Certified Emergency Nurse Flashcards
7 cards from real CEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Certified Emergency Nurse flashcards as text
A patient arrives after a high-voltage electrical injury. Beyond cardiac monitoring, what other system requires priority assessment?
Answer: Musculoskeletal and renal systems for rhabdomyolysis
High-voltage injuries cause massive muscle destruction (rhabdomyolysis), releasing myoglobin that can cause acute renal failure; aggressive IV fluids and urine output monitoring are essential.
A 6-week-old infant presents with projectile, non-bilious vomiting after every feeding and a palpable olive-shaped mass in the epigastrium. This is most consistent with:
Answer: Pyloric stenosis
Projectile non-bilious vomiting with an olive-shaped epigastric mass in a 4-8 week old infant is the classic presentation of hypertrophic pyloric stenosis.
A patient on heparin infusion develops a sudden drop in platelet count from 280,000 to 80,000 on day 7. The nurse suspects heparin-induced thrombocytopenia (HIT). What is the priority action?
Answer: Discontinue heparin and begin an alternative anticoagulant
HIT is a prothrombotic condition; all heparin must be immediately discontinued and a direct thrombin inhibitor (e.g., argatroban) started to prevent thrombosis.
A patient presents with chest pain and a widened mediastinum on CXR. BP in the right arm is 160/90 and in the left arm is 90/60. The nurse suspects aortic dissection. Which action is contraindicated?
Answer: Administer thrombolytics
Thrombolytics are absolutely contraindicated in aortic dissection as they would worsen hemorrhage and increase mortality.
A patient with type 1 diabetes presents with Kussmaul respirations, fruity breath, blood glucose of 520 mg/dL, and a serum potassium of 3.8 mEq/L. When should insulin be initiated in DKA management?
Answer: Only after potassium is greater than 3.5 mEq/L and IV fluids are running
Insulin drives potassium into cells; it must not be given until potassium is ≥3.5 mEq/L and IV fluid resuscitation is underway to prevent life-threatening hypokalemia.
Which of the following is the most reliable early indicator of inadequate perfusion in a trauma patient?
Answer: Rising serum lactate
Elevated serum lactate reflects anaerobic metabolism and tissue hypoperfusion, often rising before overt hemodynamic changes become apparent.
A patient presents with priapism following recreational drug use. Which drug class is most commonly associated with this condition?
Answer: Cocaine and other stimulants
Cocaine and other stimulants cause priapism through alpha-adrenergic mechanisms that disrupt normal penile blood flow regulation.