Page 1 of 230
Certified Emergency Nurse (CEN) Exam A&B 2026-
2027 COMPLETE 500 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
Certified Emergency Nurse (CEN) Exam A
QUESTION: A 19 year old patient presents with complaints of a new-onset fluttering in the
chest that started approximately 60 mins ealier. The pt is alert and answering questions
appropriately. The skin is dry and pink. The BP is 102/74 O2 is 95%, HR 160 bpm, RR 18. You
note SVT on the telemetry monitor. Initial treatment for this would be:
1. Vagal maneuver
2. Sync Cardiovert
3. IV metoprolol
4. O2 - ANSWER-1. Vagal maneuver
These are always first line, IV meds second only with stable narrow tachycardias, yeah o2 is
helpful but not our priority.
,Page 2 of 230
QUESTION: Which of the following tools will be most useful to differentiate a hypertensive
urgency from a hypertensive emergency?
1. Glucometer
2. Tongue Blade
3. Electrocardiogram
4. BP cuff - ANSWER-3. Electrocardiogram
Both types of hypertension are above 180/120, however, EKG changes can only be seen in
hypertensive Emergency.
QUESTION: A patient presents in acute Left-sided Heart Failure and the ER RN allows the pt to
tripod over a bedside table with the legs dangling on the side of the bed. The position will have
similar effects to which of the following medications?
1. Dopamine
2. Metoprolol
,Page 3 of 230
3. Dobutamine
4. Nitroglycerin - ANSWER-4. Nitroglycerin
Nitro decreases the amount of blood in the heart through coronary and peripheral vasodilation.
Dopamine is a vasoconstrictor...
QUESTION: A pt presents with Chest pain consistent with MI. JVD noted during assessment.
Which of the following changes would be anticipated on the EKG?
1. Tall R waves in leads V1 and V2
2. ST elevation in leads V3 and V4
3. ST depression in leads V5, V6, I, and aVL
4. Elongated PR interval in leads II, II and aVF. - ANSWER-1. Tall R waves in leads V1 and V2
JVD= decreased R ventricle=backup in systemic circulation=post MI.
Elevation in leads 3-4=anterior MI (L sided)
, Page 4 of 230
Depression in leads 5,6,aVL= lateral MI=L ventricular failure.
Elongated PR= heart block.
QUESTION: A pt presents to the ED shortly after sustaining an isolated blunt cardiac injury.
Which of the following symptoms is most likely to be noted in this patient?
1. An irregular pulse
2. A systolic murmur
3. Crackles to auscultation
4. Non-radiating chest pain - ANSWER-4. Non-radiating chest pain
CP isolated to the site of injury is the first sx of blunt cardiac injury. Irregular pulses and crackles
to auscultation show up after time. Systolic murmurs are not typical of blunt cardiac injury.
Q;A patient presents to the ED in the manic phase of a bipolar affective disorder. Which of the
following statements made by the ER Nurse, is most therapeutic for a patient with this
diagnosis?
Certified Emergency Nurse (CEN) Exam A&B 2026-
2027 COMPLETE 500 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
Certified Emergency Nurse (CEN) Exam A
QUESTION: A 19 year old patient presents with complaints of a new-onset fluttering in the
chest that started approximately 60 mins ealier. The pt is alert and answering questions
appropriately. The skin is dry and pink. The BP is 102/74 O2 is 95%, HR 160 bpm, RR 18. You
note SVT on the telemetry monitor. Initial treatment for this would be:
1. Vagal maneuver
2. Sync Cardiovert
3. IV metoprolol
4. O2 - ANSWER-1. Vagal maneuver
These are always first line, IV meds second only with stable narrow tachycardias, yeah o2 is
helpful but not our priority.
,Page 2 of 230
QUESTION: Which of the following tools will be most useful to differentiate a hypertensive
urgency from a hypertensive emergency?
1. Glucometer
2. Tongue Blade
3. Electrocardiogram
4. BP cuff - ANSWER-3. Electrocardiogram
Both types of hypertension are above 180/120, however, EKG changes can only be seen in
hypertensive Emergency.
QUESTION: A patient presents in acute Left-sided Heart Failure and the ER RN allows the pt to
tripod over a bedside table with the legs dangling on the side of the bed. The position will have
similar effects to which of the following medications?
1. Dopamine
2. Metoprolol
,Page 3 of 230
3. Dobutamine
4. Nitroglycerin - ANSWER-4. Nitroglycerin
Nitro decreases the amount of blood in the heart through coronary and peripheral vasodilation.
Dopamine is a vasoconstrictor...
QUESTION: A pt presents with Chest pain consistent with MI. JVD noted during assessment.
Which of the following changes would be anticipated on the EKG?
1. Tall R waves in leads V1 and V2
2. ST elevation in leads V3 and V4
3. ST depression in leads V5, V6, I, and aVL
4. Elongated PR interval in leads II, II and aVF. - ANSWER-1. Tall R waves in leads V1 and V2
JVD= decreased R ventricle=backup in systemic circulation=post MI.
Elevation in leads 3-4=anterior MI (L sided)
, Page 4 of 230
Depression in leads 5,6,aVL= lateral MI=L ventricular failure.
Elongated PR= heart block.
QUESTION: A pt presents to the ED shortly after sustaining an isolated blunt cardiac injury.
Which of the following symptoms is most likely to be noted in this patient?
1. An irregular pulse
2. A systolic murmur
3. Crackles to auscultation
4. Non-radiating chest pain - ANSWER-4. Non-radiating chest pain
CP isolated to the site of injury is the first sx of blunt cardiac injury. Irregular pulses and crackles
to auscultation show up after time. Systolic murmurs are not typical of blunt cardiac injury.
Q;A patient presents to the ED in the manic phase of a bipolar affective disorder. Which of the
following statements made by the ER Nurse, is most therapeutic for a patient with this
diagnosis?
