CEN EXAM VERSION1
CEN EXAM VERSION1 NEWEST 2025/2026 COMPLETE 300
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. A HF patient with profound dyspnea, lung crackles, and pink-frothy sputum
presents to the ED. The physician orders for the pt to be placed on bilevel positive
airway pressure at an end-expiratory pressure of 10cm H2O and an inspiratory
pressure of 5cm H2O. Which of the following findings demonstrates that the pt's
symptoms and work of breathing has been reduced?:
A. Increasing the blood returned to the R side of the heart
B. Decreasing cardiac output
C. Decreasing preload
D. Increasing afterload - ANSWER-C. Decreasing the preload
NIPPV includes both continuous positive airway pressure and bilevel positive
airway pressure (BiPAP). By increasing the pressure within the thoracic cavity
through NIPPV, blood flow into the R heart is reduced, this results in a decreased
preload, which helps to improve pulmonary congestion in the CHF pt
2. IV Nitroprusside (Nipride) has been ordered for blood pressure reduction in a pt
with a hypertensive emergency. The pts BP is 280/114 with a MAP of 176. When
titrating nitroprusside for this pt, which order has the safest parameter to follow?:
A. Titrate to a MAP of 124 over the next hour
B. Titrate to a MAP of 106 over the next hour
C. Titrate to a MAP of 158 over the next hour
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, CEN EXAM VERSION1
D. Titrate to a MAP of 132 over the next hour - ANSWER-D. Titrate to a MAP of
132 over the next hour
Hypertensive emergency is defined as severe hypertension with signs or
symptoms of end organ dysfunction. It is recommended that the pts MAP be
reduced by about 20-25% within the first hour of treatment, and rapid reduction
of blood pressure should be avoided to prevent organ hypo perfusion
3. The assessment of a pt involved in a MVA reveals muffled heart sounds and
distended neck veins. The nurse understands that the treatment for this life-
threatening situation is to:
A. Minimize the administration of IV fluids
B. Prepare for a 3-4cm incision to the left of the xiphoid process
C. Prepare for the insertion of a 14-gauge needs into the midclavicular line second
intercostal space
D. Prepare for chest tube insertion at the 5th intercostal space - ANSWER-B.
Prepare for a 3-4cm incision to the left of the xiphoid process
Muffled heart sounds and distended neck veins are classic signs of pericardial
(cardiac) tamponade. A 3-4cm incision to the left of the xiphoid process allows for
pericardial decompression or release of pericardial tamponade, which is the
treatment for this life threatening situation
4. What is the best position to place a pt, in order to assess for the presence of a
cardiac friction rub?:
A. Ask the pt to stand up and then squat, then place the stethoscope at the L
sternal border and listen at mid systole
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, CEN EXAM VERSION1
B. Ask for the pt to lie or sit quietly, then place the stethoscope at the R sternal
boarder and listen for radiation to the neck
C. Ask the pt to lean forward, then place the stethoscope at the L sternal boarder
and listen at end of expiration
D. Ask the pt to lie or sit quietly, then place the stethoscope at the apex of the
heart and listen for radiation to the axilla - ANSWER-C. Ask the pt to lean forward,
then place the stethoscope at the L sternal boarder and listen at end of expiration
It has been reported that up to 85% of patients with pericarditis will have a
friction rub. Although the presence of a friction rub during initial evaluation of a pt
with pericarditis is unreliable, when present, it is best heard while the pt is leaning
forward, with the stethoscope placed at the left sternal boarder at end expiration.
The sound that is made when inflamed layers of the pericardium rub against each
other is the thought to be the cause of the friction rub
5. Raynaud's disease is characterized by which assessment finding?:
A. Severe leg cramps and redness
B. Carpopedal spasms and intense heat
C. Intense vasospasm and pallor of the digits
D. Numbness and tingling of the wrist and elbow - ANSWER-C. Intense vasospasm
and pallor of the digits
Raynauds disease affects blood vessels supplying the skin. Intense vasospasm are
noted to the digits, tip of the nose or ears. Because circulation is impaired, pallor
is also noted, especially in cold environments. This disease affects women more
than men
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6. Which of the following statements made by the pt recently diagnosed with
peripheral vascular disease indicates that the pt has an accurate understanding of
the disease?:
A. " When my leg starts to cramp, I should stop walking and rest"
B. " When pain develops in my leg, I should apply an ice pack"
C. " When my leg starts to cramp, I should elevate it on two pillows"
D. " I will limit my cig smoking to half a pack a day" - ANSWER-A. When my legs
starts to cramp, I should stop walking and rest"
Pain from peripheral vascular disease (PVD) can develop while exercising,
experiencing stress and being in a cold environement. It can be relieved by
removing or discontinuing the cause
7. Which of the following patients would demonstrate the presence of delayed
venous return resulting from increased intra-abdominal pressure, creating a high
risk for DVT and PE?:
A. 57 y/o hypertensive male
B. 48 y/o diabetic female
C. 26 y/o bariatric female
D. 32 y/o male with peripheral vascular disease - ANSWER-C. 26 y/o bariatric
female
The bariatric pt has delayed venous return resulting from increased intra-
abdominal pressure, creating a high risk for DVT or PE
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CEN EXAM VERSION1 NEWEST 2025/2026 COMPLETE 300
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. A HF patient with profound dyspnea, lung crackles, and pink-frothy sputum
presents to the ED. The physician orders for the pt to be placed on bilevel positive
airway pressure at an end-expiratory pressure of 10cm H2O and an inspiratory
pressure of 5cm H2O. Which of the following findings demonstrates that the pt's
symptoms and work of breathing has been reduced?:
A. Increasing the blood returned to the R side of the heart
B. Decreasing cardiac output
C. Decreasing preload
D. Increasing afterload - ANSWER-C. Decreasing the preload
NIPPV includes both continuous positive airway pressure and bilevel positive
airway pressure (BiPAP). By increasing the pressure within the thoracic cavity
through NIPPV, blood flow into the R heart is reduced, this results in a decreased
preload, which helps to improve pulmonary congestion in the CHF pt
2. IV Nitroprusside (Nipride) has been ordered for blood pressure reduction in a pt
with a hypertensive emergency. The pts BP is 280/114 with a MAP of 176. When
titrating nitroprusside for this pt, which order has the safest parameter to follow?:
A. Titrate to a MAP of 124 over the next hour
B. Titrate to a MAP of 106 over the next hour
C. Titrate to a MAP of 158 over the next hour
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, CEN EXAM VERSION1
D. Titrate to a MAP of 132 over the next hour - ANSWER-D. Titrate to a MAP of
132 over the next hour
Hypertensive emergency is defined as severe hypertension with signs or
symptoms of end organ dysfunction. It is recommended that the pts MAP be
reduced by about 20-25% within the first hour of treatment, and rapid reduction
of blood pressure should be avoided to prevent organ hypo perfusion
3. The assessment of a pt involved in a MVA reveals muffled heart sounds and
distended neck veins. The nurse understands that the treatment for this life-
threatening situation is to:
A. Minimize the administration of IV fluids
B. Prepare for a 3-4cm incision to the left of the xiphoid process
C. Prepare for the insertion of a 14-gauge needs into the midclavicular line second
intercostal space
D. Prepare for chest tube insertion at the 5th intercostal space - ANSWER-B.
Prepare for a 3-4cm incision to the left of the xiphoid process
Muffled heart sounds and distended neck veins are classic signs of pericardial
(cardiac) tamponade. A 3-4cm incision to the left of the xiphoid process allows for
pericardial decompression or release of pericardial tamponade, which is the
treatment for this life threatening situation
4. What is the best position to place a pt, in order to assess for the presence of a
cardiac friction rub?:
A. Ask the pt to stand up and then squat, then place the stethoscope at the L
sternal border and listen at mid systole
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, CEN EXAM VERSION1
B. Ask for the pt to lie or sit quietly, then place the stethoscope at the R sternal
boarder and listen for radiation to the neck
C. Ask the pt to lean forward, then place the stethoscope at the L sternal boarder
and listen at end of expiration
D. Ask the pt to lie or sit quietly, then place the stethoscope at the apex of the
heart and listen for radiation to the axilla - ANSWER-C. Ask the pt to lean forward,
then place the stethoscope at the L sternal boarder and listen at end of expiration
It has been reported that up to 85% of patients with pericarditis will have a
friction rub. Although the presence of a friction rub during initial evaluation of a pt
with pericarditis is unreliable, when present, it is best heard while the pt is leaning
forward, with the stethoscope placed at the left sternal boarder at end expiration.
The sound that is made when inflamed layers of the pericardium rub against each
other is the thought to be the cause of the friction rub
5. Raynaud's disease is characterized by which assessment finding?:
A. Severe leg cramps and redness
B. Carpopedal spasms and intense heat
C. Intense vasospasm and pallor of the digits
D. Numbness and tingling of the wrist and elbow - ANSWER-C. Intense vasospasm
and pallor of the digits
Raynauds disease affects blood vessels supplying the skin. Intense vasospasm are
noted to the digits, tip of the nose or ears. Because circulation is impaired, pallor
is also noted, especially in cold environments. This disease affects women more
than men
3|Page
, CEN EXAM VERSION1
6. Which of the following statements made by the pt recently diagnosed with
peripheral vascular disease indicates that the pt has an accurate understanding of
the disease?:
A. " When my leg starts to cramp, I should stop walking and rest"
B. " When pain develops in my leg, I should apply an ice pack"
C. " When my leg starts to cramp, I should elevate it on two pillows"
D. " I will limit my cig smoking to half a pack a day" - ANSWER-A. When my legs
starts to cramp, I should stop walking and rest"
Pain from peripheral vascular disease (PVD) can develop while exercising,
experiencing stress and being in a cold environement. It can be relieved by
removing or discontinuing the cause
7. Which of the following patients would demonstrate the presence of delayed
venous return resulting from increased intra-abdominal pressure, creating a high
risk for DVT and PE?:
A. 57 y/o hypertensive male
B. 48 y/o diabetic female
C. 26 y/o bariatric female
D. 32 y/o male with peripheral vascular disease - ANSWER-C. 26 y/o bariatric
female
The bariatric pt has delayed venous return resulting from increased intra-
abdominal pressure, creating a high risk for DVT or PE
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