×

Quiz Session - Attempts With Random Questions

BCEN CEN Exam Questions

Page 1 of 50

1.

If a patient has hypesthesia, which of the following is TRUE?

  • The patient has decreased sensation

  • The patient has a loss of sensation

  • The patient has impaired sensation

  • The patient has increased sensation

Correct answer: The patient has decreased sensation

Hypesthesia (also known as hypoesthesia) is an abnormal reduction in sensitivity to stimuli of a sense. It can affect one or more of the senses, such as sight, sound, touch, and smell. 

Anesthesia is a loss of sensation, dysesthesia is impaired sensation, and hyperesthesia is an increase in sensation.

2.

What is the most effective way to differentiate a Transient Ischemic Attack (TIA) from a stroke?

  • Presence of tissue damage

  • Absence of intracranial bleeding

  • Duration of symptoms

  • Severity of symptoms

Correct answer: Presence of tissue damage

A TIA is best distinguished from a stroke using imaging to determine whether neurological tissue damage has occurred following the event.

TIA diagnosis is no longer based on duration or severity of symptoms; imaging is necessary to be certain a patient has not had a stroke. Imaging may show no tissue damage in TIA, whereas a stroke often results in detectable neurological tissue damage. 

The severity of symptoms and the absence of intracranial bleeding do not reliably distinguish between the two conditions.

3.

A 47-year-old male patient with a history of severe alcohol dependence is brought to the emergency department after experiencing a generalized tonic-clonic seizure. He is now stable but confused and agitated. His vital signs are blood pressure 150/90 mmHg, heart rate 110 beats per minute, respiratory rate 24 breaths per minute, and temperature 99.2°F. 

Which intervention is MOST appropriate to prioritize in his treatment plan?

  • Administering benzodiazepines

  • Initiating intravenous fluid resuscitation

  • Administering a beta-blocker

  • Performing a CT scan of the head

Correct answer: Administering benzodiazepines

Administering benzodiazepines is the most appropriate intervention as they help manage agitation, prevent further seizures, and stabilize the nervous system during alcohol withdrawal.

IV fluids are important for hydration, especially if the patient has been vomiting or sweating excessively, but they are not the priority compared to controlling seizures and agitation.

Beta-blockers may help with elevated blood pressure and heart rate but are not the primary treatment for alcohol withdrawal symptoms.

A CT scan of the head can be considered if there is suspicion of head injury or other neurological issues, but stabilizing the patient’s withdrawal symptoms takes precedence.

4.

Which laboratory value initially indicates widespread tissue hypoperfusion in shock?

  • Serum lactate greater than 4 mmol/L

  • Serum lactate greater than 6 mmol/L

  • Serum lactate greater than 2 mmol/L

  • Serum lactate greater than 8 mmol/L

Correct answer: Serum lactate greater than 4 mmol/L

The parameter for widespread tissue perfusion is a serum lactate level greater than 4 mmol/L. There are a number of important laboratory parameters for monitoring patients in shock. These include base deficit, mixed venous saturation levels, and serum lactate levels. In general, high lactate levels correlate with high mortality rates. A high lactate level is a sign of anaerobic metabolism and occurs due to tissue hypoperfusion. Thus, the higher the value, the more hypoperfusion is present. It is also important to note that many laboratories require serum lactate specimens to be transported and stored on ice.

5.

Which of the following management strategies is MOST appropriate for a patient diagnosed with acute viral pericarditis?

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) 

  • High-dose intravenous antibiotics

  • Immediate cardiac catheterization

  • Anticoagulant therapy

Correct answer: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) 

Pericarditis is characterized by sharp, stabbing chest pain that often worsens with deep breathing (pleuritic pain) and lying flat but improves when sitting up and leaning forward. Viral infections are a common cause of pericarditis. The mainstay of treatment for acute viral pericarditis is anti-inflammatory therapy, specifically the use of NSAIDs to reduce pain and inflammation.

High-dose intravenous antibiotics are not indicated for viral pericarditis because a bacterial infection does not cause it. Immediate cardiac catheterization is indicated for conditions like myocardial infarction but not for viral pericarditis, which does not involve coronary artery occlusion. Anticoagulant therapy is primarily used for conditions involving thrombosis risk (such as atrial fibrillation and deep vein thrombosis) and could increase the risk of pericardial bleeding in the context of pericarditis.

6.

Which of the following is LEAST likely to help deescalate a potentially violent patient?

  • Involving multiple people in the conversation

  • Being polite with your conversation

  • Setting clear limits

  • Repeating your message

Correct answer: Involving multiple people in the conversation

When deescalating a potentially violent patient, it is ideal to have only one person talking with the patient to help build a personal rapport with them and ensure communication is clear and uncomplicated. Ask bystanders to leave quietly, but obtain help as quickly as possible when coping with the patient. Do not try to do it alone.

Being polite, setting clear limits and expectations, and repeating your message to reinforce it are all appropriate methods of deescalating a potentially violent patient.

7.

Which of the following factors is LEAST likely to affect the success of reimplantation after amputation?

  • Gender of the victim

  • Age of the victim

  • Amount of damage to the amputated parts

  • Amount of damage to the attached parts

Correct answer: Gender of the victim

The gender of the victim is not likely to influence the success of reimplantation after amputation. Young victims are more likely to experience successful reimplantation than older victims. The amount of damage to both the amputated and attached parts also affects the success of reimplantation.

8.

Which of the following is the MOST common cause of cardiac tamponade?

  • Penetrating chest trauma

  • Blunt chest trauma

  • Infection

  • Heart disease

Correct answer: Penetrating chest trauma

Penetrating chest injuries, such as stab wounds, are the leading cause of cardiac tamponade, accounting for 80% to 90% of cases. 

Blunt chest trauma, infection, and heart disease may be contributing factors to the development of cardiac tamponade in some situations. The vast majority of cases, however, are due to penetrating chest trauma. 

9.

A Colles fracture occurs in which area of the body?

  • Wrist

  • Ankle

  • Neck

  • Pelvis

Correct answer: Wrist

Colles fractures are very common extra-articular fractures of the distal radius and occur as a result of a fall onto an outstretched hand. They are the most common injury to the wrist. These types of fractures are often referred to as a "silverfork deformity" of the wrist because of the displaced radius. Treatment involves closed reduction (casting).

10.

A 73-year-old male patient presents with syncope, and an Electrocardiogram (ECG) reveals a PR interval of 0.40 seconds. Given his symptoms and ECG findings, which intervention is MOST appropriate?

  • Permanent pacemaker insertion

  • Continued observation with follow-up

  • Administration of intravenous epinephrine 

  • Initiation of oral beta-blocker therapy

Correct answer: Permanent pacemaker insertion

Permanent pacemaker insertion is appropriate in this context, as a significantly prolonged PR interval (0.40 seconds) indicates advanced conduction disease likely leading to symptomatic bradycardia.

Observation with follow-up is inadequate given the patient's symptomatic presentation and significant ECG abnormality. IV epinephrine might temporarily increase his heart rate but is not a long-term solution and does not address the underlying conduction issue. Oral beta-blocker therapy would further prolong the PR interval and potentially worsen the patient's symptoms and conduction delay.

11.

Which of the following conditions is an example of chronic pelvic pain?

  • Endometriosis

  • Urinary Tract Infection (UTI)

  • Ectopic pregnancy

  • Pelvic Inflammatory Disease (PID)

Correct answer: Endometriosis

Endometriosis is an example of chronic pelvic pain. It is a major cause of disability and decreased quality of life in women and teenage girls. It occurs when endometrial tissue cells grow outside the uterus, primarily on the pelvic peritoneum, ovaries, and rectovaginal septum. The resulting inflammatory response leads to adhesions, fibrosis, scarring, pain, and infertility. Therapeutic interventions may include NSAIDs, oral contraceptives, and surgery.

UTI, ectopic pregnancy, and PID are examples of acute pelvic pain. 

12.

Which male organ is responsible for storing sperm until it becomes mature?

  • Epididymis

  • Testes

  • Scrotum

  • Bulbourethral gland

Correct answer: Epididymis

The epididymis is the male genital organ that is responsible for storing spermatoza until they mature, then transporting them between the testes and vas deferens.

The testes are responsible for producing sperm and testosterone. The scrotum is the sac that holds the testes. The bulbourethral gland is responsible for secreting an alkaline component of semen that neutralizes vaginal secretions.

13.

Which body part shows symptoms in the majority of anaphylaxis cases?

  • Skin

  • Heart

  • Lungs

  • Brain

Correct answer: Skin

Anaphylaxis is an allergic reaction and may become life-threatening if it progresses to a multi-system response called anaphylactic shock. Most anaphylaxis cases involve symptoms related to the skin, including hives and a rash. Signs of a possible system-wide reaction include dyspnea, wheezing, cough, itching, bronchospasm, hypotension, and tachycardia.

14.

Regarding delirium, which statement is ACCURATE?

  • Mortality risk is higher in the patient who develops delirium

  • Delirium is an irreversible condition

  • Delirium has a slow and insidious onset

  • Patients with dementia cannot develop delirium

Correct answer: Mortality risk is higher in the patient who develops delirium

Delirium is an acute, potentially reversible condition of consciousness, attention, perception, and cognition with a rapid onset, usually developing over the course of days or hours, and is caused by a general medical condition, a substance, or a combination of factors. Patients at highest risk of delirium are those with a prior history of delirium or a diagnosis of dementia. Research has shown mortality risk increases in the patient who develops delirium.

15.

Of the following complications, which is LEAST likely to occur with a ventricular shunt?

  • Catheter coiling

  • Catheter infection

  • Catheter obstruction

  • Catheter malposition

Correct answer: Catheter coiling

Ventricular shunts are surgically placed to decrease intracranial pressure by diverting cerebrospinal fluid from the lateral ventricles to the torso or peritoneal space. Shunts are commonly placed for hydrocephalus. A number of complications that can arise with long-term shunt placement, including infection, obstruction, and malposition. Surgical intervention is required for shunts that are obstructed, fractured, or malpositioned.

16.

What type of injury is the MOST likely cause of central cord syndrome?

  • Hyperextension

  • Tumor

  • Penetration

  • Hyperflexion

Correct answer: Hyperextension

Central cord syndrome is a type of lesion that causes all extremities to weaken, but the arms have the greatest motor loss (greater loss in upper extremities than lower extremities). It is possible to see bladder dysfunction as well as a sensation of burning in the hands and arms. Central cord syndrome is generally the result of a hyperextension injury.

A penetrating trauma and a tumor are injuries that could cause Brown-Sequard syndrome. This is an uncommon injury in which transverse hemisection of the cord occurs. An acute hyperflexion injury could cause anterior cord syndrome, which involves compression of the anterior spinal artery. 

17.

When assessing an adult patient's Deep Tendon Reflexes (DTRs), the nurse notes a positive Babinski reflex. 

Which of the following statements is FALSE regarding this finding?

  • This is considered normal

  • This indicates a problem in the brain or spinal cord

  • This is considered pathological

  • The Babinski reflex is negative when the great toe and other toes flex and curl downward

Correct answer: This is considered normal

The Babinski reflex is a neurological reflex. It is considered abnormal in adult patients but normal in children under two years of age. 

In babies, the nervous system reacts to extend the toes when brisk, cutaneous stimulation is applied to the plantar surface of the foot. However, in adults, the toes should flex and curl downward when cutaneous stimulation is applied to the plantar surface of the foot (negative reaction). If the Babinski is positive in adults (the toes fan outward), it is associated with a problem in the brain or spinal cord. Clinically, a positive Babinski reflex is pathological for diagnosing an upper motor neuron lesion. 

Damage to the nerves higher up in the spinal cord or brain can occur through sudden trauma (i.e., car accident or sports injury) or can develop with nerve conditions like multiple sclerosis or cervical spondylotic myelopathy.

18.

A female patient who is pregnant has moderate cramping with moderate vaginal bleeding. Her cervical os is open 4 cm with a gross rupture of membranes. 

What term BEST describes the likelihood of a spontaneous abortion in this patient?

  • Inevitable

  • Threatened

  • Missed

  • Missed spontaneous

Correct answer: Inevitable

An abortion is defined as the death or expulsion of the fetus, or products of conception, before the age of viability.

An inevitable spontaneous abortion is one in which the patient has moderate cramping with moderate vaginal bleeding, a cervical os that is open more than 3 cm, and a gross rupture of membranes.

A threatened spontaneous abortion is one in which the patient has mild uterine cramping, slight vaginal bleeding, and a closed cervical os with a soft, enlarged uterus.

A missed abortion is one in which a spontaneous abortion occurs, but the products of conception are retained.

A missed spontaneous abortion is one in which the patient has no cramping or contraction, only slight vaginal bleeding, and a closed cervical os and her body retains the dead products of conception.

19.

A 23-year-old male patient presents to the emergency department with a painful, dark discoloration under his thumbnail after hitting it with a hammer. The wound covers more than 50% of the thumbnail. A diagnosis of a subungual hematoma is made. 

Which factor is MOST important to assess before deciding on treatment?

  • Presence of a distal phalanx fracture

  • Patient’s history of diabetes

  • Duration of the hematoma

  • Presence of other fingernail infections

Correct answer: Presence of a distal phalanx fracture

Obtaining a radiograph of the digit to rule out a distal phalanx fracture is vital because it may change the management approach. A fracture may require additional interventions, such as splinting, or referral to a specialist.

The patient’s history of diabetes is important for overall health and healing but is not directly related to the immediate treatment decision for a subungual hematoma. The duration of the hematoma provides context but is less critical than identifying any underlying fractures. The presence of other infections is relevant for overall nail health but does not directly impact the acute management of the subungual hematoma.

20.

Which of the following conditions is MOST likely to cause ovarian torsion?

  • Ovarian cyst

  • Intense activity

  • Pregnancy

  • Abdominal trauma

Correct answer: Ovarian cyst

Ovarian cysts are the most common cause of ovarian torsion. As ovarian cysts grow, they can place torque on the ovary, causing it to twist, resulting in ischemia as torsion develops. 

Intense physical activity may precede cases of testicular torsion, but it is unlikely to be a common causative factor in ovarian torsion. Pregnancy and abdominal trauma are less likely to cause ovarian torsion than ovarian cysts are.

×