CEN Practice Exam 1 Questions and Answers

A. The use of supplemental oxygen in normoxic patients has not been established. In patients with potential coronary artery syndrome, withholding of additional supplemental oxygen should be considered for those in the pr ...

A. The use of supplemental oxygen in normoxic patients has not been established. In patients with potential coronary artery syndrome, withholding of additional supplemental oxygen should be considered for those in the prehospital or in-patient hospital setting and the emergency department. - ANSWER A patient presents to the emergency department with chest pain and diaphoresis, and denies dyspnea. Vital signs are BP 148/70 mm Hg, HR 72 beats/minute, RR 18 breaths/minute, Sp02 98% on room air. Breath sounds are clear and equal. rlhe electrocardiogram shows an inferior wall ST segment elevation. You anticipate the following oxygen order. A. No supplemental oxygen at this time B. Nasal cannula at 6 L per minute C. Partial rebreather mask at 10 L per minute D. Nonrebreather mask at 15 L per minute C. Chest pain that radiates to both shoulders has a likelihood ratio of 7.1, and pain that radiates to the right shoulder has a stronger likelihood ratio of 2.9 of predicting acute Coronary syndro compared with pain that radiates only to the left shoulder. - ANSWER A patient complains of chest pain, dyspnea, and diaphoresis. Which of the following assessment factors would indicate a possible diagnosis of acute coronary syndrome? A. Pleuritic chest pain B. Positional chest pain C. Chest pain that radiates to the shoulders, with pain in the right shoulder worse than pain in the left shoulder D. Pain reproducible with chest wall palpation D. Adrenal gland stimulation causes the adrenals to release two catecholamines: epinephrine and norepinephrine. Epinephrine increases heart rate and peripheral vasoconstriction and triggers glycogenolysis. - ANSWER Which of the following human compensatory mechanisms to the presence of shock triggers glycogenolysis? A. Chemoreceptor activation B. Clotting cascade activation C. Cerebral autoregulation stimulation D. Adrenal gland stimulation D. Patients with Ehler—Danlos syndrome may be identified by hypermobile joints and skin that is hyper-extensible, has a soft velvety-like appearance, is fragile, and tears or bruises easily. Ehler—Danlos syndrome is a connective tissue disorder that places patients at risk for the presence of aortic aneurysm and dissection. - ANSWER A patient presents to the emergency department with abdominal pain and "ripping" back pain. Which condition places the patient at risk for abdominal aortic dissection? A. Down syndrome B. Romano—Ward syndrome C. Jervell and Lange-Nielsen syndrome D. Ehler—Danlos syndrome B. A low end-tidal carbon dioxide level indicates a lack of both end cellular perfusion and adenosine triphosphate production, resulting in cellular death. - ANSWER A patient presents via emergency medical services in cardiopulmonary arrest, following 15 minutes of cardiopulmonary resuscitation (CPR). On completion of the initial nursing assessment, which of the following findings would indicate that termination of resuscitation efforts should be considered? A. Decreased compliance while performing bag-mask device ventilation B. An end-tidal carbon dioxide level reading less than 10% after 20 minutes of high-quality CPR C. An initial rhythm of pulseless electrical activity D. An initial presentation of a shockable rhythm A. The child weighs 30 kg. The correct initial joule dose is 2 joules per kg. The correct dose would be 60 joules for the initial shock and increasing to 4 joules per kg. This dose can be increased up to a maximum of 10 joules per kg. - ANSWER A7-year-old suddenly develops ventricular fibrillation. The child weighs 66 lbs (30 kg). Cardiopulmonary resuscitation is started immediately. What is the correct defibrillation dose for the initial shock to be used by the emergency nurse? A. 60 joules B. 30 joules C. 120 joules D. 90 joules D. Sinus tachycardia occurs frequently from the anticholinergic effects of tricyclic antidepressant toxicity. QRS complex widening occurs as a result of sodium channel blockade, and this delayed conduction may be seen more commonly involving the right side of the heart, manifesting as a right bundle branch block. In addition, QT interval prolongation can occur with these agents. - ANSWER The emergency nurse is participating in the care of an obtunded patient presumed to have taken an overdose of a tricyclic antidepressant. patient has a palpable pulse, and an electrocardiogram (ECG) is obtained. nurse would anticipate the presence of which ECG finding? A. Sinus bradycardia with normal QRS and QT intervals B. Ventricular fibrillation C. Narrow complex supraventricular tachycardia D. Sinus tachycardia with both a widened QRS interval and prolonged QT interval B. A demand pacemaker has the capability to sense the patient's intrinsic heart rhythm and only delivers an impulse to "fire" when the patient's intrinsic heart rate falls below a given rate. - ANSWER During triage, the patient states the pacemaker only fires when the patient's heart rate slows below a certain number of beats/minute. The nurse anticipates that the patient has a(n): A. asynchronous pacemaker. B. demand pacemaker. C. dual-chamber pacemaker. D. fixed-rate pacemaker.