CEN Exam chapter 002 Test Bank practice Questions &
Answers 2023/2024 VERIFIED
Which dysrhythmia would be identified on an ECG/EKG six-second strip by a heart rate of 76 and a PR
interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm correct answers B: First-degree atrioventricular block is diagnosed partially
by an EKG showing a PR interval of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would need to be used as part of the
clinical picture with diagnosing and treating abdominal pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74 correct answers C: An elevated WBC count would be indicative of infection or
inflammation. The WBC count of 5.0 is normal. The HCT and BS levels listed would also be considered
within normal limits.
A 30-year-old man comes to the emergency department with the acute onset of left flank pain radiating
to the groin. Microscopic hematuria is present on urinalysis. What is the most likely diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis correct answers A: Ureteral calculi are a quite common cause of acute emergency evaluation,
usually causing flank pain with radiation to the back and/or groin. About 75% of these are calcium
oxalate or phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or ultrasound
may show the stone, helical CT is now the preferred diagnostic method. Additional workup includes CBC,
chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical analysis. Nursing
attention should be directed to intravenous hydration with input and output recording and narcotic or
narcotic plus NSAID (e.g., ketorolac) administration for pain. Some patients may be discharged with
analgesics and instructions for hydration and calculus capture. Testicular torsion is most common in
adolescents and usually presents with testicular and groin pain with abdominal radiation; increasing pain
by lifting the scrotum to the level of the pubic symphysis causes exacerbation of the pain (Prehn sign).
Cystitis may be infectious or drug-induced, but cystitis usually causes dysuria and pyuria and shows
positive urine cultures.
Which of the following is NOT appropriate for screening for domestic violence by the emergency
department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so, by
whom
b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the emergency department for a
medical ailment, not trauma
, d.asking if there is a partner from a previous relationship that makes the individual feel unsafe correct
answers C: Domestic violence, nearly always perpetrated against women, is a major problem confronted
by the emergency nurse. Screening for possible cases should include answers A, B and D. Interestingly,
victims of intimate partner violence often present with a medical ailment, not trauma. These include
back, abdominal, or pelvic pain, headaches, urinary infections, sexually transmitted disease, or
symptoms consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of old trauma such
as healing fractures or cosmetically concealed bruises may point toward the presence of domestic
violence. Many victims will deny it but sometimes compassionate questioning in a private setting will
elicit a positive response. The nurse may then offer advice, refer to a social agency or shelter, or ask for a
consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator alarm rings and the airway pressure
is found to be elevated. Possible causes include the following EXCEPT:
a.endotracheal tube obstruction with sputum
b.pneumothorax
c.bronchospasm
d.cuff leak correct answers D: Mechanical ventilation requires diligent observation of the patient and
ventilator by the emergency nurse. Modern ventilators usually come with alarms that indicate high or
low airway pressure. High pressure may be caused by endotracheal tube obstruction with sputum or
kinks or inadvertent endobronchial displacement. The airway should be suctioned and tube placement
checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse, worsening of the
underlying disease, and bronchospasm are also causes of elevated pressure. Leaks around the
endotracheal tube cuffs will cause low airway pressure. Auto-positive end-expiratory pressure (auto-
PEEP) is caused by premature inspiratory delivery before full expiration (as in asthma or COPD patients)
and may lead to increased pressure and lung damage.
A 2-year-old is brought to the emergency department with mild fever, persistent restlessness, crying, and
pulling his left ear. He has had a cold for about a week. Examination of the ear reveals a distorted light
reflex and slight bulging of the tympanic membrane. What is the proper diagnosis and treatment?
a.otitis externa and antibiotics
b.otitis media and antibiotics
c.otitis media and myringotomy
d.acute labyrinthitis and antivertigo drug correct answers B: Ear infections may cause severe and
persistent pain, especially in children in the 6-month to 3-year age group and are a frequent cause of
emergency department visits. Loss or distortion of the light reflex and bulging of the tympanic
membrane are cardinal signs of otitis media, usually caused by bacteria such as Streptococcus Influenza
or Haemophilus Influenza. Sinusitis and purulent rhinitis may accompany the otitis. Antibiotics to cover
these organisms, topical warmed otic analgesics, and antipyretics are the usual treatment modalities.
Otitis externa or swimmer's ear also causes otalgia and frequently follows swimming in contaminated
water or a foreign body in the ear. Keeping the ear dry and using otic analgesics and antibiotics are
indicated. Ear plugs while swimming or ear drying agents after swimming or showering are the usual
preventive measures. Myringotomy is a surgical procedure to keep the middle ear draining in chronic
otitis media and hopefully prevent such complications as mastoiditis, meningitis, ruptured tympanic
membrane, or permanent hearing loss. Labyrinthitis is an infection of the inner ear and usually causes
severe vertigo, most commonly in adults.
A 75-year-old man has a history of several episodes of transient right-sided arm and hand weakness
lasting an hour or two but with full recovery. He is diabetic and hypertensive and is taking medication for
Answers 2023/2024 VERIFIED
Which dysrhythmia would be identified on an ECG/EKG six-second strip by a heart rate of 76 and a PR
interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm correct answers B: First-degree atrioventricular block is diagnosed partially
by an EKG showing a PR interval of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would need to be used as part of the
clinical picture with diagnosing and treating abdominal pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74 correct answers C: An elevated WBC count would be indicative of infection or
inflammation. The WBC count of 5.0 is normal. The HCT and BS levels listed would also be considered
within normal limits.
A 30-year-old man comes to the emergency department with the acute onset of left flank pain radiating
to the groin. Microscopic hematuria is present on urinalysis. What is the most likely diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis correct answers A: Ureteral calculi are a quite common cause of acute emergency evaluation,
usually causing flank pain with radiation to the back and/or groin. About 75% of these are calcium
oxalate or phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or ultrasound
may show the stone, helical CT is now the preferred diagnostic method. Additional workup includes CBC,
chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical analysis. Nursing
attention should be directed to intravenous hydration with input and output recording and narcotic or
narcotic plus NSAID (e.g., ketorolac) administration for pain. Some patients may be discharged with
analgesics and instructions for hydration and calculus capture. Testicular torsion is most common in
adolescents and usually presents with testicular and groin pain with abdominal radiation; increasing pain
by lifting the scrotum to the level of the pubic symphysis causes exacerbation of the pain (Prehn sign).
Cystitis may be infectious or drug-induced, but cystitis usually causes dysuria and pyuria and shows
positive urine cultures.
Which of the following is NOT appropriate for screening for domestic violence by the emergency
department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so, by
whom
b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the emergency department for a
medical ailment, not trauma
, d.asking if there is a partner from a previous relationship that makes the individual feel unsafe correct
answers C: Domestic violence, nearly always perpetrated against women, is a major problem confronted
by the emergency nurse. Screening for possible cases should include answers A, B and D. Interestingly,
victims of intimate partner violence often present with a medical ailment, not trauma. These include
back, abdominal, or pelvic pain, headaches, urinary infections, sexually transmitted disease, or
symptoms consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of old trauma such
as healing fractures or cosmetically concealed bruises may point toward the presence of domestic
violence. Many victims will deny it but sometimes compassionate questioning in a private setting will
elicit a positive response. The nurse may then offer advice, refer to a social agency or shelter, or ask for a
consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator alarm rings and the airway pressure
is found to be elevated. Possible causes include the following EXCEPT:
a.endotracheal tube obstruction with sputum
b.pneumothorax
c.bronchospasm
d.cuff leak correct answers D: Mechanical ventilation requires diligent observation of the patient and
ventilator by the emergency nurse. Modern ventilators usually come with alarms that indicate high or
low airway pressure. High pressure may be caused by endotracheal tube obstruction with sputum or
kinks or inadvertent endobronchial displacement. The airway should be suctioned and tube placement
checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse, worsening of the
underlying disease, and bronchospasm are also causes of elevated pressure. Leaks around the
endotracheal tube cuffs will cause low airway pressure. Auto-positive end-expiratory pressure (auto-
PEEP) is caused by premature inspiratory delivery before full expiration (as in asthma or COPD patients)
and may lead to increased pressure and lung damage.
A 2-year-old is brought to the emergency department with mild fever, persistent restlessness, crying, and
pulling his left ear. He has had a cold for about a week. Examination of the ear reveals a distorted light
reflex and slight bulging of the tympanic membrane. What is the proper diagnosis and treatment?
a.otitis externa and antibiotics
b.otitis media and antibiotics
c.otitis media and myringotomy
d.acute labyrinthitis and antivertigo drug correct answers B: Ear infections may cause severe and
persistent pain, especially in children in the 6-month to 3-year age group and are a frequent cause of
emergency department visits. Loss or distortion of the light reflex and bulging of the tympanic
membrane are cardinal signs of otitis media, usually caused by bacteria such as Streptococcus Influenza
or Haemophilus Influenza. Sinusitis and purulent rhinitis may accompany the otitis. Antibiotics to cover
these organisms, topical warmed otic analgesics, and antipyretics are the usual treatment modalities.
Otitis externa or swimmer's ear also causes otalgia and frequently follows swimming in contaminated
water or a foreign body in the ear. Keeping the ear dry and using otic analgesics and antibiotics are
indicated. Ear plugs while swimming or ear drying agents after swimming or showering are the usual
preventive measures. Myringotomy is a surgical procedure to keep the middle ear draining in chronic
otitis media and hopefully prevent such complications as mastoiditis, meningitis, ruptured tympanic
membrane, or permanent hearing loss. Labyrinthitis is an infection of the inner ear and usually causes
severe vertigo, most commonly in adults.
A 75-year-old man has a history of several episodes of transient right-sided arm and hand weakness
lasting an hour or two but with full recovery. He is diabetic and hypertensive and is taking medication for
