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Detailed BCEN CEN Exam Prep
Questions and Answers.
Which of the following statements made by a patient would lead the nurse to conclude that the patient understands risk factors for pulmonary embolism? While on a long flight, I should get up and walk to stretch my legs every hour. Resuming my birth control pills will lower my risk of cancer and my risk of another clot. If I drink plenty of water while driving on a long trip, this shouldn't happen again. Switching from my regular cigarettes to the electronic ones can reduce my risk. - \While on a long flight, I should get up and walk to stretch my legs every hour. An emergency nurse is providing discharge instructions for a patient with pelvic inflammatory disease. Which statement made by the patient indicates an understanding of these instructions? Getting pregnant shouldn't be a problem once the infection goes away. I'll take the medicine for nausea when I feel sick to my stomach. I will be at increased risk for ectopic pregnancy. I will follow up with my doctor tomorrow. - \I will be at increased risk for ectopic pregnancy. A 16-year-old presents with severe left upper quadrant abdominal pain after an over- the-handlebars bicycle collision. Vital signs are BP 100/60 mm Hg, HR 100 beats/min, RR 30 breaths/min, T 37.0 C (98.6 F), SpO2 89% without supplemental oxygen. There is bruising over the left upper quadrant of the abdomen. Auscultation reveals diminished breath sounds on the left accompanied by gurgling. Based on this history and assessment, the nurse suspects which injury? Small bowel rupture Ruptured diaphragm Flail chest Hepatic injury - \Ruptured diaphragm A patient presents with chest pain. The nurse performs a 12-lead electrocardiogram that reveals an abnormal Q wave. What does the nurse suspect? A current injury An old infarction An acute infarction Ischemia - \An old infarction
A patient is brought to the ED by emergency medical services with increased aggression and making clear homicidal threats. What immediate action will the nurse expect to promote staff and patient safety? Administration of antipsychotics One-to-one observation Place in a seclusion room Application of restraints - \Place in a seclusion room A 28-year-old female presents with shortness of breath, dizziness, and diaphoresis. Her vital signs are BP 118/74 mm Hg, HR 122 beats/min, RR 26 breaths/min, T 37.7 C (99. F), SpO2 92% without supplemental oxygen. Her health history includes fractures of the left tibia and fibula following an MVC 3 weeks ago. Surgical fixation was required. Her only current medications are an oral contraceptive and intermittent ibuprofen for pain. Assessment of the casted left leg reveals that the toes are swollen. With this information, which diagnostic testing will the nurse expect as the highest priority? Sputum cultures Chest radiograph Computed tomographic pulmonary angiography Radiograph of the left leg - \Computed tomographic pulmonary angiography A family of 10 presents to the ED with complaints of fever, muscle pain, and unexplained bruising ongoing for 7 days. After completing the screening, the nurse notes that the family recently traveled to Sierra Leone. What is the highest priority intervention the triage nurse needs to perform? Notify infection prevention Leave the family in the waiting room Evacuate the waiting room Inform those waiting that Ebola has been detected - \Notify infection prevention A patient presents to the ED with complaints of fatigue and insomnia. Assessment findings reveal the patient is awake, alert, and oriented, has a round moon face, buffalo hump back, hirsutism and prominent striae on the trunk. Vital signs are normal. Which of the following scenarios is most consistent with this patient's presentation? A high school wrestler who admits to taking his grandfather's furosemide before a meet A patient with insulin-dependent diabetes who took insulin, without eating breakfast. A patient with severe chronic asthma who has been on prednisone for several years A patient who underwent a thyroidectomy several years ago who recently ran out of medication - \A patient with severe chronic asthma who has been on prednisone for several years A patient who was brought to the ED by ambulance following a motor vehicle collision, in which the driver hit a tree, has BP 92/48 mm Hg, HR 128 beats/min, RR 34 breaths/min, SpO2 91% with supplemental oxygen via a nonrebreather. He has labored
Carry the evidence with them until released to law enforcement - \Limit the number of people with access to the evidence Which orthopedic condition is the result of elevated uric acid levels? Joint effusion Osteomyelitis Gouty arthritis Bursitis - \Gouty arthritis A patient presents to the ED with sensory hallucinations and delusions. He also has disorganized speech and grossly disordered behavior. What would the nurse expect to take place in order for the patient to be properly cared for? A suicide risk assessment Administration of antipsychotics Application of restraints Medical clearance - \Medical clearance A patient has just been diagnosed with endocarditis. While preparing for surgery for valvular repair, which intervention will the nurse perform? Insert a urinary catheter Insert a gastric tube Begin an infusion of nitroprusside Administer antibiotics - \Administer antibiotics A patient has an unsteady gait, weakness, diminished sensation to the face and arms, and vision changes. These findings are most likely associated with neurological condition? Myasthenia gravis Amyotrophic lateral sclerosis Multiple sclerosis Parkinson's disease - \Multiple sclerosis The emergency nurse knows that a patient who has experienced a severe electrical injury is at risk for which of the following? Arrhythmias Carboxyhemoglobinemia Tissue liquefaction Hypocalcemia - \Arrhythmias Which heart block is associated with a lengthening PR interval until a QRS complex is dropped?
First degree Second degree type II Third degree Second degree type I - \Second degree type I Which of the following interventions would be appropriate for a patient who has been diagnosed with renal calculi? Apply ice to the flank area Immediate surgical intervention Administer antiemetics NPO status - \Administer antiemetics A 67-year-old male presents with sudden-onset, sharp, stabbing pain in his chest, flank, and back. He states he's taken ibuprofen and sublingual nitroglycerin prescribed for his angina. There has been no relief. Assessment reveals he is slurring his words, there is a facial droop, and his grip strength is weaker on the right. Vital signs are BP 108/ mm Hg, HR 96 beats/min, RR 18 breaths/min, T 37.0 C (98.6 F), SpO2 91% without supplemental oxygen. What assessment can the nurse do to further determine the cause of these signs and symptoms? Take a blood pressure on the other arm Send blood to the laboratory for toxicology Perform an assessment for stroke Send blood to the laboratory for cardiac enzymes - \Take a blood pressure on the other arm A patient has just been diagnosed with diabetes insipidus. Which medication will the nurse expect to give? Hypertonic saline Methylprednisolone Vasopressin Furosemide - \Vasopressin A 56-year-old female presents with vague complaints of fatigue and bloating. Assessment reveals pitting edema of hands and feet, abdominal distention, and prominent neck veins. What condition is described by these clinical manifestations? Myocardial infarction Aortic dissection Right-sided heart failure Left-sided heart failure - \Right-sided heart failure
Colicky pain Ribbon-like stools Left lower quadrant tenderness Currant jelly-like stools - \Currant jelly-like stools A patient presents with a sudden onset of shortness of breath, cough, and mild chest pain. Past medical history includes heart failure and recent treatment for pneumonia. Considering the patient's history, the nurse anticipates a workup for which respiratory problem? Chronic bronchitis Pleural effusion Pulmonary embolism Pulmonary contusion - \Pleural effusion A patient presents to the emergency department with right-sided facial drooping, right arm weakness and slurred speech. Which of the following assessments indicates exclusion criteria for receiving tissue plasminogen activator (tPA)? Blood glucose of 180 mg/dL BP 190/110 mm Hg NIH stroke scale of 6 Headache - \BP 190/110 mm Hg A 16-year-old male is brought to the ED by his coach. The patient was playing football in moderately cold weather one hour prior to arrival and felt severe pain in the left groin area. This is suggestive of which genitourinary emergency? Paraphimosis Testicular torsion Priapism Acute epididymitis - \Testicular torsion A 3-year-old boy is brought to the ED by his mother, who noticed bruises on the boy's left thigh, back, and feet developing over the last week. Past medical history includes a mild respiratory virus a month ago. The assessment reveals, he is awake and alert, with some bleeding noted around the gums. Initial laboratory values include a low platelet count with a normal white blood cell count. Hemoglobin and hematocrit are slightly low. Which disorder does the nurse suspect is the cause of his signs and symptoms? Leukemia Thrombocytosis Disseminated intravascular coagulopathy Idiopathic thrombocytopenia purpura - \Idiopathic thrombocytopenia purpura
A 50-year-old male arrives at the emergency department via ambulance after sustaining a knife wound to the right side of his back. He has loss of movement on the right side and loss of sensation on the left side of his body. The nurse suspects that this is which type of spinal cord injury? Brown-Séquard syndrome Anterior cord syndrome Posterior cord syndrome Central cord syndrome - \Brown-Séquard syndrome Each week a community hospital emergency department employs key performance indicators (KPI) to identify opportunities to enhance customer and staff satisfaction. This type of activity is a component of what? Symptom surveillance Patient confidentiality Quality improvement Risk management - \Quality improvement A 74-year-old presents to the ED with a history of chronic bronchitis and complaints of dyspnea and shortness of breath. He is cyanotic and the nurse applies oxygen. Which of the following assessment findings will be most concerning to the nurse? A respiratory rate of 10 breaths/min An elevated hemoglobin Generalized edema Productive cough - \A respiratory rate of 10 breaths/min A patient presents to the emergency department complaining of flu-like symptoms, malaise, and fever for three days after being bitten by a bat. The emergency nurse suspects which condition? Tularemia West Nile virus Rabies Rocky Mountain spotted fever - \Rabies An older adult patient arrives in the emergency department after she fell on her bathroom floor and was unable to get up. Knowing the patient was on the floor for a prolonged period of time, what clinical manifestation will the emergency nurse assess for? Blood in the urine Dysuria Dark brown urine Anuria - \Dark brown urine
A patient presents to the ED following an incident with an acid splash to the eye. He reports severe pain, is unable to open the eye, and there is constant tearing. What is the nurse's first priority? Patch the affected eye Irrigation Visual acuity testing Test the eye for pH - \Irrigation A 22-year-old patient presents with upper respiratory symptoms, nausea and vomiting and a low-grade fever. She has a history of leukemia and underwent chemotherapy 2 weeks ago. What is the nurse's priority? Protective isolation Ondansetron oral dissolving tablet Intravenous fluid bolus Morphine intravenous - \Protective isolation A patient presents to the ED with a chief complaint of "It feels like I have something in my eye, but I can't see it." What eye injury is this most likely to represent? Corneal ulcer Keratitis Hyphema Corneal abrasion - \Corneal abrasion In compensated shock, what physiological response increases serum sodium? Sympathetic nervous system (SNS) response Intracellular fluid shift Renin-angiotensin-aldosterone system (RAAS) Altered capillary permeability - \Renin-angiotensin-aldosterone system (RAAS) A patient describes symptoms of recent onset of eye pain and denies any traumatic injury. He is seeing haloes around lights and is experiencing nausea, vomiting, and headaches. The nurse's assessment reveals loss of peripheral vision and redness of the affected eye. Which condition does this set of clinical manifestations describe? Acute angle glaucoma Keratitis Corneal ulcer Retinal detachment - \Acute angle glaucoma Which of the following clinical presentations is most consistent with a patient who has pancreatitis?
Pain with palpation of the right subcostal area during inspiration Diffuse cramping abdominal pain Epigastric pain that radiates to the back Dull, constant umbilical pain - \Epigastric pain that radiates to the back Administration of activated charcoal is indicated for which of the following overdoses? Hydrofluoric acid Carbamazepine Ferrous sulfate Lithium - \Carbamazepine Which one of the following is an appropriate intervention for acute lithium toxicity? IV fluids with hypertonic solution Urine alkalinization Hemodialysis Give activated charcoal - \Hemodialysis The level of alertness and attention displayed by a patient with a diffuse axonal injury is determined by which segment of the neurological system? Reticular activating system Brainstem Frontal lobe Limbic system - \Reticular activating system What is the first intervention that is appropriate for the nurse to perform once a neonate has been delivered? Thoroughly dry the neonate Suction the mouth and nose Measure APGAR score Clamp the umbilical cord - \Thoroughly dry the neonate The nurse is giving discharge instructions to a patient with chronic obstructive pulmonary disease - emphysema. Which response indicates the patient understands the instructions? I need to limit my fluids to prevent fluid overload. I need to sleep with my feet elevated to prevent swelling. I need to get the pneumococcal vaccine. I need to avoid snacking between meals. - \I need to get the pneumococcal vaccine.
Ischemic stroke Bell's palsy Transient ischemic attacks - \Transient ischemic attacks A 37-year-old female walks into the ED holding her abdomen. She is writhing in pain. Her history includes vaginal bleeding for the past 6 days. She soaked 5 sanitary pads in 2 hours. What is the most likely cause of the heavy bleeding? Uterine fibroids Mittelschmerz Pelvic inflammatory disease Bartholin cyst - \Uterine fibroids Wernicke-Korsakoff syndrome is characterized by which clinical manifestations? Ataxia, mental confusion, and ophthalmoplegia Delirium tremens, hyperthermia, and disorientation Tachycardia, tremors, and tachypnea Hypothermia, muscle rigidity, and bradycardia - \Ataxia, mental confusion, and ophthalmoplegia A 35-year-old man presents with complaints of stomach pain that comes and goes for the past two weeks. The nurse asks additional questions about the nature of this pain and finds that it is relieved with antacids and he feels better after eating. The patient mentions that he had some similar pain about two years ago, but it stopped after about a month and he never sought care for it. This is most likely which type of gastrointestinal disorder? Cholecystitis Pancreatitis Duodenal ulcer Stress ulcer - \Duodenal ulcer Which immunoglobulin is responsible for Type 1 allergic responses? IgA IgE IgG IgM - \IgE A middle-aged male patient presents to the ED with complaint of fever. He is awake, alert, and in no acute distress. On arrival, vital signs are BP 118/58 mm Hg, HR 112 beats/min, RR 20 breaths/min, SpO2 95%, T 38.8 C (101.9 F). His medical history includes human immunodeficiency virus (HIV) and he is taking antiviral medications. Using a 5-level triage system, this patient would be triaged as which acuity level? Acuity Level 4 (non-urgent)
Acuity Level 2 (emergent) Acuity Level 1 (life-threatening situation) Acuity Level 3 (urgent) - \Acuity Level 2 (emergent) An 84-year-old male with a decreased level of consciousness presents to the emergency department from a nursing home. The patient has a history of hypertension, gout, and chronic obstructive pulmonary disease. He is allergic to penicillin. Current medications include docusate, albuterol inhaler, colchicine, and metoprolol. Vital signs on arrival are BP 78/48 mm Hg, HR 60 beats/min, RR 28 breaths/min, T 35.3 C (95. F), and SpO2 92% without supplemental oxygen. Which type of shock do these clinical manifestations represent? Obstructive Septic Anaphylactic Hypovolemic - \Septic A 56-year-old female presents to the emergency department with complaints of abdominal pain for 5 days. The patient was involved in a motor vehicle crash, but did not feel that she needed to come to the emergency department. Upon examination, the patient has no active bowel sounds and the abdomen is rigid. The patient has which gastrointestinal emergency? Peritonitis Diverticulitis Intestinal obstruction Esophageal obstruction - \Peritonitis A patient, who was successfully defibrillated, now has an irregular rhythm at 86 beats/min. The patient remains unresponsive, with absent central pulses. These findings are associated with which condition? Ruptured aortic aneurysm Pulseless electrical activity Pericardial tamponade Coarse ventricular fibrillation - \Pulseless electrical activity An adolescent playing basketball felt a pop in her heel after a jump shot, and a sharp pain in her heel as she landed. She is unable to stand on the ball of her foot. Which injury do these clinical manifestations most likely represent? Calcaneous fracture Achilles tendon rupture Ankle strain Metatarsal fracture - \Achilles tendon rupture
An ED patient is being prepared for surgical intervention for a large bowel obstruction. The surgeon needs to obtain a signature for informed consent. The patient is unable to sign the consent form because of having been heavily sedated. Which advanced directive allows for a family member to sign the consent form? Durable power of attorney for finance Living will Do not resuscitate order Durable power of attorney for healthcare - \Durable power of attorney for healthcare A male patient arrives following a motor vehicle collision. Emergency medical services report vital signs: HR 92 beats/min, RR 20 breaths/min, BP 128/74 mm Hg, SpO2 96% with a nonrebreather at 15 L/min. They state that the airbag malfunctioned and he hit the steering wheel. The nurse assesses the patient and finds bruising to the sternum, muffled heart tones, and the following vital signs: HR 102 beats/min, RR 18 breaths/min, BP 122/94 mm Hg, SpO2 92%. What pathophysiologic process does the nurse recognize? Low pulse pressure Decrease in afterload High pulse pressure Cushing triad - \Low pulse pressure Which inherited bleeding disorder is the most common? Von Willebrand Classic hemophilia Christmas disease Rosenthal syndrome - \Von Willebrand Which complication is the most common risk for all puncture wounds? Joint effusion Osteomyelitis Abscess Hemorrhage - \Abscess
- A patient presents with vaginal bleeding and cramping. She tells the emergency nurse, "I passed clots at home. I think I lost my baby." Pelvic examination reveals that the cervical os is open. Which type of spontaneous abortion most likely occurred? Missed abortion Septic abortion Inevitable abortion Threatened abortion - \Inevitable abortion
The nurse practitioner ordered a procalcitonin to be drawn on a patient. This will identify which condition? Parathyroid disease Hyperosmolar hyperglycemic syndrome (HHS) Tuberculosis Sepsis - \Sepsis A patient presents with a sore throat and difficulty swallowing. Assessment reveals fever, muffled voice, and cervical lymphadenitis. What is the highest priority? Airway protection Pain management Preparation for incision and drainage Intravenous access for fluid resuscitation - \Airway protection A 42-year-old female patient presents to the emergency department with complaints of having right upper quadrant cramping pain that radiates to the right scapula and shoulder areas. She also complains of being "bloated and passing gas." With her history, which gastrointestinal disorder is she at risk for? Cholecystitis Hepatitis Pancreatitis Diverticulitis - \Cholecystitis A patient presents to the ED with chest pain. The nurse assesses the pain and determines that rest relieves the pain. What does the nurse determine this indicates? Stable angina Unstable angina Non-ST elevation myocardial infarction ST elevation myocardial infarction - \Stable angina A 32-year-old female patient is brought to the emergency department via emergency medical services with a complaint of coughing for the past two weeks. The patient is now complaining of severe epigastric pain and is violently retching and vomiting blood. She has a history of alcohol abuse and bulimia. Which type of gastrointestinal disorder is the most likely cause of these symptoms? Diverticulitis Mallory-Weiss syndrome Pancreatitis Gastric ulcer - \Mallory-Weiss syndrome Which stage pressure ulcer includes partial thickness skin loss?
Use a mouth guard at night - \Instill artificial tears during the day Meningeal irritation in a 26-year-old patient is considered after which one of the following assessment findings? Positive Babinski Nuchal rigidity Abnormal flexion Negative Brudzinski sign - \Nuchal rigidity A mass casualty incident occurred near a level one trauma center. There were several deaths ranging from ages 3 months to 42 years old. The nurses working that night were emotionally drained and physically stressed. A critical incident process was arranged within 24 hours. Which component of the critical incident stress management process took place? Debriefing Defusing Crisis intervention Follow-up - \Debriefing An infant with a history of hydrocephalus presents with a bulging anterior fontanel, vomiting, poor feeding, and irritability. What condition do these clinical manifestations likely represent? Malrotation with volvulus Pyloric stenosis Ventriculoperitoneal shunt malfunction Meningococcemia - \Ventriculoperitoneal shunt malfunction A 68-year-old woman presents with a chief complaint of fatigue and exhaustion. She states she nearly passed out that morning and just has no energy. She states she's nauseous, but thinks it's because she's a little dizzy from almost passing out. She is overweight and has a history of smoking for 40 years, but quit 5 years ago. The nurse's assessment reveals mild tachypnea and diaphoresis. What will be the priority diagnostic assessment for this patient? Coagulation panel Depression screening Complete blood count with differential Electrocardiogram - \Electrocardiogram A multiple trauma patient, with rib fractures, a small, simple pneumothorax, and fractures of the tibia and fibula, is being transferred by rotor wing helicopter to a facility that provides a higher level of care. What is considered prior to transport by this mode?
Ensure that fluids are infusing by gravity Chest tube is placed Air splint is applied properly Insert a urinary catheter - \Chest tube is placed Which one of the following is a significant risk factor for a patient wanting to attempt suicide? History of past attempts Age between 25 and 35 years Winter months Acute physical illness - \History of past attempts A 21-year-old female presents to the ED with complaints of pelvic pain. What possible cause of the pain is assessed for first? Urinary tract infection Ectopic pregnancy Ruptured ovarian cyst Kidney stones - \Ectopic pregnancy The emergency nurse is giving discharge instructions to a patient who has just had a laceration closed with wound glue. Which statement indicates the patient understands the instructions? I should use sunscreen tomorrow when I go outside. I'll watch for it to slough off in the next two days. I should keep it covered with a bandage. I should look for redness or drainage. - \I should look for redness or drainage. The nurse is reviewing laboratory results in a patient who presents with hyperglycemia. Which of the following statements about the difference between diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome is true? The patient with hyperosmolar hyperglycemic syndrome presents with a more significant acidosis than the patient with diabetic ketoacidosis The patient with diabetic ketoacidosis presents with ketones in the urine and the patient with hyperosmolar hyperglycemic syndrome does not The patient with diabetic ketoacidosis presents with a higher blood glucose level than the patient with hyperosmolar hyperglycemic syndrome Diabetic ketoacidosis (DKA) is a more common presentation in patients with type 1 diabetes mellitus, while hyperosmolar hyperglycemic syndrome (HHS) is more common in patients with type 2 diabetes mellitus. - \The patient with diabetic ketoacidosis presents with ketones in the urine and the patient with hyperosmolar hyperglycemic syndrome does not
