CEN Practice prep Test Questions and
Answers with Solutions 2024
1. A patient with chest pain has a 12-lead electrocardiogram that shows a new
onset left bundle branch block. There is > 1 mm concordant ST elevation in
lead aVF. What is the priority intervention for this patient?
A. Continuous ST-segment monitoring
B. Serial troponin measurements
C. Preparing the patient for transport to the cardiac catheterization lab
D. Admission to a telemetry unit for observation: C. Preparing the patient for
transport to the cardiac catheterization lab
2. During the completion of a 12-lead electrocardiogram, the nurse identifies
excessive artifact in lead II and lead III. To resolve this technical difficulty, the
nurse should:
A. change the right arm electrode.
B. check for cable movement.
C. change the left leg electrode.
D. instruct the patient to momentarily hold their breath.: C. change the left leg
electrode.
3. A patient with ST elevation in leads II, III, and aVF is likely to experience an
infarct in which location of the heart?
A. Inferior
B. Anterior
C. Lateral
D. Posterior: A. Inferior
4. A patient states they awoke from sleep with midsternal chest pain approxi-
mately 4-5 hours ago. In the presence of an acute myocardial infarction (AMI),
the initial elevation of the troponin cardiac biomarkers occurs within:
A. 1-2 hours of onset of an AMI.
B. 3-12 hours of onset of an AMI.
C. 24-30 hours of onset of an AMI.
,D. 10-24 hours of onset of an AMI.: B. 3-12 hours of onset of an AMI.
5. The nurse suspects a patient may have an acute aortic dissection when,
during the history-taking process, the patient describes the pain as:
A. squeezing, burning epigastric pain that may radiate to the middle back area.
B. right upper quadrant pain referred to the right scapula and shoulder.
C. sudden, severe tearing or ripping chest, interscapular, or back pain.
,D. sharp, stabbing chest pain radiating to the neck, arms, or left shoulder: C.
sudden, severe tearing or ripping chest, interscapular, or back pain.
6. You are assisting in the resuscitation of a patient in cardiac arrest. A wave-
form capnography is in place, and high-quality cardiopulmonary resuscitation
is being performed. A sudden increase in the level of the end-tidal carbon
dioxide indicates the:
A. need for deeper and faster chest compressions.
B. need for an additional dose of a vasopressor.
C. presence of an irreversible cardiac arrest.
D. return of spontaneous circulation.: D. return of spontaneous circulation.
7. The cardiac monitor of a patient in cardiac arrest displays sinus rhythm,
but no palpable pulse can be detected. The most likely cause of this pulseless
electrical activity (PEA) is:
A. glucose level of 145 mg/dL.
B. potassium value of 1.3 mmol/L (1.3 mEq/L).
C. arterial pH of 7.36.
D. magnesium level of 3.0 mg/dL.: B. potassium value of 1.3 mmol/L (1.3 mEq/L).
8. Which of the following physiological conditions would result in the loss of
ventricular capture for a patient with a transcutaneous pacemaker?
A. Lactic acidosis
B. Hypomagnesemia
C. Metabolic alkalosis
D. Hypokalemia: A. Lactic acidosis
9. A patient presents complaining of shortness of breath and chest pain.
Electrocardiogram reveals a ventricular rate of 210 with a regular rhythm.
Which medication should the nurse anticipate administering?
A. Adenosine
B. Amiodarone
C. Lidocaine
D. Moricizine: A. Adenosine
10. On examination of a febrile patient presenting to the emergency depart-
ment with a chief complaint of "flulike symptoms" and a history of intravenous
drug use, the nurse notes a cardiac murmur, crackles in bilateral lung bases,
subungual hemorrhages, nontender erythematous macules on the palms of
the hands and soles of the feet, and painful erythematous nodules on the tips
, of the fingers and toes. Which is the priority intervention for this patient?
A. Echocardiogram
B. Chest radiography
C. Surgery
D. Antibiotics: D. Antibiotics
11. A patient presents to the emergency department complaining of a severe
headache. Vital signs reveal a BP of 270/170 mm Hg. The patient is alert and
describes being recently diagnosed with high blood pressure. What is the
priority intervention for this patient?
A. Initiate intravenous medication to lower the patient's BP immediately
B. Obtain baseline laboratory data
C. Consider emergency cardioversion for BP control
D. Evaluate the BP cuff size for accuracy: D. Evaluate the BP cuff size for accuracy
12. Administration of nitroprusside (Nipride) to a patient in a hypertensive
crisis without evidence of aortic dissection is considered effective when the
patient demonstrates which of the following?
A. The patient responds to verbal stimuli.
B. The systolic blood pressure reaches 160 mm Hg.
C. The systolic blood pressure reaches 120 mm Hg.
D. The patient reports relief of chest pain.: B. The systolic blood pressure reaches
160 mm Hg.
13. Which of the following is a symptom of pericardial tamponade?
A. Muffled heart tones
B. Widening pulse pressure
C. Jugular vein flattening
D. Tracheal deviation: A. Muffled heart tones
14. A child with a recent diagnosis of hand, foot, and mouth disease complains
of chest pain that hurts more while coughing and "when taking a deep breath."
The nurse notes that the child is sitting upright on the mother's lap and is
leaning forward. Based on the patient's most recent illness history, the nurse
knows this patient is at risk for developing:
A. pneumonia.
B. pericarditis.
Answers with Solutions 2024
1. A patient with chest pain has a 12-lead electrocardiogram that shows a new
onset left bundle branch block. There is > 1 mm concordant ST elevation in
lead aVF. What is the priority intervention for this patient?
A. Continuous ST-segment monitoring
B. Serial troponin measurements
C. Preparing the patient for transport to the cardiac catheterization lab
D. Admission to a telemetry unit for observation: C. Preparing the patient for
transport to the cardiac catheterization lab
2. During the completion of a 12-lead electrocardiogram, the nurse identifies
excessive artifact in lead II and lead III. To resolve this technical difficulty, the
nurse should:
A. change the right arm electrode.
B. check for cable movement.
C. change the left leg electrode.
D. instruct the patient to momentarily hold their breath.: C. change the left leg
electrode.
3. A patient with ST elevation in leads II, III, and aVF is likely to experience an
infarct in which location of the heart?
A. Inferior
B. Anterior
C. Lateral
D. Posterior: A. Inferior
4. A patient states they awoke from sleep with midsternal chest pain approxi-
mately 4-5 hours ago. In the presence of an acute myocardial infarction (AMI),
the initial elevation of the troponin cardiac biomarkers occurs within:
A. 1-2 hours of onset of an AMI.
B. 3-12 hours of onset of an AMI.
C. 24-30 hours of onset of an AMI.
,D. 10-24 hours of onset of an AMI.: B. 3-12 hours of onset of an AMI.
5. The nurse suspects a patient may have an acute aortic dissection when,
during the history-taking process, the patient describes the pain as:
A. squeezing, burning epigastric pain that may radiate to the middle back area.
B. right upper quadrant pain referred to the right scapula and shoulder.
C. sudden, severe tearing or ripping chest, interscapular, or back pain.
,D. sharp, stabbing chest pain radiating to the neck, arms, or left shoulder: C.
sudden, severe tearing or ripping chest, interscapular, or back pain.
6. You are assisting in the resuscitation of a patient in cardiac arrest. A wave-
form capnography is in place, and high-quality cardiopulmonary resuscitation
is being performed. A sudden increase in the level of the end-tidal carbon
dioxide indicates the:
A. need for deeper and faster chest compressions.
B. need for an additional dose of a vasopressor.
C. presence of an irreversible cardiac arrest.
D. return of spontaneous circulation.: D. return of spontaneous circulation.
7. The cardiac monitor of a patient in cardiac arrest displays sinus rhythm,
but no palpable pulse can be detected. The most likely cause of this pulseless
electrical activity (PEA) is:
A. glucose level of 145 mg/dL.
B. potassium value of 1.3 mmol/L (1.3 mEq/L).
C. arterial pH of 7.36.
D. magnesium level of 3.0 mg/dL.: B. potassium value of 1.3 mmol/L (1.3 mEq/L).
8. Which of the following physiological conditions would result in the loss of
ventricular capture for a patient with a transcutaneous pacemaker?
A. Lactic acidosis
B. Hypomagnesemia
C. Metabolic alkalosis
D. Hypokalemia: A. Lactic acidosis
9. A patient presents complaining of shortness of breath and chest pain.
Electrocardiogram reveals a ventricular rate of 210 with a regular rhythm.
Which medication should the nurse anticipate administering?
A. Adenosine
B. Amiodarone
C. Lidocaine
D. Moricizine: A. Adenosine
10. On examination of a febrile patient presenting to the emergency depart-
ment with a chief complaint of "flulike symptoms" and a history of intravenous
drug use, the nurse notes a cardiac murmur, crackles in bilateral lung bases,
subungual hemorrhages, nontender erythematous macules on the palms of
the hands and soles of the feet, and painful erythematous nodules on the tips
, of the fingers and toes. Which is the priority intervention for this patient?
A. Echocardiogram
B. Chest radiography
C. Surgery
D. Antibiotics: D. Antibiotics
11. A patient presents to the emergency department complaining of a severe
headache. Vital signs reveal a BP of 270/170 mm Hg. The patient is alert and
describes being recently diagnosed with high blood pressure. What is the
priority intervention for this patient?
A. Initiate intravenous medication to lower the patient's BP immediately
B. Obtain baseline laboratory data
C. Consider emergency cardioversion for BP control
D. Evaluate the BP cuff size for accuracy: D. Evaluate the BP cuff size for accuracy
12. Administration of nitroprusside (Nipride) to a patient in a hypertensive
crisis without evidence of aortic dissection is considered effective when the
patient demonstrates which of the following?
A. The patient responds to verbal stimuli.
B. The systolic blood pressure reaches 160 mm Hg.
C. The systolic blood pressure reaches 120 mm Hg.
D. The patient reports relief of chest pain.: B. The systolic blood pressure reaches
160 mm Hg.
13. Which of the following is a symptom of pericardial tamponade?
A. Muffled heart tones
B. Widening pulse pressure
C. Jugular vein flattening
D. Tracheal deviation: A. Muffled heart tones
14. A child with a recent diagnosis of hand, foot, and mouth disease complains
of chest pain that hurts more while coughing and "when taking a deep breath."
The nurse notes that the child is sitting upright on the mother's lap and is
leaning forward. Based on the patient's most recent illness history, the nurse
knows this patient is at risk for developing:
A. pneumonia.
B. pericarditis.
