Certification Exam Practice Test

Certified Emergency Nurse (CEN) Certification Exam Practice Test Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

• A patient arrives with chest pain radiating to the left arm and jaw. The

nurse’s priority action is to:

• Administer morphine 2 mg IV
• Obtain a 12-lead ECG
• Give nitroglycerin sublingually
• Draw cardiac enzyme levels

Rationale: An ECG should be obtained within 10 minutes of arrival to

assess for ST elevation or ischemic changes. This determines further treatment priorities.

• / 4

• A 35-year-old male presents with a deep laceration from a rusty nail.

His last tetanus shot was 9 years ago. The nurse should:

• Do nothing
• Give tetanus immune globulin only
• Give a tetanus toxoid booster
• Start antibiotics

Rationale: Tetanus boosters are indicated every 10 years or every 5

years for dirty wounds.

• A patient with a head injury presents with clear drainage from the

nose. What should the nurse suspect?

• Sinus infection
• Cerebrospinal fluid (CSF) leak
• Allergic rhinitis
• Nasal fracture only

Rationale: Clear drainage from the nose following trauma may

indicate a CSF leak, suggesting basilar skull fracture.

• Which rhythm requires immediate defibrillation?
• Asystole
• Pulseless electrical activity (PEA)
• Ventricular fibrillation
• Sinus tachycardia 2 / 4

Rationale: Ventricular fibrillation is a shockable rhythm requiring

immediate defibrillation.

• The nurse is caring for a burn patient with singed nasal hairs and soot

around the mouth. The priority action is to:

• Start IV fluids
• Assess airway patency
• Apply oxygen via nasal cannula
• Administer pain medication

Rationale: Airway assessment is the first priority due to potential

inhalation injury.

• A 22-year-old woman presents with lower right quadrant pain and

fever. Which condition is most likely?

• Cholecystitis
• Pancreatitis
• Appendicitis
• Ovarian cyst rupture

Rationale: Classic symptoms of appendicitis include right lower

quadrant pain, fever, and nausea.

• / 4

• Which of the following findings indicates hypovolemic shock?
• Bradycardia and hypertension
• Tachycardia and hypotension
• Bounding pulses
• Jugular vein distention

Rationale: Decreased volume leads to compensatory tachycardia and

low blood pressure.

• A 65-year-old man presents with shortness of breath and frothy pink

sputum. This is most consistent with:

• COPD exacerbation
• Pneumonia
• Pulmonary edema
• Asthma attack

Rationale: Pink frothy sputum is characteristic of pulmonary edema

caused by left-sided heart failure.

• During triage, which patient should be seen first?
• A 25-year-old with a broken wrist
• A 40-year-old with a fever of 38.5°C
• A 60-year-old with chest pain and diaphoresis
• A 10-year-old with a laceration
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