Medical Tests Medical Tests Certifications CEN Questions & Answers

• Question 31:

  You are caring for an alcoholic in withdrawal. Which symptoms would alert the nurse to delirium tremors?

  A. Hypertension, change in level of consciousness, hallucinations

  B. Hypotension, ataxia, hunger

  C. Stupor, agitation, muscular rigidity

  D. Hypotension, coarse hand tremors, agitation

  Correct Answer: A

  Hypertension, change in level of consciousness and hallucinations are symptoms that the nurse would see if the patient is in delirium tremors. Other symptoms the nurse might see are anxiety, insomnia, anorexia, disorientation, agitation, fever and delusions.

• Question 32:

  You are caring for a patient in cardiogenic shock who has a multilumen pulmonary artery catheter in place. What cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) would you see if the patient were unstable?

  A. CO 5 L/min, PCWP low

  B. CO 4 L/min, PCWP high

  C. CO 3 L/min, PCWP high

  D. CO 2 L/min, PCWP low

  Correct Answer: C

  A CO 3 L/min and PCWP that is high would indicate that the patient in cardiogenic shock is unstable. Normal cardiac output is 4 to 8 L/min. The heart fails to pump, which leads to the cardiac output falling and PCWP rising.

• Question 33:

  Your patient came in to the emergency department with chest pain. Over the last hour the patient's blood pressure has dropped, pulse has increased and respirations have increased. What do you suspect these changes indicate?

  A. Cardiogenic shock

  B. Cardiac tamponade

  C. Pulmonary embolism

  D. Aortic aneurysm

  Correct Answer: A

  The changes in vital signs indicate that the patient is going into cardiogenic shock. Cardiogenic shock occurs when there is severe damage to the left ventricle. The patient may also display signs of decreased urine output and cool, clammy skin.

• Question 34:

  What would you want to assess your patient for if they have a myocardial infarction that is developing into cardiogenic shock?

  A. Ventricular dysrhythmia

  B. Bradycardia

  C. Rising diastolic blood pressure

  D. Falling central venous pressure

  Correct Answer: A

  The nurse would want to assess the patient for ventricular dysrhythmia. The left ventricle may have been damaged by the myocardial infarction, which could lead to left ventricular failure. The patient would have tachycardia, low blood pressure and rising central venous pressure.

• Question 35:

  You are caring for an infant with a diagnosis of sepsis. Which is the priority assessment for this infant?

  A. Skin integrity

  B. Temperature

  C. Jaundice

  D. Respiratory function

  Correct Answer: D

  The priority assessment would be respiratory function. The infant's airway should always be the priority. The other choices are all symptoms of sepsis that the nurse would also want to assess.

• Question 36:

  You are caring for a patient who has been stung by a bee. The patient has dyspnea, pruritis and localized swelling on the arm where he was stung. What would your priority intervention be for this patient?

  A. Remove the stinger.

  B. Place blankets over the patient.

  C. Listen for stridor and check the patient's tongue for swelling.

  D. Put the patient in the Trendelenburg position.

  Correct Answer: C

  The priority for this patient would be to assess for stridor and swelling of the tongue. The patient is displaying signs of anaphylactic reaction and will need to be treated immediately. Stridor and tongue swelling are signs of impending airway obstruction. Epinephrine will need to be administered to correct the problem.

• Question 37:

  You are caring for a patient who has been taking methylergonovine maleate (Methergine) for postpartum hemorrhage. It is not helping to control the hemorrhage. What procedure will most likely be ordered for this patient?

  A. Dilatation and curettage

  B. Laparotomy

  C. Hysterotomy

  D. Hysterectomy

  Correct Answer: A

  The patient will most likely need a dilatation and curettage. This vaginal procedure is to remove retained tissue from the uterus. The other procedures would be inappropriate for this type of hemorrhage.

• Question 38:

  What would the nurse do to prevent a woman who had a cesarean birth from having early postpartum hemorrhage?

  A. IV fluids at 125 mL/hr

  B. Assess uterus every 15 minutes

  C. Abdominal dressing for drainage

  D. Monitor urinary output

  Correct Answer: B

  The nurse would want to assess the uterus every 15 minutes to prevent early postpartum hemorrhage. Early detection of a boggy uterus will allow for interventions to prevent postpartum hemorrhage. Other choices are not appropriate in preventing postpartum hemorrhage.

• Question 39:

  You are caring for a postpartum mother who is in hypovalemic shock from hemorrhage. What would you expect to be the priority for this patient?

  A. Oxygen at 3 to 4 liters

  B. Oxytocic drug via IV

  C. Heart rate every 5 minutes

  D. Increase IV fluid rate

  Correct Answer: D

  A patient in hypovalemic shock would benefit most from increasing IV fluids. Increasing the IV fluids helps to replace the fluids lost by the patient during the hemorrhage. Blood products may also be necessary but may take a while to obtain. Oxygen and oxytocic drugs will also be required but are not the priority for this patient.

• Question 40:

  An elderly patient comes into the emergency department to rule out stroke. On admission, vital signs are pulse 90, blood pressure 150/100 and respirations 20. Upon reassessment 30 minutes later, vital signs are pulse 78, blood pressure 170/90 and respirations 24 and irregular. What should be the nurse's first priority?

  A. Have the patient describe how they are feeling.

  B. Check the patient's Dilantin level.

  C. Decrease fluids.

  D. Encourage the patient to drink.

  Correct Answer: C

  The nurse should decrease the fluids based on this assessment. The patient is showing signs of hypervolemia and increased intracranial pressure. The other three options are inappropriate for a patient who is be monitored for a stroke.