Certified Emergency Nurse Practitioner (ENP)
Practice Exam Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 45-year-old male presents with crushing chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, and aVF. The
most likely diagnosis is:
A. Unstable angina
B. Inferior STEMI
C. Pulmonary embolism
D. Pericarditis
Rationale: ST elevation in leads II, III, and aVF corresponds to the
inferior wall of the heart, typically supplied by the right coronary
artery.
2. Which of the following is the first-line treatment for anaphylaxis
in the emergency setting?
A. Antihistamines
B. Corticosteroids
C. Epinephrine IM
D. Oxygen
Rationale: Epinephrine administered intramuscularly is the first-line
therapy for anaphylaxis; it acts quickly to reverse airway obstruction
and hypotension.
,3. A patient presents with sudden onset dyspnea, pleuritic chest
pain, and hemoptysis. Which condition should be immediately
suspected?
A. Pneumothorax
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumonia
Rationale: The classic triad of dyspnea, pleuritic chest pain, and
hemoptysis suggests pulmonary embolism, especially in patients with
risk factors like immobility.
4. Which of the following is the antidote for acetaminophen
overdose?
A. N-acetylcysteine
B. Naloxone
C. N-acetylcysteine
D. Flumazenil
Rationale: N-acetylcysteine replenishes glutathione and prevents
hepatotoxicity from acetaminophen overdose.
5. The initial management of a patient with suspected tension
pneumothorax includes:
A. Oxygen supplementation
B. Needle decompression
C. Chest tube placement after imaging
D. Immediate needle decompression
Rationale: Tension pneumothorax is a life-threatening emergency;
immediate needle decompression relieves intrathoracic pressure
before definitive chest tube placement.
,6. A patient with sepsis presents with hypotension unresponsive to
fluids. What is the next step?
A. Start antibiotics
B. Begin vasopressors (e.g., norepinephrine)
C. Intubate immediately
D. Order echocardiogram
Rationale: In septic shock with persistent hypotension despite fluids,
vasopressors are indicated to maintain organ perfusion.
7. A 60-year-old female presents with sudden severe headache,
nausea, and neck stiffness. CT scan is negative. What is the next
recommended test?
A. MRI
B. Lumbar puncture
C. EEG
D. Carotid ultrasound
Rationale: A negative CT does not rule out subarachnoid hemorrhage;
lumbar puncture is indicated to detect xanthochromia.
8. Which cardiac rhythm is most commonly associated with sudden
cardiac arrest in adults?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Rationale: Ventricular fibrillation is the most common initial rhythm in
sudden cardiac arrest and is shockable.
, 9. In acute stroke management, which medication should be
administered within 3–4.5 hours of symptom onset in eligible
patients?
A. Aspirin
B. tPA (alteplase)
C. Heparin
D. Clopidogrel
Rationale: Intravenous tissue plasminogen activator (tPA) is indicated
for ischemic stroke within the 3–4.5 hour window to restore cerebral
perfusion.
10. Which of the following is a classic finding in pericarditis?
A. ST depression in all leads
B. Widespread ST elevation with PR depression
C. Right bundle branch block
D. Q waves in inferior leads
Rationale: Acute pericarditis often presents with diffuse ST elevation
and PR depression on ECG.
11. Which of the following is the most sensitive test for detecting
acute myocardial infarction?
A. CK-MB
B. Troponin I or T
C. Myoglobin
D. ECG alone
Rationale: Troponins are highly specific and sensitive for myocardial
injury and remain elevated longer than CK-MB.
Practice Exam Questions And Correct
Answers (Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A 45-year-old male presents with crushing chest pain radiating to
the left arm. ECG shows ST elevation in leads II, III, and aVF. The
most likely diagnosis is:
A. Unstable angina
B. Inferior STEMI
C. Pulmonary embolism
D. Pericarditis
Rationale: ST elevation in leads II, III, and aVF corresponds to the
inferior wall of the heart, typically supplied by the right coronary
artery.
2. Which of the following is the first-line treatment for anaphylaxis
in the emergency setting?
A. Antihistamines
B. Corticosteroids
C. Epinephrine IM
D. Oxygen
Rationale: Epinephrine administered intramuscularly is the first-line
therapy for anaphylaxis; it acts quickly to reverse airway obstruction
and hypotension.
,3. A patient presents with sudden onset dyspnea, pleuritic chest
pain, and hemoptysis. Which condition should be immediately
suspected?
A. Pneumothorax
B. Pulmonary embolism
C. Myocardial infarction
D. Pneumonia
Rationale: The classic triad of dyspnea, pleuritic chest pain, and
hemoptysis suggests pulmonary embolism, especially in patients with
risk factors like immobility.
4. Which of the following is the antidote for acetaminophen
overdose?
A. N-acetylcysteine
B. Naloxone
C. N-acetylcysteine
D. Flumazenil
Rationale: N-acetylcysteine replenishes glutathione and prevents
hepatotoxicity from acetaminophen overdose.
5. The initial management of a patient with suspected tension
pneumothorax includes:
A. Oxygen supplementation
B. Needle decompression
C. Chest tube placement after imaging
D. Immediate needle decompression
Rationale: Tension pneumothorax is a life-threatening emergency;
immediate needle decompression relieves intrathoracic pressure
before definitive chest tube placement.
,6. A patient with sepsis presents with hypotension unresponsive to
fluids. What is the next step?
A. Start antibiotics
B. Begin vasopressors (e.g., norepinephrine)
C. Intubate immediately
D. Order echocardiogram
Rationale: In septic shock with persistent hypotension despite fluids,
vasopressors are indicated to maintain organ perfusion.
7. A 60-year-old female presents with sudden severe headache,
nausea, and neck stiffness. CT scan is negative. What is the next
recommended test?
A. MRI
B. Lumbar puncture
C. EEG
D. Carotid ultrasound
Rationale: A negative CT does not rule out subarachnoid hemorrhage;
lumbar puncture is indicated to detect xanthochromia.
8. Which cardiac rhythm is most commonly associated with sudden
cardiac arrest in adults?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
Rationale: Ventricular fibrillation is the most common initial rhythm in
sudden cardiac arrest and is shockable.
, 9. In acute stroke management, which medication should be
administered within 3–4.5 hours of symptom onset in eligible
patients?
A. Aspirin
B. tPA (alteplase)
C. Heparin
D. Clopidogrel
Rationale: Intravenous tissue plasminogen activator (tPA) is indicated
for ischemic stroke within the 3–4.5 hour window to restore cerebral
perfusion.
10. Which of the following is a classic finding in pericarditis?
A. ST depression in all leads
B. Widespread ST elevation with PR depression
C. Right bundle branch block
D. Q waves in inferior leads
Rationale: Acute pericarditis often presents with diffuse ST elevation
and PR depression on ECG.
11. Which of the following is the most sensitive test for detecting
acute myocardial infarction?
A. CK-MB
B. Troponin I or T
C. Myoglobin
D. ECG alone
Rationale: Troponins are highly specific and sensitive for myocardial
injury and remain elevated longer than CK-MB.
