,CEN Certification Exam 2026 | Comprehensive Test Bank | Questions
And Answers
TABLE OF CONTENTS
1. Cardiovascular Emergencies — Q1–Q24
2. Respiratory Emergencies — Q25–Q47
3. Neurological Emergencies — Q48–Q70
4. Gastrointestinal Emergencies — Q71–Q89
5. Genitourinary, Gynecology, and Obstetrical Emergencies — Q90–Q102
6. Mental Health Emergencies — Q103–Q119
7. Medical Emergencies — Q120–Q139
8. Musculoskeletal and Wound Emergencies — Q140–Q154
9. Head, Eye, Ear, Nose, Throat Emergencies — Q155–Q167
10. Environment and Toxicology Emergencies, and Communicable
Diseases — Q168–Q184
11. Professional Issues — Q185–Q200
1. CARDIOVASCULAR EMERGENCIES
Q1. A patient presents with crushing substernal chest pain,
diaphoresis, and nausea. Which assessment finding requires the
most immediate attention?
A) Heart rate 104/min
B) Blood pressure 86/52 mm Hg
C) Mild anxiety
D) Pain rated 7/10
Correct Answer: B) Blood pressure 86/52 mm Hg
Rationale: Hypotension in a patient with suspected acute coronary
syndrome may indicate impaired cardiac output or cardiogenic shock.
Circulatory instability requires immediate assessment and intervention while
ischemia is being evaluated.
,Q2. Which ECG finding is most concerning for an acute ST-elevation
myocardial infarction?
A) ST-segment elevation in contiguous leads
B) Sinus bradycardia
C) First-degree AV block
D) Isolated premature atrial contractions
Correct Answer: A) ST-segment elevation in contiguous leads
Rationale: ST-segment elevation in anatomically related leads can indicate
acute myocardial injury from coronary occlusion and requires rapid
evaluation for reperfusion therapy.
Q3. A patient develops sudden tearing chest pain radiating to the
back with unequal radial pulses. Which condition should the nurse
suspect?
A) Pericarditis
B) Aortic dissection
C) Stable angina
D) Pulmonary edema
Correct Answer: B) Aortic dissection
Rationale: Abrupt tearing chest or back pain with pulse asymmetry is highly
concerning for aortic dissection. Extension of the dissection can compromise
major arterial branches and cause severe complications.
Q4. A patient with ventricular tachycardia has a pulse, BP 72/40 mm
Hg, and altered mental status. Which treatment should the nurse
anticipate?
A) Synchronized cardioversion
B) Oral antiarrhythmic therapy
C) Vagal maneuvers
D) Observation
Correct Answer: A) Synchronized cardioversion
Rationale: Ventricular tachycardia causing hypotension and altered mental
status is hemodynamically unstable. Synchronized cardioversion is used to
rapidly restore a perfusing rhythm when a pulse is present.
Q5. A patient is pulseless and has ventricular fibrillation on the
monitor. What is the priority intervention?
, A) Synchronized cardioversion
B) Defibrillation with CPR
C) Atropine administration
D) Vagal stimulation
Correct Answer: B) Defibrillation with CPR
Rationale: Ventricular fibrillation is a pulseless shockable rhythm.
Immediate defibrillation combined with high-quality CPR is required to
restore organized cardiac activity and circulation.
Q6. Which finding is most consistent with cardiac tamponade?
A) Hypertension, bradycardia, and bounding pulses
B) Hypotension, jugular venous distention, and muffled heart sounds
C) Pulmonary edema with severe hypertension
D) Increased pulse pressure and warm skin
Correct Answer: B) Hypotension, jugular venous distention, and muffled heart
sounds
Rationale: Cardiac tamponade restricts ventricular filling. The resulting
reduction in cardiac output can produce hypotension, while venous pressure
rises and heart sounds become muffled.
Q7. A patient with acute heart failure develops severe dyspnea,
diffuse crackles, and pink frothy sputum. Which intervention is the
priority?
A) Place the patient flat
B) Encourage oral fluids
C) Position the patient upright and support oxygenation
D) Encourage ambulation
Correct Answer: C) Position the patient upright and support oxygenation
Rationale: Pulmonary edema severely impairs gas exchange. Upright
positioning improves lung expansion and reduces venous return, while
oxygen supports oxygenation.
Q8. Which finding most strongly suggests cardiogenic shock?
A) Warm skin with wide pulse pressure
B) Hypotension with cool clammy skin and oliguria
C) Hypertension with increased urine output
D) Bradycardia with flushed skin
And Answers
TABLE OF CONTENTS
1. Cardiovascular Emergencies — Q1–Q24
2. Respiratory Emergencies — Q25–Q47
3. Neurological Emergencies — Q48–Q70
4. Gastrointestinal Emergencies — Q71–Q89
5. Genitourinary, Gynecology, and Obstetrical Emergencies — Q90–Q102
6. Mental Health Emergencies — Q103–Q119
7. Medical Emergencies — Q120–Q139
8. Musculoskeletal and Wound Emergencies — Q140–Q154
9. Head, Eye, Ear, Nose, Throat Emergencies — Q155–Q167
10. Environment and Toxicology Emergencies, and Communicable
Diseases — Q168–Q184
11. Professional Issues — Q185–Q200
1. CARDIOVASCULAR EMERGENCIES
Q1. A patient presents with crushing substernal chest pain,
diaphoresis, and nausea. Which assessment finding requires the
most immediate attention?
A) Heart rate 104/min
B) Blood pressure 86/52 mm Hg
C) Mild anxiety
D) Pain rated 7/10
Correct Answer: B) Blood pressure 86/52 mm Hg
Rationale: Hypotension in a patient with suspected acute coronary
syndrome may indicate impaired cardiac output or cardiogenic shock.
Circulatory instability requires immediate assessment and intervention while
ischemia is being evaluated.
,Q2. Which ECG finding is most concerning for an acute ST-elevation
myocardial infarction?
A) ST-segment elevation in contiguous leads
B) Sinus bradycardia
C) First-degree AV block
D) Isolated premature atrial contractions
Correct Answer: A) ST-segment elevation in contiguous leads
Rationale: ST-segment elevation in anatomically related leads can indicate
acute myocardial injury from coronary occlusion and requires rapid
evaluation for reperfusion therapy.
Q3. A patient develops sudden tearing chest pain radiating to the
back with unequal radial pulses. Which condition should the nurse
suspect?
A) Pericarditis
B) Aortic dissection
C) Stable angina
D) Pulmonary edema
Correct Answer: B) Aortic dissection
Rationale: Abrupt tearing chest or back pain with pulse asymmetry is highly
concerning for aortic dissection. Extension of the dissection can compromise
major arterial branches and cause severe complications.
Q4. A patient with ventricular tachycardia has a pulse, BP 72/40 mm
Hg, and altered mental status. Which treatment should the nurse
anticipate?
A) Synchronized cardioversion
B) Oral antiarrhythmic therapy
C) Vagal maneuvers
D) Observation
Correct Answer: A) Synchronized cardioversion
Rationale: Ventricular tachycardia causing hypotension and altered mental
status is hemodynamically unstable. Synchronized cardioversion is used to
rapidly restore a perfusing rhythm when a pulse is present.
Q5. A patient is pulseless and has ventricular fibrillation on the
monitor. What is the priority intervention?
, A) Synchronized cardioversion
B) Defibrillation with CPR
C) Atropine administration
D) Vagal stimulation
Correct Answer: B) Defibrillation with CPR
Rationale: Ventricular fibrillation is a pulseless shockable rhythm.
Immediate defibrillation combined with high-quality CPR is required to
restore organized cardiac activity and circulation.
Q6. Which finding is most consistent with cardiac tamponade?
A) Hypertension, bradycardia, and bounding pulses
B) Hypotension, jugular venous distention, and muffled heart sounds
C) Pulmonary edema with severe hypertension
D) Increased pulse pressure and warm skin
Correct Answer: B) Hypotension, jugular venous distention, and muffled heart
sounds
Rationale: Cardiac tamponade restricts ventricular filling. The resulting
reduction in cardiac output can produce hypotension, while venous pressure
rises and heart sounds become muffled.
Q7. A patient with acute heart failure develops severe dyspnea,
diffuse crackles, and pink frothy sputum. Which intervention is the
priority?
A) Place the patient flat
B) Encourage oral fluids
C) Position the patient upright and support oxygenation
D) Encourage ambulation
Correct Answer: C) Position the patient upright and support oxygenation
Rationale: Pulmonary edema severely impairs gas exchange. Upright
positioning improves lung expansion and reduces venous return, while
oxygen supports oxygenation.
Q8. Which finding most strongly suggests cardiogenic shock?
A) Warm skin with wide pulse pressure
B) Hypotension with cool clammy skin and oliguria
C) Hypertension with increased urine output
D) Bradycardia with flushed skin
