Page 1 of 198
CEN EXAM VERSION1 NEWEST 2025/2026 COMPLETE
300 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
A patient presents with a partial amputation of the left lower extremity
from a boat propeller. They arrive one hour post incident with a
tourniquet in place, and massive transfusion protocol has been
initiated. Current vital signs include a heart rate of 145 beats/min and
blood pressure of 84/62 mmHg. The NEXT priority action is to?
A) Target blood pressure goal of 120 mmHg systolic
B) Bolus an isotonic crystalloid solution
C) Initiate intravenous antibiotics
D) Administer tranexamic acid (TXA) - ANSWER-D
Rationale; Tranexamic acid (TXA) should be used when encountering
the patient with massive hemorrhage and/or receiving blood
transfusion. TXA is a medication which prevents the breakdown of
fibrin and the breakdown of clots that have formed. Studies have
shown that, if given within 3 hours of injury, administration of
intravenous TXA has significantly reduced mortality. Rapid bolus of an
isotonic crystalloid solution can cause hemodilution and break clots
,Page 2 of 198
that have already formed. Blood pressure drives bleeding; research
supports permissive hypotension of a systolic blood pressure targeted
to no higher than 90 to 100 mm Hg. Antibiotics should be considered
in treatment but are not priority.
The triage nurse should prioritize a patient who has ?
A) hypertension and a headache.
B) a cough and fever.
C) stridor after being stung by a bee.
D) abdominal pain and distention. - ANSWER-C
Rationale; Stridor is indicative of an upper airway obstruction. After
being stung by a bee, stridor should cause high suspicion for
anaphylaxis and requires immediate intervention to protect the
patency of the airway. While the other conditions are concerning,
stridor can be a sign of airway compromise and should be the priority.
A patient presenting with headache, fever and a stiff neck now
complains of restlessness and is hypotensive with altered mental status.
The PRIORITY intervention is to administer?
A) antibiotics.
,Page 3 of 198
B) antipyretics.
C)analgesics.
D) antiemetics. - ANSWER-A
Rationale; The patient should be treated for suspected bacterial
meningitis, which requires urgent administration of antibiotics as
patients can become severely ill and progress to septic shock.
Analgesics, antipyretics and antiemetics may be used to treat the
patient's symptoms but do not treat the underlying bacterial
infection.
An adolescent patient presents to the emergency room with reports
that they were hit in the eye with a baseball. No visual loss is noted
when a Snellen visual acuity is performed, but while waiting to be
assessed by a provider, the patient reports "aching" pain in their eye
and sudden onset of blurry vision. What statement made would cause
the greatest concern in the emergency nurse?
A) Reports everything looks red
B) Complaints of increased lacrimation
C) Increased swelling
D) Decreased ability to look up - ANSWER-A
, Page 4 of 198
Rationale; "Seeing red" is an indication that blood is present in the
anterior chamber. Activities such as coughing, sneezing, or leaning
forward can cause the bleeding to continue or increase. This causes
the anterior chamber to fill with blood and can lead to increased
intraocular pressure due to blood clotting. Increased swelling and
lacrimation are anticipated after an eye injury. Decreased ability to
look upward may be a sign on entrapment, however without vision
loss, this would take less priority than the chamber of the eye filling
with blood.
The MOST lethal method of anthrax exposure is by?
A) contaminated water sources
B) inhalation
C) contact with open wounds
D) ingestion of spores - ANSWER-B
Rationale; Anthrax can enter the body via several routes but the most
lethal is via inhalation. It can start with symptoms of seasonal illness
such as the flu but deterioration can occur rapidly and result in death
within several hours with possible mediastinitis or hemorrhagic
meningitis. Ingestion via food or water would eventually manifest as
sepsis, abdominal pain, and bloody diarrhea. Skin contact would
result in lesions itching and urticaria.
CEN EXAM VERSION1 NEWEST 2025/2026 COMPLETE
300 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
A patient presents with a partial amputation of the left lower extremity
from a boat propeller. They arrive one hour post incident with a
tourniquet in place, and massive transfusion protocol has been
initiated. Current vital signs include a heart rate of 145 beats/min and
blood pressure of 84/62 mmHg. The NEXT priority action is to?
A) Target blood pressure goal of 120 mmHg systolic
B) Bolus an isotonic crystalloid solution
C) Initiate intravenous antibiotics
D) Administer tranexamic acid (TXA) - ANSWER-D
Rationale; Tranexamic acid (TXA) should be used when encountering
the patient with massive hemorrhage and/or receiving blood
transfusion. TXA is a medication which prevents the breakdown of
fibrin and the breakdown of clots that have formed. Studies have
shown that, if given within 3 hours of injury, administration of
intravenous TXA has significantly reduced mortality. Rapid bolus of an
isotonic crystalloid solution can cause hemodilution and break clots
,Page 2 of 198
that have already formed. Blood pressure drives bleeding; research
supports permissive hypotension of a systolic blood pressure targeted
to no higher than 90 to 100 mm Hg. Antibiotics should be considered
in treatment but are not priority.
The triage nurse should prioritize a patient who has ?
A) hypertension and a headache.
B) a cough and fever.
C) stridor after being stung by a bee.
D) abdominal pain and distention. - ANSWER-C
Rationale; Stridor is indicative of an upper airway obstruction. After
being stung by a bee, stridor should cause high suspicion for
anaphylaxis and requires immediate intervention to protect the
patency of the airway. While the other conditions are concerning,
stridor can be a sign of airway compromise and should be the priority.
A patient presenting with headache, fever and a stiff neck now
complains of restlessness and is hypotensive with altered mental status.
The PRIORITY intervention is to administer?
A) antibiotics.
,Page 3 of 198
B) antipyretics.
C)analgesics.
D) antiemetics. - ANSWER-A
Rationale; The patient should be treated for suspected bacterial
meningitis, which requires urgent administration of antibiotics as
patients can become severely ill and progress to septic shock.
Analgesics, antipyretics and antiemetics may be used to treat the
patient's symptoms but do not treat the underlying bacterial
infection.
An adolescent patient presents to the emergency room with reports
that they were hit in the eye with a baseball. No visual loss is noted
when a Snellen visual acuity is performed, but while waiting to be
assessed by a provider, the patient reports "aching" pain in their eye
and sudden onset of blurry vision. What statement made would cause
the greatest concern in the emergency nurse?
A) Reports everything looks red
B) Complaints of increased lacrimation
C) Increased swelling
D) Decreased ability to look up - ANSWER-A
, Page 4 of 198
Rationale; "Seeing red" is an indication that blood is present in the
anterior chamber. Activities such as coughing, sneezing, or leaning
forward can cause the bleeding to continue or increase. This causes
the anterior chamber to fill with blood and can lead to increased
intraocular pressure due to blood clotting. Increased swelling and
lacrimation are anticipated after an eye injury. Decreased ability to
look upward may be a sign on entrapment, however without vision
loss, this would take less priority than the chamber of the eye filling
with blood.
The MOST lethal method of anthrax exposure is by?
A) contaminated water sources
B) inhalation
C) contact with open wounds
D) ingestion of spores - ANSWER-B
Rationale; Anthrax can enter the body via several routes but the most
lethal is via inhalation. It can start with symptoms of seasonal illness
such as the flu but deterioration can occur rapidly and result in death
within several hours with possible mediastinitis or hemorrhagic
meningitis. Ingestion via food or water would eventually manifest as
sepsis, abdominal pain, and bloody diarrhea. Skin contact would
result in lesions itching and urticaria.
