ESTUDYR
CERTIFIED EMERGENCY NURSE (CEN) MOST TESTED
QUESTIONS AND ANSWERS GRADED A+ WITH
RATIONALES
1. Which of the following statements by a patient indicates understanding of pulmonary embolism
risk factors?
A. Resuming birth control lowers clot risk.
B. Drinking water prevents clots.
C. Switching to e-cigarettes lowers risk.
D. Getting up and walking every hour on a long flight.
Rationale: Immobility increases risk; ambulation promotes circulation.
2. Which statement by a patient with pelvic inflammatory disease shows understanding?
A. Getting pregnant is easy after infection.
B. I’ll take nausea medicine when needed.
C. I’m at increased risk for ectopic pregnancy.
D. I’ll see my doctor tomorrow.
Rationale: Scarring from PID raises risk of ectopic pregnancy.
3. A 16-year-old has LUQ pain, bruising, and gurgling breath sounds after a bike crash. Suspected
injury?
A. Small bowel rupture
B. Ruptured diaphragm
C. Flail chest
D. Hepatic injury
Rationale: LUQ trauma, bowel sounds in chest → diaphragm rupture.
4. Abnormal Q wave on ECG suggests:
A. Current injury
B. Acute infarction
C. Ischemia
D. Old infarction
Rationale: Pathologic Q waves indicate past MI scar tissue.
,ESTUDYR
5. Patient with aggression and homicidal threats arrives. First priority?
A. One-to-one observation
B. Antipsychotic medication
C. Restraints
D. Place in seclusion room
Rationale: Seclusion ensures immediate safety for staff and patient.
6. A post-op patient on oral contraceptives with casted leg has SOB, dizziness, and SpO₂ 92%.
Priority test?
A. Sputum cultures
B. Chest X-ray
C. CT pulmonary angiography
D. Leg X-ray
Rationale: Signs of PE warrant immediate CT angiography.
7. After a family returns from Sierra Leone with fever, bruising, and muscle pain, the nurse should:
A. Evacuate waiting room
B. Inform everyone about Ebola
C. Notify infection prevention
D. Leave family in waiting room
Rationale: Follow isolation protocols and notify infection control.
8. Patient with moon face, buffalo hump, and striae likely has:
A. Diuretic misuse
B. Diabetes hypoglycemia
C. Chronic prednisone therapy
D. Thyroid hormone deficiency
Rationale: Long-term corticosteroids cause Cushingoid appearance.
9. A trauma patient has cyanosis, JVD, absent right breath sounds. Suspected diagnosis?
A. Cardiac tamponade
B. Tension pneumothorax
C. Aspiration
D. Flail chest
Rationale: Air trapped under pressure shifts mediastinum & compresses vessels.
,ESTUDYR
10. Most common cause of cardiogenic shock?
A. Acute valvular dysfunction
B. End-stage cardiomyopathy
C. Sustained dysrhythmia
D. Myocardial infarction
Rationale: MI impairs pump function → low cardiac output.
11. Which disease involves catarrhal, paroxysmal & convalescent stages?
A. HIV
B. Pertussis (treated with macrolides)
C. Steroid-induced myopathy
D. Rubella
Rationale: Whooping cough progresses through these stages.
12. Patient has dizziness, fear of dying, tachypnea, and tremors. Diagnosis?
A. PTSD
B. Panic attack
C. Acute stress disorder
D. Generalized anxiety disorder
Rationale: Sudden intense fear + physical symptoms = panic attack.
13. Severe unilateral headache, red eye, flushed skin suggests:
A. Tension headache
B. Migraine
C. Cluster headache
D. Traumatic headache
Rationale: Cluster headaches cause ipsilateral autonomic symptoms.
14. To maintain chain of custody, the nurse should:
A. Keep evidence at station
B. Carry it until law enforcement arrives
C. Sign & tape in front of police
D. Limit access to evidence
Rationale: Fewer handlers preserve integrity of evidence.
, ESTUDYR
15. Which orthopedic disorder results from high uric acid?
A. Osteomyelitis
B. Joint effusion
C. Bursitis
D. Gouty arthritis
Rationale: Urate crystals deposit in joints → gout.
16. Patient with delusions, hallucinations, and disorganized speech needs:
A. Suicide risk assessment
B. Restraints
C. Medical clearance
D. Antidepressants
Rationale: Rule out organic causes before psychiatric treatment.
17. First nursing intervention for endocarditis pre-surgery:
A. Place urinary catheter
B. Insert NG tube
C. Start nitroprusside infusion
D. Administer antibiotics
Rationale: IV antibiotics prevent bacteremia complications.
18. Which patient is at highest risk of pulmonary embolism?
A. Long-term smoker with cough
B. Post-hip surgery with immobilization
C. Healthy runner with calf pain
D. Asthmatic with shortness of breath
Rationale: Surgery + immobility → DVT → PE.
19. A patient with pinpoint pupils, bradypnea, and lethargy likely overdosed on:
A. Benzodiazepines
B. Opioids
C. Stimulants
D. Anticholinergics
Rationale: Opioids cause miosis, respiratory depression, CNS depression.
CERTIFIED EMERGENCY NURSE (CEN) MOST TESTED
QUESTIONS AND ANSWERS GRADED A+ WITH
RATIONALES
1. Which of the following statements by a patient indicates understanding of pulmonary embolism
risk factors?
A. Resuming birth control lowers clot risk.
B. Drinking water prevents clots.
C. Switching to e-cigarettes lowers risk.
D. Getting up and walking every hour on a long flight.
Rationale: Immobility increases risk; ambulation promotes circulation.
2. Which statement by a patient with pelvic inflammatory disease shows understanding?
A. Getting pregnant is easy after infection.
B. I’ll take nausea medicine when needed.
C. I’m at increased risk for ectopic pregnancy.
D. I’ll see my doctor tomorrow.
Rationale: Scarring from PID raises risk of ectopic pregnancy.
3. A 16-year-old has LUQ pain, bruising, and gurgling breath sounds after a bike crash. Suspected
injury?
A. Small bowel rupture
B. Ruptured diaphragm
C. Flail chest
D. Hepatic injury
Rationale: LUQ trauma, bowel sounds in chest → diaphragm rupture.
4. Abnormal Q wave on ECG suggests:
A. Current injury
B. Acute infarction
C. Ischemia
D. Old infarction
Rationale: Pathologic Q waves indicate past MI scar tissue.
,ESTUDYR
5. Patient with aggression and homicidal threats arrives. First priority?
A. One-to-one observation
B. Antipsychotic medication
C. Restraints
D. Place in seclusion room
Rationale: Seclusion ensures immediate safety for staff and patient.
6. A post-op patient on oral contraceptives with casted leg has SOB, dizziness, and SpO₂ 92%.
Priority test?
A. Sputum cultures
B. Chest X-ray
C. CT pulmonary angiography
D. Leg X-ray
Rationale: Signs of PE warrant immediate CT angiography.
7. After a family returns from Sierra Leone with fever, bruising, and muscle pain, the nurse should:
A. Evacuate waiting room
B. Inform everyone about Ebola
C. Notify infection prevention
D. Leave family in waiting room
Rationale: Follow isolation protocols and notify infection control.
8. Patient with moon face, buffalo hump, and striae likely has:
A. Diuretic misuse
B. Diabetes hypoglycemia
C. Chronic prednisone therapy
D. Thyroid hormone deficiency
Rationale: Long-term corticosteroids cause Cushingoid appearance.
9. A trauma patient has cyanosis, JVD, absent right breath sounds. Suspected diagnosis?
A. Cardiac tamponade
B. Tension pneumothorax
C. Aspiration
D. Flail chest
Rationale: Air trapped under pressure shifts mediastinum & compresses vessels.
,ESTUDYR
10. Most common cause of cardiogenic shock?
A. Acute valvular dysfunction
B. End-stage cardiomyopathy
C. Sustained dysrhythmia
D. Myocardial infarction
Rationale: MI impairs pump function → low cardiac output.
11. Which disease involves catarrhal, paroxysmal & convalescent stages?
A. HIV
B. Pertussis (treated with macrolides)
C. Steroid-induced myopathy
D. Rubella
Rationale: Whooping cough progresses through these stages.
12. Patient has dizziness, fear of dying, tachypnea, and tremors. Diagnosis?
A. PTSD
B. Panic attack
C. Acute stress disorder
D. Generalized anxiety disorder
Rationale: Sudden intense fear + physical symptoms = panic attack.
13. Severe unilateral headache, red eye, flushed skin suggests:
A. Tension headache
B. Migraine
C. Cluster headache
D. Traumatic headache
Rationale: Cluster headaches cause ipsilateral autonomic symptoms.
14. To maintain chain of custody, the nurse should:
A. Keep evidence at station
B. Carry it until law enforcement arrives
C. Sign & tape in front of police
D. Limit access to evidence
Rationale: Fewer handlers preserve integrity of evidence.
, ESTUDYR
15. Which orthopedic disorder results from high uric acid?
A. Osteomyelitis
B. Joint effusion
C. Bursitis
D. Gouty arthritis
Rationale: Urate crystals deposit in joints → gout.
16. Patient with delusions, hallucinations, and disorganized speech needs:
A. Suicide risk assessment
B. Restraints
C. Medical clearance
D. Antidepressants
Rationale: Rule out organic causes before psychiatric treatment.
17. First nursing intervention for endocarditis pre-surgery:
A. Place urinary catheter
B. Insert NG tube
C. Start nitroprusside infusion
D. Administer antibiotics
Rationale: IV antibiotics prevent bacteremia complications.
18. Which patient is at highest risk of pulmonary embolism?
A. Long-term smoker with cough
B. Post-hip surgery with immobilization
C. Healthy runner with calf pain
D. Asthmatic with shortness of breath
Rationale: Surgery + immobility → DVT → PE.
19. A patient with pinpoint pupils, bradypnea, and lethargy likely overdosed on:
A. Benzodiazepines
B. Opioids
C. Stimulants
D. Anticholinergics
Rationale: Opioids cause miosis, respiratory depression, CNS depression.
