CEN Practice Exam Questions with Answers

The emergency nurse is participating in the care of an obtunded patient presumed to have taken an overdose of a tricyclic antidepressant. patient has a palpable pulse, and an electrocardiogram (ECG) is obtained. nurse would anticipate the presence of which ECG finding? A. Sinus bradycardia with normal QRS and QT intervals B. Ventricular fibrillation C. Narrow complex supraventricular tachycardia D. Sinus tachycardia with both a widened QRS interval and prolonged QT interval D. Sinus tachycardia occurs frequently from the anticholinergic effects of tricyclic antidepressant toxicity. QRS complex widening occurs as a result of sodium channel blockade, and this delayed conduction may be seen more commonly involving the right side of the heart, manifesting as a right bundle branch block. In addition, QT interval prolongation can occur with these agents. During triage, the patient states the pacemaker only fires when the patient's heart rate slows below a certain number of beats/minute. The nurse anticipates that the patient has a(n): A. asynchronous pacemaker. B. demand pacemaker. C. dual-chamber pacemaker. D. fixed-rate pacemaker. B. A demand pacemaker has the capability to sense the patient's intrinsic heart rhythm and only delivers an impulse to "fire" when the patient's intrinsic heart rate falls below a given rate. A patient presents to the emergency department with chest pain and diaphoresis, and denies dyspnea. Vital signs are BP 148/70 mm Hg, HR 72 beats/minute, RR 18 breaths/minute, Sp02 98% on room air. Breath sounds are clear and equal. rlhe electrocardiogram shows an inferior wall ST segment elevation. You anticipate the following oxygen order. A. No supplemental oxygen at this time B. Nasal cannula at 6 L per minute C. Partial rebreather mask at 10 L per minute D. Nonrebreather mask at 15 L per minute A. The use of supplemental oxygen in normoxic patients has not been established. In patients with potential coronary artery syndrome, withholding of additional supplemental oxygen should be considered for those in the prehospital or in-patient hospital setting and the emergency department. A patient complains of chest pain, dyspnea, and diaphoresis. Which of the following assessment factors would indicate a possible diagnosis of acute coronary syndrome? A. Pleuritic chest pain B. Positional chest pain C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in the left shoulder D. Pain reproducible with chest wall palpation C. Chest pain that radiates to both shoulders has a likelihood ratio of 7.1, and pain that radiates to the right shoulder has a stronger likelihood ratio of 2.9 of predicting acute Coronary syndrome compared with pain that radiates only to the left shoulder.