CEN Exam
A patient presents with vaginal bleeding and cramping. She tells the emergency
nurse, "I passed clots at home. I think I lost my baby." Pelvic examination reveals
that the cervical os is open. Which type of spontaneous abortion most likely
occurred?
A. Missed abortion
B. Septic abortion
C. Inevitable abortion
D. Threatened abortion
Answer: C
A 12-year-old male is brought to the emergency department by his mother with
complaints of difficulty breathing, swollen eyes and lips, and hives. The mother
states that the child had just finished eating a peanut butter cookie. Epinephrine was
administered. What is the next class of medications to be administered to the
patient?
A. Inhaled beta 2 agonist
B. Corticosteroid
C. Antihistamine
D. Anticholinergic
Answer: A
A 13-year-old presents to the emergency department. His parents state that he
passed out at home and had been vomiting and had diarrhea for the last few days.
He answers questions appropriately, although he complains of dizziness. His vital
signs on arrival: BP 70/40 mm Hg, HR 132 beats/min, RR 24 breaths/min, T 36.9 C
(98.4 F), and SpO2 97% without supplemental oxygen. A new graduate nurse
inserted an intravenous line and is about to begin a fluid bolus of D5W. What does
the preceptor explain to the new graduate nurse regarding fluid resuscitation?
A. Because of the electrolyte disturbances from vomiting and diarrhea, use D5.45%
sodium chloride.
B. Because the patient is likely in septic shock, the fluid resuscitation is done slowly.
,C. The appropriate fluid for hypotension is isotonic crystalloid, not D5W
D. As a pediatric patient, D5W fluid is given at a bolus rate of 20 mL/kg.
Answer: C
A 15-year-old female presents to the emergency department with crampy left lower
quadrant abdominal pain that lasted for 4 hours prior to arrival. She also is having
frequent, severe, bloody diarrhea. What gastrointestinal disorder is she most likely
experiencing?
A. Ulcerative colitis
B. Diverticulitis
C. Crohn's disease
D. Appendicitis
Answer: A
A 16-year-old male is brought to the ED by his coach. The patient was playing
football in moderately cold weather one hour prior to arrival and felt severe pain in
the left groin area. This is suggestive of which genitourinary emergency?
A. Paraphimosis
B. Testicular torsion
C. Priapism
D. Acute epididymitis
Answer: B
A 16-year-old presents with severe left upper quadrant abdominal pain after an
over-the-handlebars bicycle collision. Vital signs are BP 100/60 mm Hg, HR 100
beats/min, RR 30 breaths/min, T 37.0 C (98.6 F), SpO2 89% without supplemental
oxygen. There is bruising over the left upper quadrant of the abdomen. Auscultation
reveals diminished breath sounds on the left accompanied by gurgling. Based on this
history and assessment, the nurse suspects which injury?
A. Small bowel rupture
B. Ruptured diaphragm
C. Flail chest
,D. Hepatic injury
Answer: B
A 20-year-old male presents with a sudden onset of pleuritic chest pain, mild
dyspnea, and a cough. Assessment reveals a tall, thin patient with tachycardia and
diminished breath sounds on the right side. What thoracic condition is the most likely
cause?
A. Spontaneous pneumothorax
B. Open pneumothorax
C. Tension pneumothorax
D. Hemothorax
Answer: A
A 21-year-old female presents to the ED with complaints of pelvic pain. What
possible cause of the pain is assessed for first?
A. Urinary tract infection
B. Ectopic pregnancy
C. Ruptured ovarian cyst
D. Kidney stones
Answer: B
A 22-year-old patient presents with upper respiratory symptoms, nausea and
vomiting and a low-grade fever. She has a history of leukemia and underwent
chemotherapy 2 weeks ago. What is the nurse's priority?
A. Protective isolation
B. Ondansetron oral dissolving tablet
C. Intravenous fluid bolus
D. Morphine intravenous
Answer: A
A 23-year-old patient with a stable ectopic pregnancy is being cared for by an
emergency nurse. The emergency physician ordered methotrexate to be
, administered intramuscularly. Which statement by the nurse indicates an
understanding of the medication?
A. I'll instruct the patient to follow up in two weeks.
B. I can give this medication because there is only scant vaginal bleeding.
C. I'll give this medication because there is fetal cardiac activity.
D. I can't administer this medication. I'm pregnant.
Answer: D
A 28-year-old female presents to the ED with complaints of dizziness, fear of dying,
and hot flashes that began 10 minutes prior to arrival. The patient is trembling and
tachypneic. Which anxiety disorder is the patient exhibiting?
A. Post-traumatic stress disorder
B. Panic attack
C. Acute stress disorder
D. Generalized anxiety disorder
Answer: B
A 28-year-old female presents with shortness of breath, dizziness, and diaphoresis.
Her vital signs are BP 118/74 mm Hg, HR 122 beats/min, RR 26 breaths/min, T 37.7
C (99.9 F), SpO2 92% without supplemental oxygen. Her health history includes
fractures of the left tibia and fibula following an MVC 3 weeks ago. Surgical fixation
was required. Her only current medications are an oral contraceptive and intermittent
ibuprofen for pain. Assessment of the casted left leg reveals that the toes are
swollen. With this information, which diagnostic testing will the nurse expect as the
highest priority?
A. Sputum cultures
B. Chest radiograph
C. Computed tomographic pulmonary angiography
D. Radiograph of the left leg
Answer: C
A 3-year-old boy is brought to the ED by his mother, who noticed bruises on the
boy's left thigh, back, and feet developing over the last week. Past medical history
A patient presents with vaginal bleeding and cramping. She tells the emergency
nurse, "I passed clots at home. I think I lost my baby." Pelvic examination reveals
that the cervical os is open. Which type of spontaneous abortion most likely
occurred?
A. Missed abortion
B. Septic abortion
C. Inevitable abortion
D. Threatened abortion
Answer: C
A 12-year-old male is brought to the emergency department by his mother with
complaints of difficulty breathing, swollen eyes and lips, and hives. The mother
states that the child had just finished eating a peanut butter cookie. Epinephrine was
administered. What is the next class of medications to be administered to the
patient?
A. Inhaled beta 2 agonist
B. Corticosteroid
C. Antihistamine
D. Anticholinergic
Answer: A
A 13-year-old presents to the emergency department. His parents state that he
passed out at home and had been vomiting and had diarrhea for the last few days.
He answers questions appropriately, although he complains of dizziness. His vital
signs on arrival: BP 70/40 mm Hg, HR 132 beats/min, RR 24 breaths/min, T 36.9 C
(98.4 F), and SpO2 97% without supplemental oxygen. A new graduate nurse
inserted an intravenous line and is about to begin a fluid bolus of D5W. What does
the preceptor explain to the new graduate nurse regarding fluid resuscitation?
A. Because of the electrolyte disturbances from vomiting and diarrhea, use D5.45%
sodium chloride.
B. Because the patient is likely in septic shock, the fluid resuscitation is done slowly.
,C. The appropriate fluid for hypotension is isotonic crystalloid, not D5W
D. As a pediatric patient, D5W fluid is given at a bolus rate of 20 mL/kg.
Answer: C
A 15-year-old female presents to the emergency department with crampy left lower
quadrant abdominal pain that lasted for 4 hours prior to arrival. She also is having
frequent, severe, bloody diarrhea. What gastrointestinal disorder is she most likely
experiencing?
A. Ulcerative colitis
B. Diverticulitis
C. Crohn's disease
D. Appendicitis
Answer: A
A 16-year-old male is brought to the ED by his coach. The patient was playing
football in moderately cold weather one hour prior to arrival and felt severe pain in
the left groin area. This is suggestive of which genitourinary emergency?
A. Paraphimosis
B. Testicular torsion
C. Priapism
D. Acute epididymitis
Answer: B
A 16-year-old presents with severe left upper quadrant abdominal pain after an
over-the-handlebars bicycle collision. Vital signs are BP 100/60 mm Hg, HR 100
beats/min, RR 30 breaths/min, T 37.0 C (98.6 F), SpO2 89% without supplemental
oxygen. There is bruising over the left upper quadrant of the abdomen. Auscultation
reveals diminished breath sounds on the left accompanied by gurgling. Based on this
history and assessment, the nurse suspects which injury?
A. Small bowel rupture
B. Ruptured diaphragm
C. Flail chest
,D. Hepatic injury
Answer: B
A 20-year-old male presents with a sudden onset of pleuritic chest pain, mild
dyspnea, and a cough. Assessment reveals a tall, thin patient with tachycardia and
diminished breath sounds on the right side. What thoracic condition is the most likely
cause?
A. Spontaneous pneumothorax
B. Open pneumothorax
C. Tension pneumothorax
D. Hemothorax
Answer: A
A 21-year-old female presents to the ED with complaints of pelvic pain. What
possible cause of the pain is assessed for first?
A. Urinary tract infection
B. Ectopic pregnancy
C. Ruptured ovarian cyst
D. Kidney stones
Answer: B
A 22-year-old patient presents with upper respiratory symptoms, nausea and
vomiting and a low-grade fever. She has a history of leukemia and underwent
chemotherapy 2 weeks ago. What is the nurse's priority?
A. Protective isolation
B. Ondansetron oral dissolving tablet
C. Intravenous fluid bolus
D. Morphine intravenous
Answer: A
A 23-year-old patient with a stable ectopic pregnancy is being cared for by an
emergency nurse. The emergency physician ordered methotrexate to be
, administered intramuscularly. Which statement by the nurse indicates an
understanding of the medication?
A. I'll instruct the patient to follow up in two weeks.
B. I can give this medication because there is only scant vaginal bleeding.
C. I'll give this medication because there is fetal cardiac activity.
D. I can't administer this medication. I'm pregnant.
Answer: D
A 28-year-old female presents to the ED with complaints of dizziness, fear of dying,
and hot flashes that began 10 minutes prior to arrival. The patient is trembling and
tachypneic. Which anxiety disorder is the patient exhibiting?
A. Post-traumatic stress disorder
B. Panic attack
C. Acute stress disorder
D. Generalized anxiety disorder
Answer: B
A 28-year-old female presents with shortness of breath, dizziness, and diaphoresis.
Her vital signs are BP 118/74 mm Hg, HR 122 beats/min, RR 26 breaths/min, T 37.7
C (99.9 F), SpO2 92% without supplemental oxygen. Her health history includes
fractures of the left tibia and fibula following an MVC 3 weeks ago. Surgical fixation
was required. Her only current medications are an oral contraceptive and intermittent
ibuprofen for pain. Assessment of the casted left leg reveals that the toes are
swollen. With this information, which diagnostic testing will the nurse expect as the
highest priority?
A. Sputum cultures
B. Chest radiograph
C. Computed tomographic pulmonary angiography
D. Radiograph of the left leg
Answer: C
A 3-year-old boy is brought to the ED by his mother, who noticed bruises on the
boy's left thigh, back, and feet developing over the last week. Past medical history
