1|Page
CEN Pretest by PDB Nurse Education, LLC (BCEN)
ALL THE TYPES OF EMERGENCIES INCLUDED
WITH QUESTIONS AND ANSWERS
CONTAINS BCEN GUIDELINES AND
FREQUENTLY TESTED QUESTIONS WITH
ANSWERS
Board of Certification for Emergency Nursing
CEN - Certified Emergency Nurse Specialization
1. Pulse pressure is the difference between systolic blood pressure and diastolic blood pressure, and is widened in
which of the following disorders?
a. Early hypovolemic shock.
b. Increased intracranial pressure.
c. Cardiac tamponade.
d. Neurogenic shock.
2. Parents bring in their 4-week-old infant with non-bilious projectile vomiting and persistent hunger. Which of the
following conditions is suspected?
a. Pyloric Stenosis
b. Intussusception
c. Appendicitis
d. Volvulus
3. Systemic vascular resistance (SVR) is decreased in which type of shock?
a. Hypovolemic
b. Cardiogenic
c. Obstructive
d. Distributive
4. A 64-year-old female fell and transported to the ED via EMS for severe hip pain and inability to move. What
classification of medications may mask the early signs of hypovolemic shock?
a. Beta-blockers
b. ACE inhibitors
c. Angiotensin receptor blockers
d. Calcium channel blockers
5. A patient is transported to the ED via EMS for headache, vomiting, and progressive confusion after a fall three
days ago. Which of the following head injuries is the most likely cause of these symptoms?
a. Concussion
b. Epidural hematoma
c. Subdural hematoma
d. Basilar skull fracture
6. Which of the following is the hallmark symptom of Prinzmetal’s angina?
a. Chest pain with physical exertion.
b. Chest pain at rest due to coronary vasospasm.
c. Chest pain relieved by nitroglycerin and rest.
d. Atypical symptoms such as epigastric pain.
7. A patient with a stab wound to the left flank area is unable to move his left side and unable to feel the right side
of his body. These symptoms are associated with which of the following incomplete spinal cord injuries?
a. Anterior cord syndrome
1
,2|Page
b. Posterior cord syndrome
c. Central cord syndrome
d. Brown-Sequard syndrome
8. ST segment elevation in ECG leads II, III, and aVF indicates injury to which area of the heart?
a. Inferior wall
b. Anterior wall
c. Posterior wall
d. Lateral wall
9. Sutures placed in the eyebrows should be removed within:
a. 4 to 5 days
b. 5 to 7 days
c. 7 to 10 days
10. 10 to 14 daysA patient complains of ripping chest pain radiating to the back, has unequal bilateral blood
pressures, and numbness in the lower extremities. The nurse suspects which emergent condition?
a. Cardiac tamponade
b. Tension pneumothorax
c. Aortic dissection
d. Posterior MI
11. A 40-year-old female who is 36-weeks pregnant patient presents to the ED with painless bright red vaginal
bleeding. The nurse knows a pelvic exam is contraindicated since the most likely cause of the bleeding is:
a. Abruptio placenta
b. Placenta previa
c. Uterine rupture
d. Eclampsia
12. A 14-year-old complains of lightheadedness and palpitations. Which cardiac disorder is characterized by a short
PR interval and a Delta wave?
a. Torsades de Pointes
b. R or T phenomenon
c. AV Nodal Reentry Tachycardia (AVNRT)
d. Wolff-Parkinson-White Syndrome (WPW)
13. A 22-year-old female complains of a thick, white, “cottage-cheese” like vaginal discharge, pruritis, vulvar
burning, and dyspareunia. The nurse suspects a diagnosis of:
a. Gonorrhea
b. Chlamydia
c. Candidiasis
d. Trichomoniasis
14. Which atrioventricular block is characterized by a consistent but prolonged PR interval, and a consistent R to R
interval?
a. First degree AV block
b. Second degree AV block, type 1
c. Second degree AV block, type 2
d. Third degree AV block
15. Fever, bloating, and pain at the right costal margin upon palpation is associated with which disorder?
a. Pancreatitis
b. Cholecystitis
c. Appendicitis
d. Diverticulitis
16. Jugular vein distention (JVD), and increased central venous pressure (CVP), hepatomegaly, and peripheral
edema is seen in which disorder?
a. Endocarditis
b. Pericarditis
c. Right heart failure
d. Left heart failure
17. Which of the following signs/symptoms is typically seen in patients with Guillain-Barre syndrome?
a. Prickly sensation in extremities and ascending symmetrical paralysis.
2
,3|Page
b. Right-sided paralysis with left homonymous hemianopsia.
c. Ptosis and descending symmetrical paralysis.
d. Right-sided hemiplegia with left pupil dilation.
18. The following are signs of pericardial tamponade, EXCEPT?
a. Kussmaul sign
b. Pulsus paradoxus
c. Electrical alternans
d. Tracheal deviation
19. hich of the following is an early sign/symptom of left ventricular heart failure?
a. Jugular vein distention (JVD)
b. Paroxysmal nocturnal dyspnea
c. Abdominal ascites
d. Peripheral edema
20. Morphine is contraindicated in a right ventricular myocardial infarction (RV MI) because of what drug action?
a. Morphine increases oxygen demand.
b. Narcotics may lead to opioid dependence.
c. Morphine decreases preload.
d. Morphine increases afterload.
21. A multi-trauma patient rapidly decompensates on arrival to the emergency department. ABG results are as
follows: pH 7.25, CO2 50, HCO3 18. The patient is in which acid-base imbalance?
a. Uncompensated respiratory acidosis
b. Uncompensated metabolic acidosis
c. Uncompensated respiratory and metabolic acidosis
d. Partially compensated metabolic acidosis
22. A 20-year-old male was discharged home yesterday after a femur fracture from a fall. He returns to the ED
today with dyspnea, tachypnea, and tachycardia. You notice a petechial rash on the chest, so you suspect which
disorder?
a. Systemic inflammatory response syndrome.
b. Disseminated intravascular coagulation.
c. Rhabdomyolysis
d. Fat emboli syndrome
23. Which of the following signs/symptoms is NOT characteristic of Wernicke’s encephalopathy?
a. Confabulation
b. Chronic memory loss
c. Ataxia
d. Nystagmus
24. A patient complains of an excruciating unilateral headache with nasal congestion and excessive lacrimation on
the affected side. The nurse suspects:
a. Migraine
b. Temporal arteritis
c. Sinus headache
d. Cluster headache
25. A patient complains off crampy left lower quadrant abdominal pain with alternating episodes of explosive
diarrhea and severe constipation. The nurse knows rehydration is critical since she/he suspects which disorder?
a. Diverticulitis
b. Bowel obstruction
c. Crohn’s disease
d. Volvulus
26. Which highly communicable infection is characterized by swollen salivary and parotid glands?
a. Mumps
b. Measles
c. Pertussis
d. Diphtheria
27. A 68-year-old female with a history of atrial fibrillation complains of a sudden onset of painless unilateral vision
loss and denies any trauma. Which ocular emergency does the nurse suspect?
3
, 4|Page
a. Acute angle closure glaucoma
b. Central retinal artery occlusion
c. Retinal detachment
d. Hyphema
28. Which of the following signs/symptoms should raise an index of suspicion that a patient is experiencing retinal
detachment?
a. “Tunnel vision” and seeing halos around lights.
b. Reddish hue to vision after getting punched in the face.
c. Crusty eyelids with yellow discharge from the eye.
d. Photopsia and “floaters” in the visual field.
29. A hazardous vulnerability assessment is completed in which phase of disaster management?
a. Mitigation
b. Preparedness
c. Response
d. Recovery
30. A patient complains of sharp chest pain that worsens with inspiration and lying down. Which sound is
commonly heard in pericarditis?
a. Systolic murmur
b. Wheezing on exhalation
c. Stridor on inspiration
d. Friction rub
31. Pertussis is a highly communicable infection characterized by gagging, vomiting, and what hallmark sign?
a. Inspiratory stridor
b. Expiratory wheeze
c. Paroxysmal cough
d. Drooling
32. A patient complaining of chest pain exhibits restlessness, tachycardia, hypertension, dilated pupils, and paranoia
so the nurse suspects which illicit drug use?
a. Cocaine
b. Heroin
c. Phencyclidine
d. Marijuana
33. A patient with a history of alcoholism has steady dull epigastric pain radiating to the back and elevated amylase
and lipase levels. A common complication of pancreatitis is:
a. Pneumonia
b. Pleural effusion
c. Pneumothorax
d. Pulmonary embolus
34. The following are common signs/symptoms of Digoxin toxicity, EXCEPT:
a. Ventricular dysrhythmias
b. Yellow or green halos in vision
c. Miosis
d. Nausea and vomiting
35. Which of the following is not a cause of priapism?
a. Sickle cell crisis
b. Testicular torsion
c. Spinal cord injury
d. Antidepressants such as Trazadone
36. Which laboratory value will be decreased in thyrotoxic crisis (thyroid storm)?
a. Calcium
b. T3 and T4
c. Alkaline phosphatase
d. Thyroid stimulating hormone (TSH)
37. Which foreign body will more likely cause an infection?
a. Bullet
4
CEN Pretest by PDB Nurse Education, LLC (BCEN)
ALL THE TYPES OF EMERGENCIES INCLUDED
WITH QUESTIONS AND ANSWERS
CONTAINS BCEN GUIDELINES AND
FREQUENTLY TESTED QUESTIONS WITH
ANSWERS
Board of Certification for Emergency Nursing
CEN - Certified Emergency Nurse Specialization
1. Pulse pressure is the difference between systolic blood pressure and diastolic blood pressure, and is widened in
which of the following disorders?
a. Early hypovolemic shock.
b. Increased intracranial pressure.
c. Cardiac tamponade.
d. Neurogenic shock.
2. Parents bring in their 4-week-old infant with non-bilious projectile vomiting and persistent hunger. Which of the
following conditions is suspected?
a. Pyloric Stenosis
b. Intussusception
c. Appendicitis
d. Volvulus
3. Systemic vascular resistance (SVR) is decreased in which type of shock?
a. Hypovolemic
b. Cardiogenic
c. Obstructive
d. Distributive
4. A 64-year-old female fell and transported to the ED via EMS for severe hip pain and inability to move. What
classification of medications may mask the early signs of hypovolemic shock?
a. Beta-blockers
b. ACE inhibitors
c. Angiotensin receptor blockers
d. Calcium channel blockers
5. A patient is transported to the ED via EMS for headache, vomiting, and progressive confusion after a fall three
days ago. Which of the following head injuries is the most likely cause of these symptoms?
a. Concussion
b. Epidural hematoma
c. Subdural hematoma
d. Basilar skull fracture
6. Which of the following is the hallmark symptom of Prinzmetal’s angina?
a. Chest pain with physical exertion.
b. Chest pain at rest due to coronary vasospasm.
c. Chest pain relieved by nitroglycerin and rest.
d. Atypical symptoms such as epigastric pain.
7. A patient with a stab wound to the left flank area is unable to move his left side and unable to feel the right side
of his body. These symptoms are associated with which of the following incomplete spinal cord injuries?
a. Anterior cord syndrome
1
,2|Page
b. Posterior cord syndrome
c. Central cord syndrome
d. Brown-Sequard syndrome
8. ST segment elevation in ECG leads II, III, and aVF indicates injury to which area of the heart?
a. Inferior wall
b. Anterior wall
c. Posterior wall
d. Lateral wall
9. Sutures placed in the eyebrows should be removed within:
a. 4 to 5 days
b. 5 to 7 days
c. 7 to 10 days
10. 10 to 14 daysA patient complains of ripping chest pain radiating to the back, has unequal bilateral blood
pressures, and numbness in the lower extremities. The nurse suspects which emergent condition?
a. Cardiac tamponade
b. Tension pneumothorax
c. Aortic dissection
d. Posterior MI
11. A 40-year-old female who is 36-weeks pregnant patient presents to the ED with painless bright red vaginal
bleeding. The nurse knows a pelvic exam is contraindicated since the most likely cause of the bleeding is:
a. Abruptio placenta
b. Placenta previa
c. Uterine rupture
d. Eclampsia
12. A 14-year-old complains of lightheadedness and palpitations. Which cardiac disorder is characterized by a short
PR interval and a Delta wave?
a. Torsades de Pointes
b. R or T phenomenon
c. AV Nodal Reentry Tachycardia (AVNRT)
d. Wolff-Parkinson-White Syndrome (WPW)
13. A 22-year-old female complains of a thick, white, “cottage-cheese” like vaginal discharge, pruritis, vulvar
burning, and dyspareunia. The nurse suspects a diagnosis of:
a. Gonorrhea
b. Chlamydia
c. Candidiasis
d. Trichomoniasis
14. Which atrioventricular block is characterized by a consistent but prolonged PR interval, and a consistent R to R
interval?
a. First degree AV block
b. Second degree AV block, type 1
c. Second degree AV block, type 2
d. Third degree AV block
15. Fever, bloating, and pain at the right costal margin upon palpation is associated with which disorder?
a. Pancreatitis
b. Cholecystitis
c. Appendicitis
d. Diverticulitis
16. Jugular vein distention (JVD), and increased central venous pressure (CVP), hepatomegaly, and peripheral
edema is seen in which disorder?
a. Endocarditis
b. Pericarditis
c. Right heart failure
d. Left heart failure
17. Which of the following signs/symptoms is typically seen in patients with Guillain-Barre syndrome?
a. Prickly sensation in extremities and ascending symmetrical paralysis.
2
,3|Page
b. Right-sided paralysis with left homonymous hemianopsia.
c. Ptosis and descending symmetrical paralysis.
d. Right-sided hemiplegia with left pupil dilation.
18. The following are signs of pericardial tamponade, EXCEPT?
a. Kussmaul sign
b. Pulsus paradoxus
c. Electrical alternans
d. Tracheal deviation
19. hich of the following is an early sign/symptom of left ventricular heart failure?
a. Jugular vein distention (JVD)
b. Paroxysmal nocturnal dyspnea
c. Abdominal ascites
d. Peripheral edema
20. Morphine is contraindicated in a right ventricular myocardial infarction (RV MI) because of what drug action?
a. Morphine increases oxygen demand.
b. Narcotics may lead to opioid dependence.
c. Morphine decreases preload.
d. Morphine increases afterload.
21. A multi-trauma patient rapidly decompensates on arrival to the emergency department. ABG results are as
follows: pH 7.25, CO2 50, HCO3 18. The patient is in which acid-base imbalance?
a. Uncompensated respiratory acidosis
b. Uncompensated metabolic acidosis
c. Uncompensated respiratory and metabolic acidosis
d. Partially compensated metabolic acidosis
22. A 20-year-old male was discharged home yesterday after a femur fracture from a fall. He returns to the ED
today with dyspnea, tachypnea, and tachycardia. You notice a petechial rash on the chest, so you suspect which
disorder?
a. Systemic inflammatory response syndrome.
b. Disseminated intravascular coagulation.
c. Rhabdomyolysis
d. Fat emboli syndrome
23. Which of the following signs/symptoms is NOT characteristic of Wernicke’s encephalopathy?
a. Confabulation
b. Chronic memory loss
c. Ataxia
d. Nystagmus
24. A patient complains of an excruciating unilateral headache with nasal congestion and excessive lacrimation on
the affected side. The nurse suspects:
a. Migraine
b. Temporal arteritis
c. Sinus headache
d. Cluster headache
25. A patient complains off crampy left lower quadrant abdominal pain with alternating episodes of explosive
diarrhea and severe constipation. The nurse knows rehydration is critical since she/he suspects which disorder?
a. Diverticulitis
b. Bowel obstruction
c. Crohn’s disease
d. Volvulus
26. Which highly communicable infection is characterized by swollen salivary and parotid glands?
a. Mumps
b. Measles
c. Pertussis
d. Diphtheria
27. A 68-year-old female with a history of atrial fibrillation complains of a sudden onset of painless unilateral vision
loss and denies any trauma. Which ocular emergency does the nurse suspect?
3
, 4|Page
a. Acute angle closure glaucoma
b. Central retinal artery occlusion
c. Retinal detachment
d. Hyphema
28. Which of the following signs/symptoms should raise an index of suspicion that a patient is experiencing retinal
detachment?
a. “Tunnel vision” and seeing halos around lights.
b. Reddish hue to vision after getting punched in the face.
c. Crusty eyelids with yellow discharge from the eye.
d. Photopsia and “floaters” in the visual field.
29. A hazardous vulnerability assessment is completed in which phase of disaster management?
a. Mitigation
b. Preparedness
c. Response
d. Recovery
30. A patient complains of sharp chest pain that worsens with inspiration and lying down. Which sound is
commonly heard in pericarditis?
a. Systolic murmur
b. Wheezing on exhalation
c. Stridor on inspiration
d. Friction rub
31. Pertussis is a highly communicable infection characterized by gagging, vomiting, and what hallmark sign?
a. Inspiratory stridor
b. Expiratory wheeze
c. Paroxysmal cough
d. Drooling
32. A patient complaining of chest pain exhibits restlessness, tachycardia, hypertension, dilated pupils, and paranoia
so the nurse suspects which illicit drug use?
a. Cocaine
b. Heroin
c. Phencyclidine
d. Marijuana
33. A patient with a history of alcoholism has steady dull epigastric pain radiating to the back and elevated amylase
and lipase levels. A common complication of pancreatitis is:
a. Pneumonia
b. Pleural effusion
c. Pneumothorax
d. Pulmonary embolus
34. The following are common signs/symptoms of Digoxin toxicity, EXCEPT:
a. Ventricular dysrhythmias
b. Yellow or green halos in vision
c. Miosis
d. Nausea and vomiting
35. Which of the following is not a cause of priapism?
a. Sickle cell crisis
b. Testicular torsion
c. Spinal cord injury
d. Antidepressants such as Trazadone
36. Which laboratory value will be decreased in thyrotoxic crisis (thyroid storm)?
a. Calcium
b. T3 and T4
c. Alkaline phosphatase
d. Thyroid stimulating hormone (TSH)
37. Which foreign body will more likely cause an infection?
a. Bullet
4
