CEN EXAM 1 COMPLETE QUIZ RATED A
Which dysrhythmia would be identified on an ECG/EKG six-second strip by a heart rate of 76 and a
PR interval of 0.24?
A.sinus tachycardia
B.first-degree atrioventricular block
C.sinus bradycardia
D.junctional escape rhythm Correct Answer: B: First-degree atrioventricular block is diagnosed
partially by an EKG showing a PR interval of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would need to be used as part of the
clinical picture with diagnosing and treating abdominal pain?
A.white blood cell (WBC) count of 5.0
B.hematocrit (HCT) of 45
C.WBC count of 28.0
D.blood sugar (BS) of 74 Correct Answer: C: An elevated WBC count would be indicative of infection
or inflammation. The WBC count of 5.0 is normal. The HCT and BS levels listed would also be
considered within normal limits.
A 30-year-old man comes to the emergency department with the acute onset of left flank pain
radiating to the groin. Microscopic hematuria is present on urinalysis. What is the most likely
diagnosis?
A.ureteral calcium oxalate calculus
B.ureteral cystine calculus
C.testicular torsion
D.cystitis Correct Answer: A: Ureteral calculi are a quite common cause of acute emergency
evaluation, usually causing flank pain with radiation to the back and/or groin. About 75% of these are
calcium oxalate or phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or
ultrasound may show the stone, helical CT is now the preferred diagnostic method. Additional workup
includes CBC, chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical
analysis. Nursing attention should be directed to intravenous hydration with input and output
recording and narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some patients
may be discharged with analgesics and instructions for hydration and calculus capture. Testicular
torsion is most common in adolescents and usually presents with testicular and groin pain with
abdominal radiation; increasing pain by lifting the scrotum to the level of the pubic symphysis causes
exacerbation of the pain (Prehn sign). Cystitis may be infectious or drug-induced, but cystitis usually
causes dysuria and pyuria and shows positive urine cultures.
Which of the following is NOT appropriate for screening for domestic violence by the emergency
department nurse?
A.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so, by
whom
B.asking, "Do you feel safe in your present relationship?"
C.avoid asking about intimate person violence if the patient is in the emergency department for a
medical ailment, not trauma
D.asking if there is a partner from a previous relationship that makes the individual feel unsafe
Correct Answer: C: Domestic violence, nearly always perpetrated against women, is a major problem
, confronted by the emergency nurse. Screening for possible cases should include answers A, B and
D. Interestingly, victims of intimate partner violence often present with a medical ailment, not trauma.
These include back, abdominal, or pelvic pain, headaches, urinary infections, sexually transmitted
disease, or symptoms consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of
old trauma such as healing fractures or cosmetically concealed bruises may point toward the
presence of domestic violence. Many victims will deny it but sometimes compassionate questioning in
a private setting will elicit a positive response. The nurse may then offer advice, refer to a social
agency or shelter, or ask for a consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator alarm rings and the airway
pressure is found to be elevated. Possible causes include the following EXCEPT:
A.endotracheal tube obstruction with sputum
B.pneumothorax
C.bronchospasm
D.cuff leak Correct Answer: D: Mechanical ventilation requires diligent observation of the patient and
ventilator by the emergency nurse. Modern ventilators usually come with alarms that indicate high or
low airway pressure. High pressure may be caused by endotracheal tube obstruction with sputum or
kinks or inadvertent endobronchial displacement. The airway should be suctioned and tube
placement checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse,
worsening of the underlying disease, and bronchospasm are also causes of elevated pressure. Leaks
around the endotracheal tube cuffs will cause low airway pressure. Auto-positive end-expiratory
pressure (auto-PEEP) is caused by premature inspiratory delivery before full expiration (as in asthma
or COPD patients) and may lead to increased pressure and lung damage.
A 2-year-old is brought to the emergency department with mild fever, persistent restlessness, crying,
and pulling his left ear. He has had a cold for about a week. Examination of the ear reveals a
distorted light reflex and slight bulging of the tympanic membrane. What is the proper diagnosis and
treatment?
A.otitis externa and antibiotics
B.otitis media and antibiotics
C.otitis media and myringotomy
D.acute labyrinthitis and antivertigo drug Correct Answer: B: Ear infections may cause severe and
persistent pain, especially in children in the 6-month to 3-year age group and are a frequent cause of
emergency department visits. Loss or distortion of the light reflex and bulging of the tympanic
membrane are cardinal signs of otitis media, usually caused by bacteria such as Streptococcus
Influenza or Haemophilus Influenza. Sinusitis and purulent rhinitis may accompany the otitis.
Antibiotics to cover these organisms, topical warmed otic analgesics, and antipyretics are the usual
treatment modalities. Otitis externa or swimmer's ear also causes otalgia and frequently follows
swimming in contaminated water or a foreign body in the ear. Keeping the ear dry and using otic
analgesics and antibiotics are indicated. Ear plugs while swimming or ear drying agents after
swimming or showering are the usual preventive measures. Myringotomy is a surgical procedure to
keep the middle ear draining in chronic otitis media and hopefully prevent such complications as
mastoiditis, meningitis, ruptured tympanic membrane, or permanent hearing loss. Labyrinthitis is an
infection of the inner ear and usually causes severe vertigo, most commonly in adults.
A 75-year-old man has a history of several episodes of transient right-sided arm and hand weakness
lasting an hour or two but with full recovery. He is diabetic and hypertensive and is taking medication
for both conditions. This time the episode does not resolve and he is taken to the emergency
department some 2 hours after the onset of symptoms. He is awake and able to answer questions
and give a medical history. His chest is clear and no bruits are heard over the carotids. There is drift
Which dysrhythmia would be identified on an ECG/EKG six-second strip by a heart rate of 76 and a
PR interval of 0.24?
A.sinus tachycardia
B.first-degree atrioventricular block
C.sinus bradycardia
D.junctional escape rhythm Correct Answer: B: First-degree atrioventricular block is diagnosed
partially by an EKG showing a PR interval of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would need to be used as part of the
clinical picture with diagnosing and treating abdominal pain?
A.white blood cell (WBC) count of 5.0
B.hematocrit (HCT) of 45
C.WBC count of 28.0
D.blood sugar (BS) of 74 Correct Answer: C: An elevated WBC count would be indicative of infection
or inflammation. The WBC count of 5.0 is normal. The HCT and BS levels listed would also be
considered within normal limits.
A 30-year-old man comes to the emergency department with the acute onset of left flank pain
radiating to the groin. Microscopic hematuria is present on urinalysis. What is the most likely
diagnosis?
A.ureteral calcium oxalate calculus
B.ureteral cystine calculus
C.testicular torsion
D.cystitis Correct Answer: A: Ureteral calculi are a quite common cause of acute emergency
evaluation, usually causing flank pain with radiation to the back and/or groin. About 75% of these are
calcium oxalate or phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or
ultrasound may show the stone, helical CT is now the preferred diagnostic method. Additional workup
includes CBC, chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical
analysis. Nursing attention should be directed to intravenous hydration with input and output
recording and narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some patients
may be discharged with analgesics and instructions for hydration and calculus capture. Testicular
torsion is most common in adolescents and usually presents with testicular and groin pain with
abdominal radiation; increasing pain by lifting the scrotum to the level of the pubic symphysis causes
exacerbation of the pain (Prehn sign). Cystitis may be infectious or drug-induced, but cystitis usually
causes dysuria and pyuria and shows positive urine cultures.
Which of the following is NOT appropriate for screening for domestic violence by the emergency
department nurse?
A.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so, by
whom
B.asking, "Do you feel safe in your present relationship?"
C.avoid asking about intimate person violence if the patient is in the emergency department for a
medical ailment, not trauma
D.asking if there is a partner from a previous relationship that makes the individual feel unsafe
Correct Answer: C: Domestic violence, nearly always perpetrated against women, is a major problem
, confronted by the emergency nurse. Screening for possible cases should include answers A, B and
D. Interestingly, victims of intimate partner violence often present with a medical ailment, not trauma.
These include back, abdominal, or pelvic pain, headaches, urinary infections, sexually transmitted
disease, or symptoms consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of
old trauma such as healing fractures or cosmetically concealed bruises may point toward the
presence of domestic violence. Many victims will deny it but sometimes compassionate questioning in
a private setting will elicit a positive response. The nurse may then offer advice, refer to a social
agency or shelter, or ask for a consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator alarm rings and the airway
pressure is found to be elevated. Possible causes include the following EXCEPT:
A.endotracheal tube obstruction with sputum
B.pneumothorax
C.bronchospasm
D.cuff leak Correct Answer: D: Mechanical ventilation requires diligent observation of the patient and
ventilator by the emergency nurse. Modern ventilators usually come with alarms that indicate high or
low airway pressure. High pressure may be caused by endotracheal tube obstruction with sputum or
kinks or inadvertent endobronchial displacement. The airway should be suctioned and tube
placement checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse,
worsening of the underlying disease, and bronchospasm are also causes of elevated pressure. Leaks
around the endotracheal tube cuffs will cause low airway pressure. Auto-positive end-expiratory
pressure (auto-PEEP) is caused by premature inspiratory delivery before full expiration (as in asthma
or COPD patients) and may lead to increased pressure and lung damage.
A 2-year-old is brought to the emergency department with mild fever, persistent restlessness, crying,
and pulling his left ear. He has had a cold for about a week. Examination of the ear reveals a
distorted light reflex and slight bulging of the tympanic membrane. What is the proper diagnosis and
treatment?
A.otitis externa and antibiotics
B.otitis media and antibiotics
C.otitis media and myringotomy
D.acute labyrinthitis and antivertigo drug Correct Answer: B: Ear infections may cause severe and
persistent pain, especially in children in the 6-month to 3-year age group and are a frequent cause of
emergency department visits. Loss or distortion of the light reflex and bulging of the tympanic
membrane are cardinal signs of otitis media, usually caused by bacteria such as Streptococcus
Influenza or Haemophilus Influenza. Sinusitis and purulent rhinitis may accompany the otitis.
Antibiotics to cover these organisms, topical warmed otic analgesics, and antipyretics are the usual
treatment modalities. Otitis externa or swimmer's ear also causes otalgia and frequently follows
swimming in contaminated water or a foreign body in the ear. Keeping the ear dry and using otic
analgesics and antibiotics are indicated. Ear plugs while swimming or ear drying agents after
swimming or showering are the usual preventive measures. Myringotomy is a surgical procedure to
keep the middle ear draining in chronic otitis media and hopefully prevent such complications as
mastoiditis, meningitis, ruptured tympanic membrane, or permanent hearing loss. Labyrinthitis is an
infection of the inner ear and usually causes severe vertigo, most commonly in adults.
A 75-year-old man has a history of several episodes of transient right-sided arm and hand weakness
lasting an hour or two but with full recovery. He is diabetic and hypertensive and is taking medication
for both conditions. This time the episode does not resolve and he is taken to the emergency
department some 2 hours after the onset of symptoms. He is awake and able to answer questions
and give a medical history. His chest is clear and no bruits are heard over the carotids. There is drift
