CEN Cheat Sheet 2026

The 30 highest-yield CEN facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A cirrhotic patient presents with confusion, asterixis, and jaundice. The nurse anticipates which primary diagnosis? → Hepatic encephalopathy
2. A client's penetrating abdominal injuries has resulted in hypovolemia. What is the best procedure for resuscitating fluids quickly? → large bore peripheral IV
3. A patient is intubated and the ventilator alarms for high peak airway pressure. Breath sounds are absent on the left. What is the most likely cause? → Right mainstem intubation
4. Intussusception most commonly occurs at which anatomical location? → Ileocecal valve (ileocolic)
5. Which assessment is CONTRAINDICATED in a patient with suspected placenta previa? → Digital cervical examination
6. Which size endotracheal tube is appropriate for a 5-year-old undergoing emergency intubation? → 4.5–5.0 mm cuffed or uncuffed
7. A patient with chest pain has a 12-lead ECG showing ST depression in V1–V4. Which condition should be considered first? → Posterior MI
8. A patient with increased intracranial pressure (ICP) is being managed. Which intervention is most appropriate as a temporizing measure? → Elevate head of bed to 30 degrees and hyperventilate to PaCO2 35 mmHg
9. Which type of traumatic brain injury is associated with a 'lucid interval' followed by rapid deterioration? → Epidural hematoma
10. Which formula is used to estimate the endotracheal tube size for a child between ages 1 and 10? → (Age / 4) + 4
11. A patient presents with sudden-onset dyspnea and unilateral leg swelling. Wells score is 6. What is the next step? → CT pulmonary angiography
12. A patient has a suspected tension pneumothorax in the field. What is the prehospital treatment? → Needle thoracostomy at the 2nd intercostal space, midclavicular line
13. When should cardiopulmonary resuscitation in a pregnant patient include lateral uterine displacement? → After 20 weeks gestation or when the uterus is palpable at the umbilicus
14. Which ventilator strategy is recommended to reduce lung injury in ARDS patients? → Tidal volume of 6 mL/kg ideal body weight with permissive hypercapnia
15. A patient is in pulseless ventricular tachycardia. After the second defibrillation attempt, which medication should be given? → Amiodarone 300 mg IV push
16. Which medication is the first-line treatment for symptomatic bradycardia with hypotension in a stable patient? → Atropine
17. Which assessment finding indicates a class III hemorrhagic shock (estimated blood loss 1500–2000 mL)? → Heart rate 120–140, decreased BP, confused, decreased urine output
18. A postpartum patient (1 hour after delivery) develops heavy vaginal bleeding with a boggy, enlarged uterus. What is the priority intervention? → Uterine massage and oxytocin administration
19. A 2-year-old presents with sudden onset barky cough, inspiratory stridor, and low-grade fever. What is the most likely diagnosis? → Croup (laryngotracheobronchitis)
20. Which of the following is a contraindication to administering IV tPA for acute ischemic stroke? → Recent ischemic stroke within the last 3 months
21. A patient with suspected hyperkalemia (K+ 7.1 mEq/L) and peaked T waves on ECG is being treated. What is the priority first intervention? → Administer calcium gluconate IV
22. What is the drug of choice to prevent and treat seizures in eclampsia? → Magnesium sulfate 4–6 g loading dose IV
23. A patient with ureteral calculi presents with colicky right flank pain radiating to the groin and hematuria. Which analgesic strategy is most effective? → IV ketorolac combined with IV opioid analgesics
24. Which finding is characteristic of a positive Murphy's sign? → Pain and inspiratory arrest during deep RUQ palpation
25. Which clinical criterion is NOT part of the Berlin Definition of ARDS? → A high BNP level confirming cardiac cause
26. What is the appropriate initial fluid bolus for a child in septic shock? → 20 mL/kg NS or LR IV over 5–10 minutes, reassess after each bolus
27. An upright KUB film of a patient with stomach pain reveals air under the diaphragm. What of the following is most likely to be the cause? → bowel perforation
28. Magnesium toxicity in a preeclamptic patient on magnesium sulfate infusion is first evidenced by loss of which reflex? → Patellar (knee-jerk) reflex
29. A 3-year-old presents with a temperature of 39.5°C, petechiae spreading rapidly, and altered mental status. What diagnosis requires immediate action? → Meningococcal septicemia
30. A 10-year-old with sickle cell disease presents with fever (38.6°C), chest pain, and hypoxia. CXR shows a new infiltrate. What is this complication called? → Acute chest syndrome