CEN Exam 1 (2024) Test Questions and Detailed Correct Answer 100% Verified Which dysrhythmia would be identified on an ECG/EKG six-second strip by a heart rate of 76 and a PR interval of 0.24?a.sinus tachycardia b.first-degree atrioventricular block c.sinus bradycardia d.junctional escape rhythm - Correct Answer B: First-degree atrioventricular block is diagnosed partially by an EKG showing a PR interval of greater than 0.20 seconds.Which blood test may indicate infection or inflammation and would need to be used as part of the clinical picture with diagnosing and treating abdominal pain?a.white blood cell (WBC) count of 5.0 b.hematocrit (HCT) of 45 c.WBC count of 28.0 d.blood sugar (BS) of 74 - Correct Answer C: An elevated WBC count would be indicative of infection or inflammation. The WBC count of 5.0 is normal. The HCT and BS levels listed would also be considered within normal limits.A 30-year-old man comes to the emergency department with the acute onset of left flank pain radiating to the groin. Microscopic hematuria is present on urinalysis. What is the most likely diagnosis?a.ureteral calcium oxalate calculus b.ureteral cystine calculus c.testicular torsion d.cystitis - Correct Answer A: Ureteral calculi are a quite common cause of acute emergency evaluation, usually causing flank pain with radiation to the back and/or groin. About 75% of these are calcium oxalate or phosphate; less common are struvite, uric acid, or cystine calculi. While KUB or ultrasound may show the stone, helical CT is now the preferred diagnostic method. Additional workup includes CBC, chemistry panel, urinalysis, and straining of urine to catch a passed stone for chemical analysis. Nursing attention should be directed to intravenous hydration with input and output recording and narcotic or narcotic plus NSAID (e.g., ketorolac) administration for pain. Some patients may be discharged with analgesics and instructions for hydration and calculus capture. Testicular torsion is most common in adolescents and usually presents with testicular and groin pain with abdominal radiation; increasing 1 / 2
pain by lifting the scrotum to the level of the pubic symphysis causes exacerbation of the pain (Prehn sign). Cystitis may be infectious or drug-induced, but cystitis usually causes dysuria and pyuria and shows positive urine cultures.Which of the following is NOT appropriate for screening for domestic violence by the emergency department nurse?a.asking if the person has been hit, kicked, or otherwise hurt by someone in the past year; if so, by whom b.asking, "Do you feel safe in your present relationship?" c.avoid asking about intimate person violence if the patient is in the emergency department for a medical ailment, not trauma d.asking if there is a partner from a previous relationship that makes the individual feel unsafe - Correct Answer C: Domestic violence, nearly always perpetrated against women, is a major problem confronted by the emergency nurse. Screening for possible cases should include answers A, B and D. Interestingly, victims of intimate partner violence often present with a medical ailment, not trauma. These include back, abdominal, or pelvic pain, headaches, urinary infections, sexually transmitted disease, or symptoms consistent with posttraumatic stress disorder (PTSD). Sometimes evidence of old trauma such as healing fractures or cosmetically concealed bruises may point toward the presence of domestic violence. Many victims will deny it but sometimes compassionate questioning in a private setting will elicit a positive response. The nurse may then offer advice, refer to a social agency or shelter, or ask for a consultation by the hospital social worker.A patient is intubated and on mechanical ventilation. The ventilator alarm rings and the airway pressure
is found to be elevated. Possible causes include the following EXCEPT:
a.endotracheal tube obstruction with sputum b.pneumothorax c.bronchospasm d.cuff leak - Correct Answer D: Mechanical ventilation requires diligent observation of the patient and ventilator by the emergency nurse. Modern ventilators usually come with alarms that indicate high or low airway pressure. High pressure may be caused by endotracheal tube obstruction with sputum or kinks or inadvertent endobronchial displacement. The airway should be suctioned and tube placement checked. A chest x-ray is frequently helpful in determining the cause. Lung collapse, worsening of the underlying disease, and bronchospasm are also causes of elevated pressure. Leaks around the endotracheal tube cuffs will cause low airway pressure. Auto-positive end-expiratory pressure (auto- PEEP) is caused by premature inspiratory delivery before full expiration (as in asthma or COPD patients) and may lead to increased pressure and lung damage.
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