CEN SAMPLE TEST QUESTIONS AND ANSWERS
COMPLETE TEST
Right ventricular infarction (RVI) lead changes Correct Answer: II, III, AVF
R ventricular infarction s/s Correct Answer: clear breath sounds, hypotension, JVD.
R ventricular dilation and dec contractility>> dec preload and CO
Reperfusion therapy standard Correct Answer: Within 60 min of ED arrival
Common causes of PEA Correct Answer: Hypoxia, tension pneumo, cardiac tamponade
BNP as a marker Correct Answer: of L ventricular dysfunction bc ventricles make BNP and an inc of
over 100 pg/ml indicates symptomatic HF
Transcutaneous pacing (TCP) Correct Answer: A beat after every pacer spike is electrical capture.
Beats are wide complex bc ventricle is paced. Palpate central pulse, pt may still be hypotensive w/
diminished or absent peripheral pulses.
Preferred tx with symptomatic brady esp in pts with acute MI
Wolff Parkinson-White (WPW) syndrome Correct Answer: shortened PR interval and widened QRS
complex with a delta wave. When there is an extra electrical conduction path to heart causing
electrical signal to arrive too soon at ventricle (pt presents in tachy)
Brugada syndrome Correct Answer: R bundle branch block with ST segment elevation in leads V1-V3
and inc risk of sudden cardiac death (SUDS), common in young men
Wellen syndrome Correct Answer: T wave changes plus history of anginal chest pain w/o serum
marker abnormalities, EKG lacks Q waves and significant ST segment elevation. Assoc with critical
proximal L anterior descending (LAD) artery stenosis
Hypothermia associations Correct Answer: With bradycardia, Osborne (J) waves and prolonged QT
intervals
Sick sinus syndrome Correct Answer: Sinoatrial node (SA) the primary heart pacemaker is not
functioning properly resulting in bradydysrythmias and/or tachydysrhythmias with potential for
hypotension and syncope
Morphine and nitrates for tx pulmonary edema Correct Answer: Results in dec preload or dec venous
return>> dec pulmonary congestion
How to diagnose endocarditis Correct Answer: Echocardiogram
Pericardiocentesis Correct Answer: For suspected pericardial effusion or tamponade
Primary complication of bowel obstruction Correct Answer: Dehydration
,Testicular referred pain is indicative of? Correct Answer: Duodenal injury
S/s pancreatitis Correct Answer: Sharp, boring, epigastric pain, inc after eating and having alcohol
Dx with abd CT scan
Paracentesis Correct Answer: Procedure to remove fluid that has accumulated in the abd cavity
After doing paracentesis Correct Answer: Check pt for s/s shock, EKG, dressing, VS q 15 min
Auscultate bowel obstruction Correct Answer: Freq and high pitched
Dec or absent bowel sounds caused by Correct Answer: Paralytic ileus, paralysis, dec in peristalsis
One cause of HYPOkalemia Correct Answer: Excess fluid loss from GI (ex: diarrhea)
One cause of Magnesium depletion Correct Answer: Intestinal malabsorption
Bland diet is for Correct Answer: Peptic and gastric ulcers
Chocolate enhances Correct Answer: S/s GERD
Life threatening complications of acute pancreatitis Correct Answer: Atelectasis, pleural effusion,
ARDS
HELLP syndrome Correct Answer: Hemolysis, Elevated liver enzymes, Low platelets)
Liver panel dx it
S/s rhabdomyolysis Correct Answer: HYPERkalemia, brown urine, inc CPK, HYPERcalcemia
Septal hematoma Correct Answer: Can occur with mid facial trauma; untreated can lead to abscess
formation or avascular necrosis
Ethmoid bone fx can cause Correct Answer: CSF leakage
Preferred eye irrigation fluid Correct Answer: LR
Pocket vision screener should be held ___ inches from nose? Correct Answer: 14 inches
HHNC s/s Correct Answer: UA shows glycosuria without ketouria, polyuria, tachycardia, hypotension
Acute renal failure (ARF) s/s Correct Answer: HYPERkalemia, HYPOnatremia, HYPOcalcemia,
HYPERphosphatemia. K level is priority
BUN / Cr ratio that would dx prerenal failure Correct Answer: > 20:1
S/s HYPOcalcemia Correct Answer: muscle cramping
Latex allergy crossovers Correct Answer: Tomatoes, bananas, kiwis, white potatoes, avocados, bell
peppers, peaches
, Tx acute HYPERkalemia Correct Answer: Ca and albuterol, sodium bicarb, insulin and dextrose 50%,
kayexalate
Kayexalate Correct Answer: Sodium polystyrene sulfonate takes 1-2 hrs to kick in
Herpes zoster (shingles) transmission Correct Answer: Direct contact via vesicular fluid
Fibromyalgia Correct Answer: Chronic fatigue, multiple somatic s/s, widespread pain and
hypersensitivity
Thyrotoxic crisis/storm s/s Correct Answer: Hyperthermia, agitation, tachydysrythmias
Scabies tx Correct Answer: Pyrethrin liquid (RID), do 2nd tx 7-10 days later if 1st is done to try hair. If
hair is wet, reapply in 24 hrs. Put washable items in plastic bags for 1-2 weeks until mites die
Anterior AND lateral corticospinal tract Correct Answer: Voluntary muscle movement
Lateral spinothalamic tract Correct Answer: Sharp pain and temperature
Posterior tracts Correct Answer: Proprioception, fine touch, 2 pt discrimination
Anterior spinothalamic tract Correct Answer: Crude touch
A fib Correct Answer: Risk factor for embolic stroke
Bell's Palsy cause Correct Answer: Paralysis of CN VIII
C5 > C7 Correct Answer: innervation for arm flexion and extension
L2> L4 Correct Answer: Extension and flexion legs
L4>L5 Correct Answer: Foot flexion and toe extension
S3>S5 Correct Answer: Anal sphincter tone
9-15 GCS Correct Answer: mild to moderate head injury
3-8 GCS Correct Answer: severe head injury
Noxious stimuli that trigger autonomic dysreflexia Correct Answer: Bladder/intestinal distension,
pressure sores
Extreme hip flexion can cause Correct Answer: Inc intra-abdominal pressure; causing inc ICP, flex no
more than 90 degrees
Fosphenytoin/Phosphenytoin (Cerebyx) dosing for status epilepticus Correct Answer: 15-18 mg/kg
given 100-150 mgPE/min IV
Lorazepam dosing for status epilepticus Correct Answer: 0.05-0.1 mg/kg IV slow push
COMPLETE TEST
Right ventricular infarction (RVI) lead changes Correct Answer: II, III, AVF
R ventricular infarction s/s Correct Answer: clear breath sounds, hypotension, JVD.
R ventricular dilation and dec contractility>> dec preload and CO
Reperfusion therapy standard Correct Answer: Within 60 min of ED arrival
Common causes of PEA Correct Answer: Hypoxia, tension pneumo, cardiac tamponade
BNP as a marker Correct Answer: of L ventricular dysfunction bc ventricles make BNP and an inc of
over 100 pg/ml indicates symptomatic HF
Transcutaneous pacing (TCP) Correct Answer: A beat after every pacer spike is electrical capture.
Beats are wide complex bc ventricle is paced. Palpate central pulse, pt may still be hypotensive w/
diminished or absent peripheral pulses.
Preferred tx with symptomatic brady esp in pts with acute MI
Wolff Parkinson-White (WPW) syndrome Correct Answer: shortened PR interval and widened QRS
complex with a delta wave. When there is an extra electrical conduction path to heart causing
electrical signal to arrive too soon at ventricle (pt presents in tachy)
Brugada syndrome Correct Answer: R bundle branch block with ST segment elevation in leads V1-V3
and inc risk of sudden cardiac death (SUDS), common in young men
Wellen syndrome Correct Answer: T wave changes plus history of anginal chest pain w/o serum
marker abnormalities, EKG lacks Q waves and significant ST segment elevation. Assoc with critical
proximal L anterior descending (LAD) artery stenosis
Hypothermia associations Correct Answer: With bradycardia, Osborne (J) waves and prolonged QT
intervals
Sick sinus syndrome Correct Answer: Sinoatrial node (SA) the primary heart pacemaker is not
functioning properly resulting in bradydysrythmias and/or tachydysrhythmias with potential for
hypotension and syncope
Morphine and nitrates for tx pulmonary edema Correct Answer: Results in dec preload or dec venous
return>> dec pulmonary congestion
How to diagnose endocarditis Correct Answer: Echocardiogram
Pericardiocentesis Correct Answer: For suspected pericardial effusion or tamponade
Primary complication of bowel obstruction Correct Answer: Dehydration
,Testicular referred pain is indicative of? Correct Answer: Duodenal injury
S/s pancreatitis Correct Answer: Sharp, boring, epigastric pain, inc after eating and having alcohol
Dx with abd CT scan
Paracentesis Correct Answer: Procedure to remove fluid that has accumulated in the abd cavity
After doing paracentesis Correct Answer: Check pt for s/s shock, EKG, dressing, VS q 15 min
Auscultate bowel obstruction Correct Answer: Freq and high pitched
Dec or absent bowel sounds caused by Correct Answer: Paralytic ileus, paralysis, dec in peristalsis
One cause of HYPOkalemia Correct Answer: Excess fluid loss from GI (ex: diarrhea)
One cause of Magnesium depletion Correct Answer: Intestinal malabsorption
Bland diet is for Correct Answer: Peptic and gastric ulcers
Chocolate enhances Correct Answer: S/s GERD
Life threatening complications of acute pancreatitis Correct Answer: Atelectasis, pleural effusion,
ARDS
HELLP syndrome Correct Answer: Hemolysis, Elevated liver enzymes, Low platelets)
Liver panel dx it
S/s rhabdomyolysis Correct Answer: HYPERkalemia, brown urine, inc CPK, HYPERcalcemia
Septal hematoma Correct Answer: Can occur with mid facial trauma; untreated can lead to abscess
formation or avascular necrosis
Ethmoid bone fx can cause Correct Answer: CSF leakage
Preferred eye irrigation fluid Correct Answer: LR
Pocket vision screener should be held ___ inches from nose? Correct Answer: 14 inches
HHNC s/s Correct Answer: UA shows glycosuria without ketouria, polyuria, tachycardia, hypotension
Acute renal failure (ARF) s/s Correct Answer: HYPERkalemia, HYPOnatremia, HYPOcalcemia,
HYPERphosphatemia. K level is priority
BUN / Cr ratio that would dx prerenal failure Correct Answer: > 20:1
S/s HYPOcalcemia Correct Answer: muscle cramping
Latex allergy crossovers Correct Answer: Tomatoes, bananas, kiwis, white potatoes, avocados, bell
peppers, peaches
, Tx acute HYPERkalemia Correct Answer: Ca and albuterol, sodium bicarb, insulin and dextrose 50%,
kayexalate
Kayexalate Correct Answer: Sodium polystyrene sulfonate takes 1-2 hrs to kick in
Herpes zoster (shingles) transmission Correct Answer: Direct contact via vesicular fluid
Fibromyalgia Correct Answer: Chronic fatigue, multiple somatic s/s, widespread pain and
hypersensitivity
Thyrotoxic crisis/storm s/s Correct Answer: Hyperthermia, agitation, tachydysrythmias
Scabies tx Correct Answer: Pyrethrin liquid (RID), do 2nd tx 7-10 days later if 1st is done to try hair. If
hair is wet, reapply in 24 hrs. Put washable items in plastic bags for 1-2 weeks until mites die
Anterior AND lateral corticospinal tract Correct Answer: Voluntary muscle movement
Lateral spinothalamic tract Correct Answer: Sharp pain and temperature
Posterior tracts Correct Answer: Proprioception, fine touch, 2 pt discrimination
Anterior spinothalamic tract Correct Answer: Crude touch
A fib Correct Answer: Risk factor for embolic stroke
Bell's Palsy cause Correct Answer: Paralysis of CN VIII
C5 > C7 Correct Answer: innervation for arm flexion and extension
L2> L4 Correct Answer: Extension and flexion legs
L4>L5 Correct Answer: Foot flexion and toe extension
S3>S5 Correct Answer: Anal sphincter tone
9-15 GCS Correct Answer: mild to moderate head injury
3-8 GCS Correct Answer: severe head injury
Noxious stimuli that trigger autonomic dysreflexia Correct Answer: Bladder/intestinal distension,
pressure sores
Extreme hip flexion can cause Correct Answer: Inc intra-abdominal pressure; causing inc ICP, flex no
more than 90 degrees
Fosphenytoin/Phosphenytoin (Cerebyx) dosing for status epilepticus Correct Answer: 15-18 mg/kg
given 100-150 mgPE/min IV
Lorazepam dosing for status epilepticus Correct Answer: 0.05-0.1 mg/kg IV slow push
