CEN Certified Emergency Nurse MCQ 4

Question 1

Which toxidrome is characterized by miosis, bradycardia, bronchospasm, excessive secretions, and diaphoresis?

Accepted Answer

Cholinergic (organophosphate)

Answer

The SLUDGE/DUMBELS mnemonic describes cholinergic toxidrome caused by organophosphate poisoning, which overstimulates muscarinic receptors.

Question 2

What is the antidote for acetaminophen toxicity, and within what timeframe is it most effective?

Accepted Answer

N-acetylcysteine (NAC), within 8–10 hours of ingestion

Answer

NAC is most effective when given within 8 hours of acetaminophen ingestion but can still provide benefit if given later; it replenishes glutathione to prevent hepatotoxicity.

Question 3

A patient presents with altered mental status, fever, muscle rigidity, and clonus after starting a new antidepressant. What condition should be suspected?

Accepted Answer

Serotonin syndrome

Answer

Serotonin syndrome presents with the triad of mental status changes, autonomic instability, and neuromuscular abnormalities (especially clonus) following serotonergic medication use.

Question 4

A patient on warfarin presents with an INR of 9.5 and active GI bleeding. What is the most appropriate reversal agent?

Accepted Answer

4-factor prothrombin complex concentrate (4F-PCC) plus Vitamin K IV

Answer

4F-PCC provides rapid reversal of warfarin-induced coagulopathy in life-threatening bleeding, and Vitamin K ensures sustained reversal; this combination is preferred over FFP alone.

Question 5

Which sign is most specific for cardiac tamponade on physical examination?

Accepted Answer

Beck's triad: hypotension, muffled heart sounds, and JVD

Answer

Beck's triad (hypotension, muffled heart sounds, JVD) is the classic physical examination finding of cardiac tamponade, though it is not always present.

CEN - Certified Emergency Nurse Practice Test

CEN - Certified Emergency Nurse Practice Test

CEN Certified Emergency Nurse MCQ 4