CEN Certified Emergency Nurse 3

Question 1

A 28-year-old female presents with right lower quadrant pain, vaginal spotting, and a positive pregnancy test. Her BP is 80/50 and HR is 128. What is the priority intervention?

Accepted Answer

Establish large-bore IV access and prepare for emergency surgery

Answer

This presentation is consistent with a ruptured ectopic pregnancy causing hemorrhagic shock; immediate IV access, fluid resuscitation, and surgical preparation are priorities.

Question 2

Which Glasgow Coma Scale (GCS) score indicates the need for definitive airway management?

Accepted Answer

GCS 8 or less

Answer

A GCS of 8 or less indicates severe brain injury with inability to protect the airway, requiring endotracheal intubation.

Question 3

A patient with sickle cell disease presents with fever of 38.9°C, chest pain, and a new pulmonary infiltrate on CXR. This presentation is most consistent with:

Accepted Answer

Acute chest syndrome

Answer

Acute chest syndrome is defined by a new pulmonary infiltrate with fever, chest pain, or respiratory symptoms in a sickle cell patient.

Question 4

A nurse is caring for a patient receiving tPA for acute ischemic stroke. The patient suddenly develops severe headache and BP rises to 185/105. What is the priority action?

Accepted Answer

Stop the tPA infusion and notify the physician immediately

Answer

Sudden severe headache and hypertension during tPA therapy are signs of hemorrhagic transformation; the infusion must be stopped immediately.

Question 5

Which finding in a pediatric patient is the EARLIEST indicator of decompensated shock?

Accepted Answer

Tachycardia

Answer

Children compensate effectively for shock; tachycardia is the earliest sign, while hypotension is a late and ominous finding.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Certified Emergency Nurse 3