CEN Exam Prep: Certified Emergency Nurse (BCEN) Study Guide + 2,100+ Practice Questions

A 32-year-old female was struck in the temporal region by a softball. She was briefly unconscious, then became alert and oriented for twenty minutes, but now shows a rapidly declining level of consciousness and a dilated left pupil.

A 19-year-old male is brought to the trauma center after a diving accident in a shallow pool. He is conscious but has no motor function or sensation below the level of the umbilicus. His blood pressure is 88/46 mmHg, and his heart rate is 52 beats per minute. Which underlying condition is most consistent with these clinical findings?

A 50-year-old patient is admitted with 40% total body surface area partial and full-thickness burns after a kitchen fire. Eight hours after the injury, the patient’s urine output is 15 mL per hour, and the heart rate is 125 beats per minute. The nurse should anticipate which adjustment to the current plan of care?

A 35-year-old worker is splashed with an unidentified liquid industrial acid over his chest and arms. Upon arrival at the emergency department, he is screaming in pain, and the chemical is still visible on his clothing and skin. Which action is most appropriate for the nurse to take to limit the extent of the tissue damage?

A 65-year-old male with a history of anticoagulant use falls from a ladder, sustaining a traumatic brain injury and multiple rib fractures. On assessment, he is increasingly agitated, his systolic blood pressure has risen from 130 to 170 mmHg, and his heart rate has decreased from 80 to 54 beats per minute. What is the most likely physiological process occurring in this patient?

A 28-year-old female arrives following a high-speed motor vehicle collision with a suspected pelvic fracture and a rigid, distended abdomen. Her blood pressure is 82/40 mmHg, and her heart rate is 138 beats per minute. The primary survey reveals absent breath sounds on the left side with tracheal deviation to the right. Which action should the nurse facilitate next to address the patient’s hemodynamic instability?

A 42-year-old male is brought to the emergency department after being trapped in a structural fire for twenty minutes. He presents with soot-tinged sputum, carbonaceous deposits around his nares, and a hoarse voice, though he is currently speaking in full sentences. His initial oxygen saturation is 94% on room air, and his heart rate is 112 beats per minute. Which intervention is most appropriate for this patient’s current clinical presentation?

A 41-year-old male presents with sharp epigastric pain radiating to his back that improves when leaning forward. He reports heavy alcohol use and has a rigid abdomen with significantly decreased bowel sounds.

A 35-year-old female presents with severe right-sided flank pain radiating to the groin, accompanied by nausea and a fever of 102.1°F. Urinalysis reveals 3+ blood and the presence of white blood cell casts.

A 72-year-old female with atrial fibrillation presents with sudden, severe mid-abdominal pain. Her physical exam reveals a soft, non-tender abdomen despite her reporting 10/10 pain, and her initial serum lactate is elevated at 4.2 mmol/L.

A 48-year-old male with known cirrhosis presents with hematemesis and a blood pressure of 88/52 mmHg. He is pale and diaphoretic, with a distended abdomen and visible caput medusae noted during the primary survey.

A 19-year-old male presents with sudden, severe left scrotal pain that began two hours ago while he was sleeping. On examination, the left testicle is high-riding and transverse, and the cremasteric reflex is absent on the affected side.

A 54-year-old female with a history of Crohn’s disease presents with diffuse abdominal distention, inability to pass flatus for 24 hours, and visible peristaltic waves. She is currently tachycardic with dry mucous membranes and reports frequent bilious vomiting.

A 50-year-old female presents with a sudden, excruciating headache that she describes as the worst of her life. She has associated nausea and photophobia. Her neurological examination is currently intact with no focal deficits or weakness.

A 22-year-old male presents with a stab wound to the right side of his back at the level of the thoracic spine. Assessment reveals a loss of motor function on the right side and a loss of pain and temperature sensation on the left side.

A 65-year-old male presents with sudden, “tearing” chest pain that radiates to his shoulder blades. His blood pressure is 185/95 mmHg in the right arm and 155/80 mmHg in the left arm, and his pulses are diminished in the lower extremities.

A 19-year-old male is brought to the emergency department after a high-speed motor vehicle collision. He has clear fluid draining from his nose and bruising behind his ears. The physician orders several interventions to stabilize the patient.

A 28-year-old female with a history of a T4 spinal cord injury presents with a pounding headache and a blood pressure of 200/110 mmHg. Her skin is flushed above the injury site and pale with piloerection below the level of the injury.

A 45-year-old male arrives after a fall with a Glasgow Coma Scale score of 7. His blood pressure is 180/90 mmHg, pulse is 52 beats/minute, and his right pupil is 6 mm and non-reactive. The nurse prepares for immediate intervention to address suspected tentorial herniation.

A 35-year-old patient was rescued from a house fire. The patient has soot in the oropharynx, singed nasal hairs, and a hoarse voice, but is currently maintaining an oxygen saturation of 96% on room air.

A patient with severe pneumonia is being ventilated for Acute Respiratory Distress Syndrome (ARDS). The ventilator settings include a high level of Positive End-Expiratory Pressure (PEEP). The nurse notes a sudden drop in blood pressure and increased peak airway pressures.

Following the intubation of a trauma patient, the nurse observes a flat waveform on the quantitative waveform capnography monitor. The patient has equal chest rise and breath sounds are heard over the epigastrium.

A 68-year-old male with a history of chronic obstructive pulmonary disease presents with increased work of breathing and somnolence. Arterial blood gas shows a pH of 7.22 and a pCO2 of 75 mmHg. He is unable to follow simple commands.

A 45-year-old female is three days post-operative from a femur fracture repair. She develops sudden onset tachypnea, tachycardia, and a petechial rash across her chest and axilla. Her oxygen saturation is 88% on room air.

A 24-year-old male with a history of tall, thin stature presents with sudden pleuritic chest pain and increasing respiratory distress. Assessment reveals absent breath sounds on the right, jugular venous distension, and a blood pressure of 82/54 mmHg.

A 60-year-old male presents to the triage desk complaining of chest heaviness that started while he was watching television. He states he has stable angina usually relieved by rest, but this episode has lasted forty minutes despite sitting down.

A 72-year-old female presents with severe orthopnea, an S3 gallop on auscultation, and bilateral crackles in the lung bases. She is coughing up small amounts of pink, frothy sputum and appears cyanotic around the lips.

A 50-year-old male with a history of untreated hypertension presents with a blood pressure of 230/120 mmHg. He complains of a severe headache and blurred vision, and the nurse notes new-onset confusion during the neurological assessment.

A 24-year-old male arrives via EMS after a high-speed motor vehicle collision where his chest struck the steering wheel. He has muffled heart tones, distended neck veins, and a blood pressure of 90/60 mmHg that drops further during inspiration.

A 58-year-old female is brought to the emergency department with substernal pressure and nausea. The electrocardiogram shows ST-segment elevation in leads II, III, and aVF. The patient is hypotensive with clear lung sounds and notable jugular venous distension.