CEN Certified Emergency Nurse MCQ 3

Question 1

A patient presents with sudden onset severe headache described as 'the worst headache of my life.' What is the priority diagnosis to rule out?

Accepted Answer

Subarachnoid hemorrhage

Answer

A thunderclap headache (worst of life) is subarachnoid hemorrhage until proven otherwise, requiring immediate CT head without contrast.

Question 2

Which intervention is contraindicated in a patient with suspected increased intracranial pressure (ICP)?

Accepted Answer

Vigorous suctioning for more than 15 seconds

Answer

Prolonged suctioning causes hypoxia and Valsalva responses that spike ICP; suction attempts should be brief and limited.

Question 3

A patient with known COPD presents in respiratory distress. ABG shows pH 7.28, PaCO2 72, PaO2 55. What is the correct interpretation?

Accepted Answer

Respiratory acidosis with hypoxemia

Answer

Low pH with elevated PaCO2 indicates respiratory acidosis (CO2 retention), and PaO2 < 60 mmHg indicates hypoxemia.

Question 4

A 68-year-old is found unresponsive with a glucose of 22 mg/dL. After administering 50 mL of D50W IV, there is no improvement. What should the nurse consider next?

Accepted Answer

Assess for concurrent causes such as alcohol use or adrenal insufficiency

Answer

Failure to respond to dextrose suggests the hypoglycemia is refractory, possibly due to alcohol-induced hypoglycemia or adrenal insufficiency requiring additional treatment.

Question 5

Which of the following is the correct sequence for synchronized cardioversion in a hemodynamically unstable patient with atrial flutter?

Accepted Answer

50–100 J biphasic → increase if needed

Answer

Synchronized cardioversion for atrial flutter begins at 50–100 J biphasic and is increased stepwise if the initial attempt fails.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Certified Emergency Nurse MCQ 3