CEN Certified Emergency Nurse 4

Question 1

A patient with suspected C5 spinal cord injury is hypotensive with bradycardia and warm, flushed skin. This hemodynamic picture is most consistent with:

Accepted Answer

Neurogenic shock

Answer

Loss of sympathetic tone in neurogenic shock causes vasodilation (warm skin) and bradycardia, distinguishing it from other shock types.

Question 2

A patient with a suspected overdose has a QRS duration of 140 ms on ECG, hypotension, and altered mental status. Which drug class is most likely responsible?

Accepted Answer

Tricyclic antidepressants

Answer

Tricyclic antidepressants cause sodium channel blockade, widening the QRS complex and producing the classic toxidrome of hypotension, dysrhythmia, and CNS depression.

Question 3

A patient presents with painless monocular vision loss described as a 'curtain coming down.' This symptom is most suggestive of:

Accepted Answer

Retinal detachment

Answer

A 'curtain coming down' or 'veil' over vision is the classic description of retinal detachment due to progressive separation of the retina.

Question 4

During a mass casualty incident, a patient is found apneic. After repositioning the airway, the patient remains apneic. Under START triage, this patient is classified as:

Accepted Answer

Expectant (Black)

Answer

Under START triage, a patient who is apneic after airway repositioning is classified as Expectant (Black), indicating survival is unlikely with available resources.

Question 5

A patient presents with fever, hypotension, altered mental status, and a petechial rash spreading rapidly over the trunk. The nurse suspects:

Accepted Answer

Meningococcal septicemia

Answer

Rapidly spreading petechiae with fever, hypotension, and altered mental status is the hallmark presentation of meningococcal septicemia, a life-threatening emergency.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Certified Emergency Nurse 4