CEN Study Guide – Certified Emergency Nurse Exam Review

A comprehensive study guide for the Certified Emergency Nurse (CEN) exam, featuring actual exam questions with correct detailed answers and rationales. Covers all major emergency nursing content areas including cardiovascular emergencies (acute coronary syndromes including inferior wall MI, RV MI contraindications such as morphine and nitroglycerin, Prinzmetal's angina, pericarditis with friction rub, cardiac tamponade with Beck's triad and pulsus paradoxus, aortic dissection with tearing pain and BP differential, dysrhythmias including WPW with delta wave, first-degree AV block, and digoxin toxicity), respiratory emergencies (asthma, COPD exacerbation, epiglottitis, croup/LTB with steeple sign, pertussis with paroxysmal cough, bronchiolitis, pulmonary embolism, fat embolism syndrome with petechial rash post long bone fracture, flail chest with paradoxical movement, tension pneumothorax, hemothorax, pleural effusion as complication of pancreatitis), neurological emergencies (stroke/TIA, increased ICP with widened pulse pressure, subdural hematoma in elderly/alcoholics, epidural hematoma with lucid interval, Brown-Séquard syndrome with ipsilateral motor and contralateral sensory loss, Guillain-Barré syndrome with ascending paralysis, Wernicke's encephalopathy with ataxia/nystagmus/confusion, autonomic dysreflexia, status epilepticus), gastrointestinal emergencies (cholecystitis with Murphy's sign, appendicitis with McBurney's point and Rovsing's sign, pancreatitis with elevated amylase/lipase, diverticulitis with LLQ pain and alternating diarrhea/constipation, pyloric stenosis with non-bilious projectile vomiting in infants, esophagitis, Mallory-Weiss syndrome), genitourinary and reproductive emergencies (ectopic pregnancy, placenta previa with painless bleeding, abruptio placentae, testicular torsion, priapism causes including sickle cell, spinal cord injury, trazodone), obstetric emergencies (eclampsia, magnesium sulfate monitoring for respiratory depression, postpartum hemorrhage), renal and metabolic emergencies (rhabdomyolysis with reddish-brown urine, compartment syndrome with pain out of proportion, DIC with elevated fibrin split products, SIADH with hyponatremia post head trauma, Addisonian crisis with hypotension, thyroid storm with decreased TSH, gouty arthritis with elevated uric acid), toxicological emergencies (cocaine toxicity with sympathomimetic effects including tachycardia, hypertension, mydriasis, paranoia; digoxin toxicity with visual halos; neuroleptic dystonic reaction including facial spasms, tongue protrusion, blepharospasm from Reglan or Phenergan; acetaminophen overdose, lithium toxicity), environmental emergencies (stringray envenomation with hot water immersion for pain relief, hypothermia, heat stroke), trauma and orthopedic emergencies (flail chest, compartment syndrome, crush injury, rhabdomyolysis, boxer's fracture of 5th metacarpal, lap belt injuries including duodenal rupture, pancreatic injury, Chance fracture; epidural hematoma from middle meningeal artery injury, subdural hematoma), shock states (distributive shock with decreased SVR, neurogenic shock with bradycardia and hypotension, beta-blockers masking early shock signs), psychiatric emergencies (suicidal ideation with priority on safe environment, anorexia nervosa with amenorrhea and brittle hair/nails, bulimia), infectious diseases (mumps with parotid swelling, pertussis, erythema infectiosum (fifth disease), candidiasis with cottage cheese discharge), ocular emergencies (central retinal artery occlusion with painless unilateral vision loss, retinal detachment with photopsia and floaters, hyphema, acute angle-closure glaucoma), disaster management (mitigation phase including hazard vulnerability assessment), and legal/ethical issues (implied consent for unresponsive patients, informed consent).