CEN Exam 5 2025/2026 Exam Questions
with 100% Correct Answers | Latest
Update
1. A pt presents to the ED experiencing an anterior ST segment elevation MI. The
pts vital signs are normal. The hospital is not equipped with a cardaic
catheterization lab. The pt can be transferred to a cardaic catheterization lab within
60 mins. Which of the following would you anticipate for this pt?:
A. A bolus of tissue plasminogen activator, followed by an infusion for fibrinolytic
therapy
B. Immediate transfer to the hospital with a cardiac catheterization lab for
percutaneous coronary intervention
C. A single bolus of tenecteplase (Tnkase) for fibrinolytic therapy
,D. A bolus of reteplase (Retavase), followed by a second bolus of reteplase 30
mins later for fibrinolytic therapy - 🧠ANSWER ✔✔B. Immediate transfer to the
hospital with a cardiac catheterization lab for percutaneous coronary intervention
In adult pts presenting with a STEMI of a hospital that does not have PCI
capability, it is recommended that the pt be transferred immediately without
fibrinolytics to a PCI center, instead of immediate fibrinolysis at the intial hospital
with transfer onlu for ischemia driven PCI
2. An anxious pt arrives by ambulance following an acute onset of difficulty
breathing. The pt is diaphoretic and denies chest pain. High-flow O2 by non-
rebreather mask has been applied. Vitals: BP 210/140, HR 130, RR 32, SpO2 88%.
In addition to initiating noninvasive ventilation to treat the pts difficulty breathing,
the nurse anticipates the administration of which medication to further treat the pts
symptoms?:
A. Morphine (Morphine sulfate)
B. Furosemide (Lasix)
C. Initation of a continuous nitroglycerin infusion
,D. Acetylsalicylic acid (Aspirin) - 🧠ANSWER ✔✔C. Initation of a continuous
nitroglycerin infusion
Pts who present with acute pulmonary edema are typically markedly hypertensive
and in acute respiratory distress. Rapid initiation of appropriate treatment is vital to
reversing the neurohormonal surge and rescuing pts from respiratory and complete
cardiac failure. Nitroglycerin is the most important first line medication in
treatment of acute pulmonary edema and respiratory distress. The initation of
continuous NTG infusion at low doses acts as a vasodilator, leading to decreased
preload: at higher doses ( >100mcg/min) acts as a potent afterload reducer
3. An unrestrained driver is brought to the ED following a motor vehicle collision.
The pt reports hitting their chest on the steering wheel and is complaining of chest
pain across the front of their chest. There are no vital sign abnormalities and no
other complaints of pain. The diagnosis of blunt cardiac injury is considered. The
nurse anticipates an order for which of the following?:
A. EKG
B. Cardiac marker evaluation (CK or Troponin)
C. Cardiac monitoring
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
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STATEMENT. ALL RIGHTS RESERVED
, D. Chest radiograph - 🧠ANSWER ✔✔B. Cardiac marker evaluation (CK or
Troponin)
Not all trauma pts with blunt cardiac injury will have acute alterations in cardiac
markers, and other organ injury may cause release of creatinine kinase and
confound the diagnosis of blunt cardiac injury
4. Which of the following is a form of distributive shock?:
A. Neurogenic
B. Metabolic
C. Respiratory
D. Obstructive - 🧠ANSWER ✔✔A. Neurogenic
5. A pt presents following an acute onset of chest pain, dyspnea and severe
diaphoresis, with near syncope. Assessment shows a pt in severe distress, with HR
110, BP 60/40 and RR 36 with bilateral rales. An EKG reveals ST segment
elevation across the precordial leads. A diagnosis of acute MI with cardiogenic
shock is made, and the pt is being prepared for transfer to the cardiac cath lab. The
vasopressor of choice, based on this pts degree of hypotension is:
with 100% Correct Answers | Latest
Update
1. A pt presents to the ED experiencing an anterior ST segment elevation MI. The
pts vital signs are normal. The hospital is not equipped with a cardaic
catheterization lab. The pt can be transferred to a cardaic catheterization lab within
60 mins. Which of the following would you anticipate for this pt?:
A. A bolus of tissue plasminogen activator, followed by an infusion for fibrinolytic
therapy
B. Immediate transfer to the hospital with a cardiac catheterization lab for
percutaneous coronary intervention
C. A single bolus of tenecteplase (Tnkase) for fibrinolytic therapy
,D. A bolus of reteplase (Retavase), followed by a second bolus of reteplase 30
mins later for fibrinolytic therapy - 🧠ANSWER ✔✔B. Immediate transfer to the
hospital with a cardiac catheterization lab for percutaneous coronary intervention
In adult pts presenting with a STEMI of a hospital that does not have PCI
capability, it is recommended that the pt be transferred immediately without
fibrinolytics to a PCI center, instead of immediate fibrinolysis at the intial hospital
with transfer onlu for ischemia driven PCI
2. An anxious pt arrives by ambulance following an acute onset of difficulty
breathing. The pt is diaphoretic and denies chest pain. High-flow O2 by non-
rebreather mask has been applied. Vitals: BP 210/140, HR 130, RR 32, SpO2 88%.
In addition to initiating noninvasive ventilation to treat the pts difficulty breathing,
the nurse anticipates the administration of which medication to further treat the pts
symptoms?:
A. Morphine (Morphine sulfate)
B. Furosemide (Lasix)
C. Initation of a continuous nitroglycerin infusion
,D. Acetylsalicylic acid (Aspirin) - 🧠ANSWER ✔✔C. Initation of a continuous
nitroglycerin infusion
Pts who present with acute pulmonary edema are typically markedly hypertensive
and in acute respiratory distress. Rapid initiation of appropriate treatment is vital to
reversing the neurohormonal surge and rescuing pts from respiratory and complete
cardiac failure. Nitroglycerin is the most important first line medication in
treatment of acute pulmonary edema and respiratory distress. The initation of
continuous NTG infusion at low doses acts as a vasodilator, leading to decreased
preload: at higher doses ( >100mcg/min) acts as a potent afterload reducer
3. An unrestrained driver is brought to the ED following a motor vehicle collision.
The pt reports hitting their chest on the steering wheel and is complaining of chest
pain across the front of their chest. There are no vital sign abnormalities and no
other complaints of pain. The diagnosis of blunt cardiac injury is considered. The
nurse anticipates an order for which of the following?:
A. EKG
B. Cardiac marker evaluation (CK or Troponin)
C. Cardiac monitoring
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
3
STATEMENT. ALL RIGHTS RESERVED
, D. Chest radiograph - 🧠ANSWER ✔✔B. Cardiac marker evaluation (CK or
Troponin)
Not all trauma pts with blunt cardiac injury will have acute alterations in cardiac
markers, and other organ injury may cause release of creatinine kinase and
confound the diagnosis of blunt cardiac injury
4. Which of the following is a form of distributive shock?:
A. Neurogenic
B. Metabolic
C. Respiratory
D. Obstructive - 🧠ANSWER ✔✔A. Neurogenic
5. A pt presents following an acute onset of chest pain, dyspnea and severe
diaphoresis, with near syncope. Assessment shows a pt in severe distress, with HR
110, BP 60/40 and RR 36 with bilateral rales. An EKG reveals ST segment
elevation across the precordial leads. A diagnosis of acute MI with cardiogenic
shock is made, and the pt is being prepared for transfer to the cardiac cath lab. The
vasopressor of choice, based on this pts degree of hypotension is:
