account for the patient's presentation. A patient with
a history of hepatocellular carcinoma presents with jaundice,
confusion and is combative. The nurse suspects?
A. an elevated ammonia level.
B. an elevated glucose level.
C. elevated liver function levels.
D. an elevated bilirubin level.
Answer:
A
Question 4: Ammonia is a byproduct of protein metabolism, which
is converted to urea by the liver and excreted by the kidneys. At
high levels, ammonia crosses the blood-brain barrier and can lead
to cerebral edema. Clinical features of hyperammonemia include
sleep-wake cycle disturbances, irritability and confusion. As
ammonia rises, it can lead to seizures, coma and eventually death.
Elevated bilirubin, liver enzymes and hyperglycemia are significant
findings but do not typically cause acute confusion. A patient with
a history of heart failure presents with shortness of breath and is
unable to speak in complete sentences. A chest x-ray shows a
large collection of fluid in the pleural space. The PRIORITY
intervention is?
A. administration of antibiotics.
B. a paracentesis.
C. a thoracentesis.
D. insertion of urinary catheter.
Answer:
, C
Question 5: The patient has a pleural effusion. Because the pleural
effusion is large, and the patient is in respiratory distress, a
thoracentesis is indicated to remove the fluid and improve the
patient's respiratory status. Paracentesis is a procedure to remove
fluid from the peritoneal cavity, not from the pleural space. The
patient may require antibiotics if there are signs of infection, but
this is not the priority intervention based on the x-ray findings. Due
to the risk of infection, a urinary catheter should only be inserted if
indicated. An adult patient sustains blunt trauma to the abdomen in
a motor vehicle crash. The patient refuses to allow any invasive
treatments. Initial assessment reveals an ecchymotic area in the
left upper quadrant. The nurse should?
A. obtain consent from a relative for treatment.
B. assess the patient's neurological status
C. allow the patient to leave after signing a medical release form.
D. request an order to sedate the patient.
Answer:
B
Question 6: A rational, competent adult can refuse any treatment.
The first step is to establish the patient's ability to understand the
consequences of refusing treatment. Due to the mechanism of
injury, the patient should be evaluated for the presence of a head
injury. The nurse is caring for a patient who has sustained a femur
fracture. The patient suddenly has alterations in their mental status
and a petechial rash is noted to the chest and axilla. The nurse
immediately?
A. administers oxygen
, B. prepares for chest tube insertion
C. releases the traction splint
D. prepares an intra-compartmental pressure monitor
Answer:
A
Question 7: Petechial rash on the chest and axilla are associated
with fatty embolism, which the patient would be at a higher risk for
after sustaining a long bone fracture. The hallmark sign of fatty
embolism is hypoxemia and altered mental status. Initial treatment
is focused on symptom management and correcting hypoxia and
hypotension. There is no indication to release traction or prepare
for chest tube insertion at this time. An intra-compartmental
pressure monitor is indicated for the detection of compartment
syndrome, of which there are no symptoms indicated with the
information provided. A patient with pancreatic cancer presents to
the emergency department in acute distress with sudden shortness
of breath, palpitations, anxiety and chest pain exacerbated with
deep breaths. The patient has a history of recurrent bilateral deep
vein thrombosis. The patient's vital signs are: BP 101/57 mm HgHR
117 beats/minRR 24 breaths/minT (oral) : 98.8■ F (37.1■ C)O2 sat
92% on room air The nurse suspects?
A. a myocardial infarction.
B. pericardial tamponade.
C. a pulmonary embolism.
D. a spontaneous pneumothorax.
Answer:
C
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: The nurse is caring for a patient with an obvious femur
fracture and bleeding from the urethra. The nurse should question
which of the following orders?
A. viscoelastrometric testing
B. traction splint
C. ankle-brachial index
D. elevation of extremity
Answer:
B
Question 2: The nurse should be suspicious of a possible pelvic
injury with urethral bleeding. Traction is contraindicated in the
presence of a pelvic injury. The other interventions are appropriate
for this patient's injuries. The emergency nurse is treating a patient
who was rescued from a burning building. The patient is restless,
intermittently confused, and nauseated. The nurse understands the
MOST likely cause of this presentation is?
A. decreased carbon dioxide.
B. increased carboxyhemoglobin.
C. increased carbon dioxide
D. decreased carboxyhemoglobin.
Answer:
B
,Question 3: Carbon monoxide poisoning is the most immediate
threat to life in survivors of inhalation injury. Because carbon
monoxide binds readily to hemoglobin, the most likely cause of the
patient's symptoms is increased carboxyhemoglobin. The other
options do not account for the patient's presentation. A patient with
a history of hepatocellular carcinoma presents with jaundice,
confusion and is combative. The nurse suspects?
A. an elevated ammonia level.
B. an elevated glucose level.
C. elevated liver function levels.
D. an elevated bilirubin level.
Answer:
A
Question 4: Ammonia is a byproduct of protein metabolism, which
is converted to urea by the liver and excreted by the kidneys. At
high levels, ammonia crosses the blood-brain barrier and can lead
to cerebral edema. Clinical features of hyperammonemia include
sleep-wake cycle disturbances, irritability and confusion. As
ammonia rises, it can lead to seizures, coma and eventually death.
Elevated bilirubin, liver enzymes and hyperglycemia are significant
findings but do not typically cause acute confusion. A patient with
a history of heart failure presents with shortness of breath and is
unable to speak in complete sentences. A chest x-ray shows a
large collection of fluid in the pleural space. The PRIORITY
intervention is?
A. administration of antibiotics.
B. a paracentesis.
C. a thoracentesis.
D. insertion of urinary catheter.
Answer:
, C
Question 5: The patient has a pleural effusion. Because the pleural
effusion is large, and the patient is in respiratory distress, a
thoracentesis is indicated to remove the fluid and improve the
patient's respiratory status. Paracentesis is a procedure to remove
fluid from the peritoneal cavity, not from the pleural space. The
patient may require antibiotics if there are signs of infection, but
this is not the priority intervention based on the x-ray findings. Due
to the risk of infection, a urinary catheter should only be inserted if
indicated. An adult patient sustains blunt trauma to the abdomen in
a motor vehicle crash. The patient refuses to allow any invasive
treatments. Initial assessment reveals an ecchymotic area in the
left upper quadrant. The nurse should?
A. obtain consent from a relative for treatment.
B. assess the patient's neurological status
C. allow the patient to leave after signing a medical release form.
D. request an order to sedate the patient.
Answer:
B
Question 6: A rational, competent adult can refuse any treatment.
The first step is to establish the patient's ability to understand the
consequences of refusing treatment. Due to the mechanism of
injury, the patient should be evaluated for the presence of a head
injury. The nurse is caring for a patient who has sustained a femur
fracture. The patient suddenly has alterations in their mental status
and a petechial rash is noted to the chest and axilla. The nurse
immediately?
A. administers oxygen
, B. prepares for chest tube insertion
C. releases the traction splint
D. prepares an intra-compartmental pressure monitor
Answer:
A
Question 7: Petechial rash on the chest and axilla are associated
with fatty embolism, which the patient would be at a higher risk for
after sustaining a long bone fracture. The hallmark sign of fatty
embolism is hypoxemia and altered mental status. Initial treatment
is focused on symptom management and correcting hypoxia and
hypotension. There is no indication to release traction or prepare
for chest tube insertion at this time. An intra-compartmental
pressure monitor is indicated for the detection of compartment
syndrome, of which there are no symptoms indicated with the
information provided. A patient with pancreatic cancer presents to
the emergency department in acute distress with sudden shortness
of breath, palpitations, anxiety and chest pain exacerbated with
deep breaths. The patient has a history of recurrent bilateral deep
vein thrombosis. The patient's vital signs are: BP 101/57 mm HgHR
117 beats/minRR 24 breaths/minT (oral) : 98.8■ F (37.1■ C)O2 sat
92% on room air The nurse suspects?
A. a myocardial infarction.
B. pericardial tamponade.
C. a pulmonary embolism.
D. a spontaneous pneumothorax.
Answer:
C
