Certified Emergency Nurse (CEN) Practice Exam Questions And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
1. A 65-year-old patient presents with sudden-onset chest pain radiating to
the left arm and jaw. Which is the priority initial action?
A. Obtain a chest X-ray
B. Administer aspirin
C. Attach cardiac monitor and obtain ECG
D. Start IV fluids
Rationale: Immediate ECG monitoring is essential to identify myocardial
infarction and guide emergent interventions.
2. Which of the following is the most sensitive indicator of hypovolemic
shock in a trauma patient?
A. Blood pressure
B. Heart rate
C. Mental status changes
D. Respiratory rate
Rationale: Early mental status changes reflect decreased cerebral perfusion and
are more sensitive than vital signs.
3. A patient presents with sudden shortness of breath, pleuritic chest pain,
and unilateral leg swelling. What is the most likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Myocardial infarction
,Certified Emergency Nurse (CEN) Practice Exam Questions And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
Rationale: This triad of symptoms strongly suggests pulmonary embolism;
prompt diagnosis is critical.
4. In a patient with suspected sepsis, what is the first step in management?
A. Start antibiotics immediately
B. Obtain blood cultures and start broad-spectrum antibiotics
C. Administer corticosteroids
D. Start vasopressors
Rationale: Early blood cultures followed by broad-spectrum antibiotics within
the first hour improve survival.
5. A 7-year-old child presents with drooling, tripod positioning, and
inspiratory stridor. What is the most appropriate immediate action?
A. Attempt oral intubation
B. Prepare for emergent airway management and call anesthesia/ENT
C. Administer nebulized albuterol
D. Give oral fluids
Rationale: Signs indicate possible epiglottitis; airway should be secured by
experienced personnel without delay.
6. Which type of burn is most concerning for potential airway compromise?
A. Superficial partial-thickness
B. Deep partial-thickness
C. Inhalation injury
D. Full-thickness hand burn
Rationale: Inhalation injuries can rapidly compromise the airway, requiring
early assessment and intervention.
7. Which rhythm on ECG is most commonly associated with sudden cardiac
arrest?
A. Sinus bradycardia
B. Ventricular fibrillation
, Certified Emergency Nurse (CEN) Practice Exam Questions And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
C. Atrial fibrillation
D. Second-degree AV block
Rationale: Ventricular fibrillation is the most common initial rhythm in sudden
cardiac arrest.
8. A patient presents with abdominal pain, hypotension, and a rigid
abdomen. What is the priority intervention?
A. Start oral fluids
B. Rapid IV fluid resuscitation and surgical consult
C. Give analgesics
D. Perform abdominal ultrasound only
Rationale: Hypotension and a rigid abdomen suggest internal bleeding; prompt
fluids and surgical evaluation are critical.
9. Which of the following is the most accurate method to assess fluid status
in a critically ill adult?
A. Capillary refill
B. Heart rate
C. Central venous pressure (CVP) monitoring
D. Blood pressure
Rationale: CVP monitoring provides a more direct assessment of intravascular
volume in critically ill patients.
10. Which medication is first-line for anaphylactic shock?
A. Diphenhydramine
B. Albuterol
C. Epinephrine IM
D. Hydrocortisone
Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis
to rapidly reverse airway and circulatory compromise.
Plus Rationales 2026 Q&A | Instant Download Pdf
1. A 65-year-old patient presents with sudden-onset chest pain radiating to
the left arm and jaw. Which is the priority initial action?
A. Obtain a chest X-ray
B. Administer aspirin
C. Attach cardiac monitor and obtain ECG
D. Start IV fluids
Rationale: Immediate ECG monitoring is essential to identify myocardial
infarction and guide emergent interventions.
2. Which of the following is the most sensitive indicator of hypovolemic
shock in a trauma patient?
A. Blood pressure
B. Heart rate
C. Mental status changes
D. Respiratory rate
Rationale: Early mental status changes reflect decreased cerebral perfusion and
are more sensitive than vital signs.
3. A patient presents with sudden shortness of breath, pleuritic chest pain,
and unilateral leg swelling. What is the most likely diagnosis?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Myocardial infarction
,Certified Emergency Nurse (CEN) Practice Exam Questions And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
Rationale: This triad of symptoms strongly suggests pulmonary embolism;
prompt diagnosis is critical.
4. In a patient with suspected sepsis, what is the first step in management?
A. Start antibiotics immediately
B. Obtain blood cultures and start broad-spectrum antibiotics
C. Administer corticosteroids
D. Start vasopressors
Rationale: Early blood cultures followed by broad-spectrum antibiotics within
the first hour improve survival.
5. A 7-year-old child presents with drooling, tripod positioning, and
inspiratory stridor. What is the most appropriate immediate action?
A. Attempt oral intubation
B. Prepare for emergent airway management and call anesthesia/ENT
C. Administer nebulized albuterol
D. Give oral fluids
Rationale: Signs indicate possible epiglottitis; airway should be secured by
experienced personnel without delay.
6. Which type of burn is most concerning for potential airway compromise?
A. Superficial partial-thickness
B. Deep partial-thickness
C. Inhalation injury
D. Full-thickness hand burn
Rationale: Inhalation injuries can rapidly compromise the airway, requiring
early assessment and intervention.
7. Which rhythm on ECG is most commonly associated with sudden cardiac
arrest?
A. Sinus bradycardia
B. Ventricular fibrillation
, Certified Emergency Nurse (CEN) Practice Exam Questions And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant Download Pdf
C. Atrial fibrillation
D. Second-degree AV block
Rationale: Ventricular fibrillation is the most common initial rhythm in sudden
cardiac arrest.
8. A patient presents with abdominal pain, hypotension, and a rigid
abdomen. What is the priority intervention?
A. Start oral fluids
B. Rapid IV fluid resuscitation and surgical consult
C. Give analgesics
D. Perform abdominal ultrasound only
Rationale: Hypotension and a rigid abdomen suggest internal bleeding; prompt
fluids and surgical evaluation are critical.
9. Which of the following is the most accurate method to assess fluid status
in a critically ill adult?
A. Capillary refill
B. Heart rate
C. Central venous pressure (CVP) monitoring
D. Blood pressure
Rationale: CVP monitoring provides a more direct assessment of intravascular
volume in critically ill patients.
10. Which medication is first-line for anaphylactic shock?
A. Diphenhydramine
B. Albuterol
C. Epinephrine IM
D. Hydrocortisone
Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis
to rapidly reverse airway and circulatory compromise.
