CEN Exam test questions with
correct answers
79. A patient presents with vaginal bleeding and cramping. She tells the emergency nurse, "I passed clots at home. I think I lost my baby." Pelvic
examination reveals that the cervical os is open. Which type of spontaneous abortion most likely occurred?
Missed abortion
Septic abortion
Inevitable abortion
Threatened abortion - CORRECT ANSWER-Inevitable abortion
A 12-year-old male is brought to the emergency department by his mother with complaints of difficulty breathing, swollen eyes and lips, and hives.
The mother states that the child had just finished eating a peanut butter cookie. Epinephrine was administered. What is the next class of
medications to be administered to the patient?
Inhaled beta 2 agonist
Corticosteroid
Antihistamine
Anticholinergic - CORRECT ANSWER-Inhaled beta 2 agonist
A 13-year-old presents to the emergency department. His parents state that he passed out at home and had been vomiting and had diarrhea for
the last few days. He answers questions appropriately, although he complains of dizziness. His vital signs on arrival: BP 70/40 mm Hg, HR 132
beats/min, RR 24 breaths/min, T 36.9 C (98.4 F), and SpO2 97% without supplemental oxygen. A new graduate nurse inserted an intravenous
line and is about to begin a fluid bolus of D5W. What does the preceptor explain to the new graduate nurse regarding fluid resuscitation?
Because of the electrolyte disturbances from vomiting and diarrhea, use D5.45% sodium chloride.
Because the patient is likely in septic shock, the fluid resuscitation is done slowly.
The appropriate fluid for hypotension is isotonic crystalloid, not D5W
As a pediatric patient, D5W fluid is given at a bolus rate of 20 mL/kg. - CORRECT ANSWER-The appropriate fluid for hypotension is isotonic
crystalloid, not D5W
A 15-year-old female presents to the emergency department with crampy left lower quadrant abdominal pain that lasted for 4 hours prior to
arrival. She also is having frequent, severe, bloody diarrhea. What gastrointestinal disorder is she most likely experiencing?
Ulcerative colitis
Diverticulitis
Crohn's disease
Appendicitis - CORRECT ANSWER-Ulcerative colitis
A 16-year-old male is brought to the ED by his coach. The patient was playing football in moderately cold weather one hour prior to arrival and felt
severe pain in the left groin area. This is suggestive of which genitourinary emergency?
Paraphimosis
Testicular torsion
Priapism
Acute epididymitis - CORRECT ANSWER-Testicular torsion
A 16-year-old presents with severe left upper quadrant abdominal pain after an over-the-handlebars bicycle collision. Vital signs are BP 100/60
mm Hg, HR 100 beats/min, RR 30 breaths/min, T 37.0 C (98.6 F), SpO2 89% without supplemental oxygen. There is bruising over the left upper
quadrant of the abdomen. Auscultation reveals diminished breath sounds on the left accompanied by gurgling. Based on this history and
assessment, the nurse suspects which injury?
Small bowel rupture
Ruptured diaphragm
Flail chest
Hepatic injury - CORRECT ANSWER-Ruptured diaphragm
A 20-year-old male presents with a sudden onset of pleuritic chest pain, mild dyspnea, and a cough. Assessment reveals a tall, thin patient with
tachycardia and diminished breath sounds on the right side. What thoracic condition is the most likely cause?
Spontaneous pneumothorax
Open pneumothorax
Tension pneumothorax
Hemothorax - CORRECT ANSWER-Spontaneous pneumothorax
A 21-year-old female presents to the ED with complaints of pelvic pain. What possible cause of the pain is assessed for first?
Urinary tract infection
, Ectopic pregnancy
Ruptured ovarian cyst
Kidney stones - CORRECT ANSWER-Ectopic pregnancy
A 22-year-old patient presents with upper respiratory symptoms, nausea and vomiting and a low-grade fever. She has a history of leukemia and
underwent chemotherapy 2 weeks ago. What is the nurse's priority?
Protective isolation
Ondansetron oral dissolving tablet
Intravenous fluid bolus
Morphine intravenous - CORRECT ANSWER-Protective isolation
A 23-year-old patient with a stable ectopic pregnancy is being cared for by an emergency nurse. The emergency physician ordered methotrexate
to be administered intramuscularly. Which statement by the nurse indicates an understanding of the medication?
I'll instruct the patient to follow up in two weeks.
I can give this medication because there is only scant vaginal bleeding.
I'll give this medication because there is fetal cardiac activity.
I can't administer this medication. I'm pregnant. - CORRECT ANSWER-I can't administer this medication. I'm pregnant.
A 28-year-old female presents to the ED with complaints of dizziness, fear of dying, and hot flashes that began 10 minutes prior to arrival. The
patient is trembling and tachypneic. Which anxiety disorder is the patient exhibiting?
Post-traumatic stress disorder
Panic attack
Acute stress disorder
Generalized anxiety disorder - CORRECT ANSWER-Panic attack
A 28-year-old female presents with shortness of breath, dizziness, and diaphoresis. Her vital signs are BP 118/74 mm Hg, HR 122 beats/min, RR
26 breaths/min, T 37.7 C (99.9 F), SpO2 92% without supplemental oxygen. Her health history includes fractures of the left tibia and fibula
following an MVC 3 weeks ago. Surgical fixation was required. Her only current medications are an oral contraceptive and intermittent ibuprofen
for pain. Assessment of the casted left leg reveals that the toes are swollen. With this information, which diagnostic testing will the nurse expect
as the highest priority?
Sputum cultures
Chest radiograph
Computed tomographic pulmonary angiography
Radiograph of the left leg - CORRECT ANSWER-Computed tomographic pulmonary angiography
A 3-year-old boy is brought to the ED by his mother, who noticed bruises on the boy's left thigh, back, and feet developing over the last week.
Past medical history includes a mild respiratory virus a month ago. The assessment reveals, he is awake and alert, with some bleeding noted
around the gums. Initial laboratory values include a low platelet count with a normal white blood cell count. Hemoglobin and hematocrit are
slightly low. Which disorder does the nurse suspect is the cause of his signs and symptoms?
Leukemia
Thrombocytosis
Disseminated intravascular coagulopathy
Idiopathic thrombocytopenia purpura - CORRECT ANSWER-Idiopathic thrombocytopenia purpura
A 30-year-old male presents to the emergency department with excruciating pain on the right side of his head. It has been coming and going all
day. His right eye is reddened and skin is flushed. What type of headache is this patient experiencing?
Tension
Traumatic
Cluster
Migraine - CORRECT ANSWER-Cluster
A 32-year-old female patient is brought to the emergency department via emergency medical services with a complaint of coughing for the past
two weeks. The patient is now complaining of severe epigastric pain and is violently retching and vomiting blood. She has a history of alcohol
abuse and bulimia. Which type of gastrointestinal disorder is the most likely cause of these symptoms?
Diverticulitis
Mallory-Weiss syndrome
Pancreatitis
Gastric ulcer - CORRECT ANSWER-Mallory-Weiss syndrome
A 32-year-old female patient presents to the ED with complaints of abdominal pain that is 10 out of 10 on a numeric rating scale. A pregnancy test
is negative. A computed tomography (CT) scan of the abdomen has been ordered. The physician wants to hold analgesia until the CT is
completed. As an advocate for the patient, what might the emergency nurse do in this situation?
Request an order for an opioid
Request an order for a nonopioid
Have the patient use distraction techniques
Have the patient use deep breathing - CORRECT ANSWER-Request an order for an opioid
A 35-year-old man presents with complaints of stomach pain that comes and goes for the past two weeks. The nurse asks additional questions
about the nature of this pain and finds that it is relieved with antacids and he feels better after eating. The patient mentions that he had some
similar pain about two years ago, but it stopped after about a month and he never sought care for it. This is most likely which type of
gastrointestinal disorder?
Cholecystitis
Pancreatitis
Duodenal ulcer
Stress ulcer - CORRECT ANSWER-Duodenal ulcer
A 37-year-old female walks into the ED holding her abdomen. She is writhing in pain. Her history includes vaginal bleeding for the past 6 days.
She soaked 5 sanitary pads in 2 hours. What is the most likely cause of the heavy bleeding?
Uterine fibroids
Mittelschmerz
Pelvic inflammatory disease
Bartholin cyst - CORRECT ANSWER-Uterine fibroids
A 40-year-old man presents to the emergency department with minimal urine output for the past two days. His history includes recent kidney
stones. Which type of renal injury does this represent?
Intrarenal
correct answers
79. A patient presents with vaginal bleeding and cramping. She tells the emergency nurse, "I passed clots at home. I think I lost my baby." Pelvic
examination reveals that the cervical os is open. Which type of spontaneous abortion most likely occurred?
Missed abortion
Septic abortion
Inevitable abortion
Threatened abortion - CORRECT ANSWER-Inevitable abortion
A 12-year-old male is brought to the emergency department by his mother with complaints of difficulty breathing, swollen eyes and lips, and hives.
The mother states that the child had just finished eating a peanut butter cookie. Epinephrine was administered. What is the next class of
medications to be administered to the patient?
Inhaled beta 2 agonist
Corticosteroid
Antihistamine
Anticholinergic - CORRECT ANSWER-Inhaled beta 2 agonist
A 13-year-old presents to the emergency department. His parents state that he passed out at home and had been vomiting and had diarrhea for
the last few days. He answers questions appropriately, although he complains of dizziness. His vital signs on arrival: BP 70/40 mm Hg, HR 132
beats/min, RR 24 breaths/min, T 36.9 C (98.4 F), and SpO2 97% without supplemental oxygen. A new graduate nurse inserted an intravenous
line and is about to begin a fluid bolus of D5W. What does the preceptor explain to the new graduate nurse regarding fluid resuscitation?
Because of the electrolyte disturbances from vomiting and diarrhea, use D5.45% sodium chloride.
Because the patient is likely in septic shock, the fluid resuscitation is done slowly.
The appropriate fluid for hypotension is isotonic crystalloid, not D5W
As a pediatric patient, D5W fluid is given at a bolus rate of 20 mL/kg. - CORRECT ANSWER-The appropriate fluid for hypotension is isotonic
crystalloid, not D5W
A 15-year-old female presents to the emergency department with crampy left lower quadrant abdominal pain that lasted for 4 hours prior to
arrival. She also is having frequent, severe, bloody diarrhea. What gastrointestinal disorder is she most likely experiencing?
Ulcerative colitis
Diverticulitis
Crohn's disease
Appendicitis - CORRECT ANSWER-Ulcerative colitis
A 16-year-old male is brought to the ED by his coach. The patient was playing football in moderately cold weather one hour prior to arrival and felt
severe pain in the left groin area. This is suggestive of which genitourinary emergency?
Paraphimosis
Testicular torsion
Priapism
Acute epididymitis - CORRECT ANSWER-Testicular torsion
A 16-year-old presents with severe left upper quadrant abdominal pain after an over-the-handlebars bicycle collision. Vital signs are BP 100/60
mm Hg, HR 100 beats/min, RR 30 breaths/min, T 37.0 C (98.6 F), SpO2 89% without supplemental oxygen. There is bruising over the left upper
quadrant of the abdomen. Auscultation reveals diminished breath sounds on the left accompanied by gurgling. Based on this history and
assessment, the nurse suspects which injury?
Small bowel rupture
Ruptured diaphragm
Flail chest
Hepatic injury - CORRECT ANSWER-Ruptured diaphragm
A 20-year-old male presents with a sudden onset of pleuritic chest pain, mild dyspnea, and a cough. Assessment reveals a tall, thin patient with
tachycardia and diminished breath sounds on the right side. What thoracic condition is the most likely cause?
Spontaneous pneumothorax
Open pneumothorax
Tension pneumothorax
Hemothorax - CORRECT ANSWER-Spontaneous pneumothorax
A 21-year-old female presents to the ED with complaints of pelvic pain. What possible cause of the pain is assessed for first?
Urinary tract infection
, Ectopic pregnancy
Ruptured ovarian cyst
Kidney stones - CORRECT ANSWER-Ectopic pregnancy
A 22-year-old patient presents with upper respiratory symptoms, nausea and vomiting and a low-grade fever. She has a history of leukemia and
underwent chemotherapy 2 weeks ago. What is the nurse's priority?
Protective isolation
Ondansetron oral dissolving tablet
Intravenous fluid bolus
Morphine intravenous - CORRECT ANSWER-Protective isolation
A 23-year-old patient with a stable ectopic pregnancy is being cared for by an emergency nurse. The emergency physician ordered methotrexate
to be administered intramuscularly. Which statement by the nurse indicates an understanding of the medication?
I'll instruct the patient to follow up in two weeks.
I can give this medication because there is only scant vaginal bleeding.
I'll give this medication because there is fetal cardiac activity.
I can't administer this medication. I'm pregnant. - CORRECT ANSWER-I can't administer this medication. I'm pregnant.
A 28-year-old female presents to the ED with complaints of dizziness, fear of dying, and hot flashes that began 10 minutes prior to arrival. The
patient is trembling and tachypneic. Which anxiety disorder is the patient exhibiting?
Post-traumatic stress disorder
Panic attack
Acute stress disorder
Generalized anxiety disorder - CORRECT ANSWER-Panic attack
A 28-year-old female presents with shortness of breath, dizziness, and diaphoresis. Her vital signs are BP 118/74 mm Hg, HR 122 beats/min, RR
26 breaths/min, T 37.7 C (99.9 F), SpO2 92% without supplemental oxygen. Her health history includes fractures of the left tibia and fibula
following an MVC 3 weeks ago. Surgical fixation was required. Her only current medications are an oral contraceptive and intermittent ibuprofen
for pain. Assessment of the casted left leg reveals that the toes are swollen. With this information, which diagnostic testing will the nurse expect
as the highest priority?
Sputum cultures
Chest radiograph
Computed tomographic pulmonary angiography
Radiograph of the left leg - CORRECT ANSWER-Computed tomographic pulmonary angiography
A 3-year-old boy is brought to the ED by his mother, who noticed bruises on the boy's left thigh, back, and feet developing over the last week.
Past medical history includes a mild respiratory virus a month ago. The assessment reveals, he is awake and alert, with some bleeding noted
around the gums. Initial laboratory values include a low platelet count with a normal white blood cell count. Hemoglobin and hematocrit are
slightly low. Which disorder does the nurse suspect is the cause of his signs and symptoms?
Leukemia
Thrombocytosis
Disseminated intravascular coagulopathy
Idiopathic thrombocytopenia purpura - CORRECT ANSWER-Idiopathic thrombocytopenia purpura
A 30-year-old male presents to the emergency department with excruciating pain on the right side of his head. It has been coming and going all
day. His right eye is reddened and skin is flushed. What type of headache is this patient experiencing?
Tension
Traumatic
Cluster
Migraine - CORRECT ANSWER-Cluster
A 32-year-old female patient is brought to the emergency department via emergency medical services with a complaint of coughing for the past
two weeks. The patient is now complaining of severe epigastric pain and is violently retching and vomiting blood. She has a history of alcohol
abuse and bulimia. Which type of gastrointestinal disorder is the most likely cause of these symptoms?
Diverticulitis
Mallory-Weiss syndrome
Pancreatitis
Gastric ulcer - CORRECT ANSWER-Mallory-Weiss syndrome
A 32-year-old female patient presents to the ED with complaints of abdominal pain that is 10 out of 10 on a numeric rating scale. A pregnancy test
is negative. A computed tomography (CT) scan of the abdomen has been ordered. The physician wants to hold analgesia until the CT is
completed. As an advocate for the patient, what might the emergency nurse do in this situation?
Request an order for an opioid
Request an order for a nonopioid
Have the patient use distraction techniques
Have the patient use deep breathing - CORRECT ANSWER-Request an order for an opioid
A 35-year-old man presents with complaints of stomach pain that comes and goes for the past two weeks. The nurse asks additional questions
about the nature of this pain and finds that it is relieved with antacids and he feels better after eating. The patient mentions that he had some
similar pain about two years ago, but it stopped after about a month and he never sought care for it. This is most likely which type of
gastrointestinal disorder?
Cholecystitis
Pancreatitis
Duodenal ulcer
Stress ulcer - CORRECT ANSWER-Duodenal ulcer
A 37-year-old female walks into the ED holding her abdomen. She is writhing in pain. Her history includes vaginal bleeding for the past 6 days.
She soaked 5 sanitary pads in 2 hours. What is the most likely cause of the heavy bleeding?
Uterine fibroids
Mittelschmerz
Pelvic inflammatory disease
Bartholin cyst - CORRECT ANSWER-Uterine fibroids
A 40-year-old man presents to the emergency department with minimal urine output for the past two days. His history includes recent kidney
stones. Which type of renal injury does this represent?
Intrarenal
