CEN Exam – Certified Emergency Nurse Practice Question Bank

A comprehensive practice exam question bank for the Certified Emergency Nurse (CEN) certification, featuring actual exam questions with correct verified answers. Covers all major emergency nursing content areas including cardiovascular emergencies (acute coronary syndromes with ECG lead interpretation for inferior MI in II, III, aVF and anterior MI in V1-V4, right ventricular MI management avoiding preload reduction, aortic dissection with tearing chest pain and BP differential, pericarditis with friction rub, cardiac tamponade with Beck's triad of hypotension/JVD/muffled heart sounds, dysrhythmias including WPW with delta wave, heart blocks including second-degree type I (Wenckebach), atrial fibrillation, ventricular tachycardia/fibrillation, defibrillation and synchronized cardioversion), respiratory emergencies (asthma exacerbation with peak flow monitoring, COPD, pulmonary embolism with decreased PaO2 and decreased PaCO2, pneumonia, tension pneumothorax with hyperresonance, open pneumothorax with occlusive dressing after full exhalation, hemothorax, pulmonary contusion peaking at 6-12 hours post injury, pertussis with paroxysmal cough, croup/LTB with steeple sign, epiglottitis with drooling and tripod positioning, bronchiolitis, spontaneous pneumothorax risk factors including Marfan syndrome, carbon monoxide poisoning with cherry-red skin and ST depression, cyanide poisoning), neurological emergencies (stroke with aphasia in left hemisphere lesions, transient ischemic attack, status epilepticus treatment with benzodiazepines, increased intracranial pressure with Cushing's triad of widened pulse pressure/bradycardia/irregular breathing, subdural hematoma in elderly/alcoholics, epidural hematoma with lucid interval from middle meningeal artery injury, spinal cord injury syndromes including Brown-Séquard with ipsilateral motor/contralateral sensory loss, central cord syndrome with greater upper extremity motor loss, anterior cord syndrome, cauda equina syndrome with bowel/bladder dysfunction, Guillain-Barré syndrome with ascending paralysis and decreased deep tendon reflexes, myasthenia gravis with Tension test and atropine at bedside, Wernicke's encephalopathy, cluster headache with unilateral lacrimation/nasal congestion, migraine, temporal arteritis with palpable cord-like artery treated with steroids), gastrointestinal emergencies (cholecystitis with Murphy's sign at right costal margin, appendicitis with McBurney's point and Rovsing's sign, pancreatitis with pleural effusion complication, diverticulitis, bowel obstruction, intussusception in pediatrics treated with barium enema, cyclic vomiting syndrome in children age 3-7, cannabinoid hyperemesis syndrome treated with capsaicin), genitourinary and reproductive emergencies (ectopic pregnancy, placenta previa with painless bright red bleeding, abruptio placentae with painful dark bleeding and DIC risk, testicular torsion with sudden onset pain and Doppler showing decreased blood flow, prostatitis, ovarian cyst, priapism causes including sickle cell, spinal cord injury, trazodone), obstetrical emergencies (preeclampsia/eclampsia treated with magnesium sulfate monitoring respiratory rate, postpartum hemorrhage treated with manual uterine massage, shoulder dystocia, neonatal resuscitation with mouth then nose suctioning, heart rate 60 requiring compressions), endocrine emergencies (diabetic ketoacidosis with treatment until pH 7.30 and HCO3 18, Addisonian crisis with hypotension and hyperkalemia, thyroid storm with fever/tachycardia/CNS dysfunction, SIADH with dilutional hyponatremia and seizure risk, Cushing's syndrome with moon face/buffalo hump from chronic steroids), renal emergencies (hyperkalemia with peaked T waves treated with calcium gluconate as cardiac stabilizer, hypokalemia with respiratory muscle weakness, rhabdomyolysis with dark urine and elevated CK treated with aggressive IV fluids), hematologic emergencies (DIC with elevated fibrin split products/decreased platelets, hemophilia A/B, von Willebrand disease, sickle cell disease treated with hydroxyurea to increase fetal hemoglobin, fat embolism syndrome 24-72 hours post long bone fracture with petechial rash over chest/axillae), trauma and orthopedic emergencies (compartment syndrome with pain out of proportion to injury, crush injury, rhabdomyolysis, pelvic fracture with bladder/urethra injury treated with pelvic binder to tamponade bleeding and permissive hypotension, scaphoid fracture with anatomic snuffbox pain treated with thumb spica splint, boxer's fracture of 5th metacarpal, eye injuries including ruptured globe with rigid eye shield, hyphema, corneal abrasion not patched due to infection risk, chemical burn irrigation until pH 7.4, retinal detachment with photopsia/floaters, central retinal artery occlusion with painless unilateral vision loss, acute angle-closure glaucoma with tunnel vision/halos treated to reduce intraocular pressure to 18 mmHg), burn injuries (electrical burns risk of ventricular fibrillation, Parkland formula 4 mL/kg/%BSA with half in first 8 hours, ABA formula 2 mL/kg/%BSA, cement in eyes requiring copious irrigation), toxicological emergencies (acetaminophen overdose, salicylate toxicity with metabolic acidosis, ethylene glycol toxicity with metabolic acidosis and oxalate crystals, lithium toxicity, iron ingestion not treated with activated charcoal as it does not bind heavy metals, opioid overdose, sympathomimetic toxicity including cocaine, organophosphate poisoning treated with atropine/pralidoxime, cat bite Pasteurella infection), environmental emergencies (frostbite pain management, snake envenomation with DIC risk, heat exhaustion, high-altitude pulmonary edema, lightning injury, blast injuries with primary injury affecting air-filled organs causing tympanic membrane rupture and pneumothorax), infectious diseases (mumps with parotid swelling, measles with Koplik spots, pertussis, tuberculosis, mononucleosis with Monospot test, viral hemorrhagic fever including Ebola requiring isolation, Lyme disease with stage 2 facial palsy, rabies with HRIG 20 U/kg infiltrated in wound), shock states (hypovolemic shock with narrowed pulse pressure, neurogenic shock with bradycardia/hypotension, obstructive shock from PE/tamponade/tension pneumothorax, distributive shock with decreased SVR, anaphylaxis treated with epinephrine IM, septic shock with early warm flushed skin), disaster management (hazard vulnerability assessment in mitigation phase, START and JumpSTART triage, just culture for error reporting), legal and ethical issues (EMTALA based on justice, implied consent for unresponsive patients, chain of custody for forensic evidence, drug diversion reporting, workplace violence with history as best predictor, assault vs. battery, slander vs. libel, transgender patient care and gender bias, moral distress), pharmacology (antiplatelets including aspirin/clopidogrel/ticagrelor, anticoagulants including heparin/warfarin/apixaban/rivaroxaban/dabigatran, reversal agents including protamine for heparin, idarucizumab for dabigatran, atropine for symptomatic bradycardia, epinephrine in cardiac arrest, amiodarone/lidocaine for refractory VF, norepinephrine for neurogenic shock, dobutamine/dopamine as positive inotropes for RVMI, glucagon for beta-blocker toxicity, calcium for hydrofluoric acid burns, corticosteroids for temporal arteritis and prematurity, SSRIs with black box warning for suicidality in adolescents, antipsychotics causing extrapyramidal reactions including dystonia), and medication-specific side effects (ipratropium bromide causing dry mouth and blurred vision, adenosine rapid IV push for SVT, nitroglycerin contraindicated with phosphodiesterase inhibitors for pulmonary hypertension, octreotide requiring serum glucose monitoring due to glucagon inhibition, metoclopramide causing dystonic reactions).