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CEN EXAM VERSION1 NEWEST 2025/2026 COMPLETE
300 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
A patient presents with a partial amputation of the left lower extremity from a boat propeller. They arrive one hour post incident with a tourniquet in place, and massive transfusion protocol has been initiated. Current vital signs include a heart rate of 145 beats/min and blood pressure of 84/62 mmHg. The NEXT priority action is to?
- Target blood pressure goal of 120 mmHg systolic
- Bolus an isotonic crystalloid solution
- Initiate intravenous antibiotics
- Administer tranexamic acid (TXA) - ANSWER-D
Rationale; Tranexamic acid (TXA) should be used when encountering the patient with massive hemorrhage and/or receiving blood transfusion. TXA is a medication which prevents the breakdown of fibrin and the breakdown of clots that have formed. Studies have shown that, if given within 3 hours of injury, administration of intravenous TXA has significantly reduced mortality. Rapid bolus of an isotonic crystalloid solution can cause hemodilution and break clots 1 / 4
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that have already formed. Blood pressure drives bleeding; research supports permissive hypotension of a systolic blood pressure targeted to no higher than 90 to 100 mm Hg. Antibiotics should be considered in treatment but are not priority.
The triage nurse should prioritize a patient who has ?
- hypertension and a headache.
- a cough and fever.
- stridor after being stung by a bee.
- abdominal pain and distention. - ANSWER-C
Rationale; Stridor is indicative of an upper airway obstruction. After being stung by a bee, stridor should cause high suspicion for anaphylaxis and requires immediate intervention to protect the patency of the airway. While the other conditions are concerning, stridor can be a sign of airway compromise and should be the priority.
A patient presenting with headache, fever and a stiff neck now complains of restlessness and is hypotensive with altered mental status.The PRIORITY intervention is to administer?
- antibiotics. 2 / 4
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- antipyretics.
- antiemetics. - ANSWER-A
C)analgesics.
Rationale; The patient should be treated for suspected bacterial meningitis, which requires urgent administration of antibiotics as patients can become severely ill and progress to septic shock.Analgesics, antipyretics and antiemetics may be used to treat the patient's symptoms but do not treat the underlying bacterial infection.
An adolescent patient presents to the emergency room with reports that they were hit in the eye with a baseball. No visual loss is noted when a Snellen visual acuity is performed, but while waiting to be assessed by a provider, the patient reports "aching" pain in their eye and sudden onset of blurry vision. What statement made would cause the greatest concern in the emergency nurse?
- Reports everything looks red
- Complaints of increased lacrimation
- Increased swelling
- Decreased ability to look up - ANSWER-A
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Rationale; "Seeing red" is an indication that blood is present in the anterior chamber. Activities such as coughing, sneezing, or leaning forward can cause the bleeding to continue or increase. This causes the anterior chamber to fill with blood and can lead to increased intraocular pressure due to blood clotting. Increased swelling and lacrimation are anticipated after an eye injury. Decreased ability to look upward may be a sign on entrapment, however without vision loss, this would take less priority than the chamber of the eye filling with blood.
The MOST lethal method of anthrax exposure is by?
- contaminated water sources
- inhalation
- contact with open wounds
- ingestion of spores - ANSWER-B
Rationale; Anthrax can enter the body via several routes but the most lethal is via inhalation. It can start with symptoms of seasonal illness such as the flu but deterioration can occur rapidly and result in death within several hours with possible mediastinitis or hemorrhagic meningitis. Ingestion via food or water would eventually manifest as sepsis, abdominal pain, and bloody diarrhea. Skin contact would result in lesions itching and urticaria.
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