BCEN Patient Assessment and Diagnosis 5

Question 1

A 28-year-old female of childbearing age presents to the ED with lower abdominal pain and vaginal spotting. Which assessment is MOST critical before further workup?

Accepted Answer

Urine pregnancy test

Answer

A urine pregnancy test must be performed first to rule out ectopic pregnancy before other diagnostics, as this is a life-threatening condition.

Question 2

Which capnography waveform finding indicates esophageal intubation?

Accepted Answer

Absence of waveform with ETCO2 near zero

Answer

Absence of a capnography waveform and ETCO2 near zero confirms esophageal intubation, as the stomach does not produce sustained CO2.

Question 3

A patient presents with a sudden onset of the 'worst headache of my life.' Which condition must be ruled out FIRST?

Accepted Answer

Subarachnoid hemorrhage (SAH)

Answer

A thunderclap headache described as the worst ever is the classic presentation of subarachnoid hemorrhage until proven otherwise.

Question 4

Which finding is MOST consistent with cardiac tamponade on physical examination?

Accepted Answer

Hypotension, JVD, and muffled heart sounds (Beck's triad)

Answer

Beck's triad — hypotension, JVD, and muffled heart sounds — is the classic presentation of cardiac tamponade.

Question 5

A patient presents with sudden onset dyspnea, pleuritic chest pain, and unilateral leg swelling after a long flight. SpO2 is 88%. Which condition is MOST likely?

Accepted Answer

Pulmonary embolism

Answer

Dyspnea, pleuritic chest pain, hypoxia, and unilateral leg swelling following prolonged immobility are classic features of pulmonary embolism.

(BCEN) Board of Certification of Emergency Nursing Practice Test

(BCEN) Board of Certification of Emergency Nursing Practice Test

BCEN Patient Assessment and Diagnosis 5