CEN PRACTICE QUESTIONS AND ANSWERS NEW ACTUAL EXAM SOLUTION 2022
Which of the following infection control measures is indicated in the patient with an active
methicillin resistant staphylococcus aureus wound infection?
A. Droplet precautions
B. Contact preacutions
C. Protective isolation
D. Airborne precautions - CORRECT ANSWER B. Contact precautions
Rationale: CDC recommends contact precautions for patients with active MRSA infection.
A patient with a hand wound caused by a high-pressure paint gun is awaiting surgical wound
exploration. Preoperatively, the emergency nurse will monitor the patient for the development
of
A. Lactic acidosis
B. Compartment syndrome
C. Tetanus infection
D. Muscle contracture - CORRECT ANSWER B. Compartment syndrome
Rationale: High-pressure injection injuries occur when a device (e.g., a paint or grease gun)
injects the foreign substance into a body. This injury most commonly occurs to the dominant
hand or index finger of the injection gun operator. Emergency care includes splinting the
injury, obtaining radiographs, administering parenteral analgesics and broad-spectrum ABX,
ensuring appropriate tetanus prophylaxis, and elevating the injury. High-pressure injection
injuries are a surgical emergency requiring thorough cleansing and immediate decompression
to prevent compartment syndrome and tissue necrosis. Hydrocarbon-based substances (e.g.,
fuel, paint thinners, organic solvents) cause the most severe inflammatory response and are
associated with the highest incidence of subsequence amputations.
Which of the following findings in a 20-yr-old burn patient indicates the need for burn center
referral?
A. 8% partial thickness burns to the anterior chest
B. Partial thickness burns on the anterior right thigh
C. 2% Full-thickness burns in the left knee area
D. Superficial circumferential burns of the forearms - CORRECT ANSWER C. 2% Full
thickness burns in the left knee area
Rationale: According to the American Burn Association, patients with burns that overlay major
joints should be referred to a burn center.
A 5-year-old presents with dilated pupils, tachycardia, hot flushed skin, agitation, diminished
bowel sounds, urinary retention, and hallucinations after ingesting several tiotropium (Spiriva)
inhalation powder capsules. These findings suggest
A. Neurogenic shock
, B. Diabetic ketoacidosis
C. Anticholinergic crisis
D. Beta-blocker overdose - CORRECT ANSWER C. Anticholinergic crisis
Rationale: Symptoms of anticholinergic exposure can be recalled using the mnemonic "red as a
beet, dry as a bone, blind as a bat, mad as a hatter, and hotter than Hades." Treatment is largely
symptomatic and supportive.
After spraying pesticides all day, a farmhand walks into the ED complaining of diaphoresis,
productive cough, nausea, vomiting, and diarrhea. The priority intervention is
A. Intravenous cannulation
B. O2 Supplementation
C. Antidote administration
D. Skin decontamination - CORRECT ANSWER D. Skin decontamination
The patient's presentation and recent history suggest organophosphate or cabamate poisoning.
These substances are found in industrial insecticides used on farms, as well as in home
pesticides (bug spray). Toxicity causes a cholinergic crisis resulting in stimulation and
hypersecretion of body fluids. Findings in the patient with a cholinergic toxicity are
MUDDLE. Miosis (constriction of pupils), Urination (increase in urination), Diaphoresis,
Defecation, Lacrimation, Excitement. As well as SLUDGE: Salivation, Lacrimation, Urination,
Defecation, GI upset, and Emesis. Death occurs related to respiratory occurs r/t respiratory
failure caused by respiratory muscle paralysis nd increased secretions. In the walking and
talking patient, the priority intervention is to decontaminate the patient to avoid cross-
contamination of medical caregivers and equipment. Antidote administration-intravenous
atropine and pralidoxime (2-PAM; Protopam)-will likely be required.
A patient who grasped a live elctrical wire is admitted to the ED. The entire palmar surface of
both hands is charred and dry. Anticipating fluid needs for this patient, the nurse knows
A. to apply the Parkland burn fluid calculation formula
B. these palm burns represent 1% of body surface area (BSA)
C. BSA calculations do not predict electrical burn fluid needs
D. to use the Consensus burn fluid calculation formula - CORRECT ANSWER C. BSA
calculations do not predict electrical burn fluid needs.
Rationale: Most electrical burn damage is internal, rather than dermal, BSA-based fluid
calculations do not predict fluid needs in the electrically-injury patient.
In a patient with acute onset gastrointestinal complaints, which items in the patient's history
would suggest the culprit is food poisoning rather than another etiology? The presence of
diarrhea and
A. intermittent vomiting
B. dilated pupils
C. right lower quadrant pain
D. bloody stools - CORRECT ANSWER A. Intermittent vomiting
Which of the following infection control measures is indicated in the patient with an active
methicillin resistant staphylococcus aureus wound infection?
A. Droplet precautions
B. Contact preacutions
C. Protective isolation
D. Airborne precautions - CORRECT ANSWER B. Contact precautions
Rationale: CDC recommends contact precautions for patients with active MRSA infection.
A patient with a hand wound caused by a high-pressure paint gun is awaiting surgical wound
exploration. Preoperatively, the emergency nurse will monitor the patient for the development
of
A. Lactic acidosis
B. Compartment syndrome
C. Tetanus infection
D. Muscle contracture - CORRECT ANSWER B. Compartment syndrome
Rationale: High-pressure injection injuries occur when a device (e.g., a paint or grease gun)
injects the foreign substance into a body. This injury most commonly occurs to the dominant
hand or index finger of the injection gun operator. Emergency care includes splinting the
injury, obtaining radiographs, administering parenteral analgesics and broad-spectrum ABX,
ensuring appropriate tetanus prophylaxis, and elevating the injury. High-pressure injection
injuries are a surgical emergency requiring thorough cleansing and immediate decompression
to prevent compartment syndrome and tissue necrosis. Hydrocarbon-based substances (e.g.,
fuel, paint thinners, organic solvents) cause the most severe inflammatory response and are
associated with the highest incidence of subsequence amputations.
Which of the following findings in a 20-yr-old burn patient indicates the need for burn center
referral?
A. 8% partial thickness burns to the anterior chest
B. Partial thickness burns on the anterior right thigh
C. 2% Full-thickness burns in the left knee area
D. Superficial circumferential burns of the forearms - CORRECT ANSWER C. 2% Full
thickness burns in the left knee area
Rationale: According to the American Burn Association, patients with burns that overlay major
joints should be referred to a burn center.
A 5-year-old presents with dilated pupils, tachycardia, hot flushed skin, agitation, diminished
bowel sounds, urinary retention, and hallucinations after ingesting several tiotropium (Spiriva)
inhalation powder capsules. These findings suggest
A. Neurogenic shock
, B. Diabetic ketoacidosis
C. Anticholinergic crisis
D. Beta-blocker overdose - CORRECT ANSWER C. Anticholinergic crisis
Rationale: Symptoms of anticholinergic exposure can be recalled using the mnemonic "red as a
beet, dry as a bone, blind as a bat, mad as a hatter, and hotter than Hades." Treatment is largely
symptomatic and supportive.
After spraying pesticides all day, a farmhand walks into the ED complaining of diaphoresis,
productive cough, nausea, vomiting, and diarrhea. The priority intervention is
A. Intravenous cannulation
B. O2 Supplementation
C. Antidote administration
D. Skin decontamination - CORRECT ANSWER D. Skin decontamination
The patient's presentation and recent history suggest organophosphate or cabamate poisoning.
These substances are found in industrial insecticides used on farms, as well as in home
pesticides (bug spray). Toxicity causes a cholinergic crisis resulting in stimulation and
hypersecretion of body fluids. Findings in the patient with a cholinergic toxicity are
MUDDLE. Miosis (constriction of pupils), Urination (increase in urination), Diaphoresis,
Defecation, Lacrimation, Excitement. As well as SLUDGE: Salivation, Lacrimation, Urination,
Defecation, GI upset, and Emesis. Death occurs related to respiratory occurs r/t respiratory
failure caused by respiratory muscle paralysis nd increased secretions. In the walking and
talking patient, the priority intervention is to decontaminate the patient to avoid cross-
contamination of medical caregivers and equipment. Antidote administration-intravenous
atropine and pralidoxime (2-PAM; Protopam)-will likely be required.
A patient who grasped a live elctrical wire is admitted to the ED. The entire palmar surface of
both hands is charred and dry. Anticipating fluid needs for this patient, the nurse knows
A. to apply the Parkland burn fluid calculation formula
B. these palm burns represent 1% of body surface area (BSA)
C. BSA calculations do not predict electrical burn fluid needs
D. to use the Consensus burn fluid calculation formula - CORRECT ANSWER C. BSA
calculations do not predict electrical burn fluid needs.
Rationale: Most electrical burn damage is internal, rather than dermal, BSA-based fluid
calculations do not predict fluid needs in the electrically-injury patient.
In a patient with acute onset gastrointestinal complaints, which items in the patient's history
would suggest the culprit is food poisoning rather than another etiology? The presence of
diarrhea and
A. intermittent vomiting
B. dilated pupils
C. right lower quadrant pain
D. bloody stools - CORRECT ANSWER A. Intermittent vomiting
