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Friday, May 15, 2015
After getting good response on Nursing Entrance Exam Practice in my other blog from my blog readers I want to write this blog for Nursing Entrance Exam Practice. I am adding this exam in this health blog because nursing jobs are related to health.
A certified emergency nurse commonly treats patients while they face a life-threatening crisis. They are most likely to be involved while an illness or injury is still in a critical stage. They must be able to operate autonomously and reach important decisions quickly. Beyond the emergency room, they often play an important role in educating and supporting patients and their families during a critical medical situation.
The Board of Certification for Emergency Nursing (BCEN) sponsors the certification exam for emergency nurses. The BCEN reviews current practice every five years and incorporates any changes into future exams. The Certified Emergency Nurse
The Certified Emergency Nurse exam is a computer-based examination. It consists of 175 multiple choice questions. 150 of these CEN test items are scored, and 25 items are pretest items. The pretest items are not scored. There is a maximum of three hours in which to complete the entire CEN examination. Thirteen subject areas are covered on the CEN examination, and they are as follows: Cardiovascular Emergencies (17 items), Gastrointestinal Emergencies (9 items), Obstetrical, Genitourinary, and Gynecological Emergencies (10 items), Maxillofacial and Ocular Emergencies (9 items), Neurological Emergencies (12 items), Orthopedic Emergencies and Wound Management (15 items), Psycho/Social (7 items), Respiratory Emergencies (18 items), Patient Care Management (12 items), Substance Abuse/Toxicological and Environmental Emergencies (13 items), Shock/Multi-System Trauma Emergencies (8 items), Medical Emergencies/Communicable Diseases (13 items), and Professional Issues (7 items). Details about specific possible CEN test items in each of these thirteen subject areas can be found online on the BCEN website.
The Certified Emergency Nurse Exam is scored based on how many answers out of the 150 scored CEN test items are answered correctly. A passing score is 109. This is approximately equal to answering 75% of the 150 scored test items correctly. A CEN test score report is given to each test taker upon completion of the CEN examination. If a passing score is achieved, the CEN certification is good for four years. There are several ways to prepare for the CEN examination. Familiarization with the CEN test content is imperative. Studying this content using textbooks, study guides, or other materials can prove useful. In addition, taking CEN practice tests and practice problems is also useful. Prior to the CEN examination, taking advantage of the computer orientation on exam day can be beneficial. This can help eliminate problems or confusion with the computer-based testing system during the CEN exam. In addition, since the score on the CEN exam is based on how many questions are answered correctly, it is imperative to answer all presented questions. Even if the answer is not known, a best guess answer is better than no answer at all. And, pacing oneself during the CEN exam is important, so no questions are left blank. The CEN exam is sponsored by the Emergency Nurses Association.
What is the normal intraocular pressure of the eye?
A. 2 to 7 mm Hg
B. 10 to 21 mm Hg
C. 22 to 30 mm Hg
D. 31 to 35 mm Hg
A 7-year-old child is brought to the emergency department after multiple bee stings about 30 minutes previously. He complains of itching, swollen lips, and difficulty breathing. Wheezing and stridor are heard. What is the most immediate treatment required?
a.epinephrine 0.1 mg intramuscularly
After an auto accident, x-rays of the patient's leg show a transverse fracture of the midfemur with several bone fragments surrounding the fracture site. The skin of the leg is intact. This type fracture is called:
A cancer patient is seen in the emergency department with high fevers and malaise for 2 days. She received chemotherapy about 10 days ago. Her physical exam is not revealing but her temperature is 103°F. A CBC shows a hemoglobin of 10 g/dL, WBC 4000 with 10% polys, 5% bands, 70% lymphs, 10% monos, and 5% other white or unidentified cells. Platelets are 60,000/mm3. Which of the following is NOT immediately appropriate?
a.blood cultures from different sites
b.electrolytes, liver and renal function tests
c.eask if she has been receiving granulocyte colony-stimulating factor (G-CSF)
d.white blood cell transfusion
Which statement best describes acute respiratory distress syndrome (ARDS)?
a.ARDS is caused by trauma only.
b.ARDS is sudden, progressive, and severe.
c.ARDS is caused by an illness only.
d.ARDS never results in lung scarring.
Q 6 Which of the following PQRST mnemonic descriptions is untrue?
A. P: prodromal/palliative
B. Q: quality of pain (stabbing, aching)
C. R: region and radiation (if so, where)
D. S: severity on a scale of 0 to 20
Q 7. Define the following signs/symptoms: Right upper quadrant pain, fever (chills), and jaundice associated with cholangitis.
A. Bouchard's Nodes
B. Chandelier's Sign
C. Charcot's Triad
D. Chvostek's Sign
Define the following signs/symptoms: Calf pain with forcible dorsiflexion of the foot, associated with venous thrombosis.
A. Hegar's Sign
B. Hoffmann's Sign/Reflex
C. Homans' Sign
D. Horner's Syndrome
Which of the following is not a characteristic of Beck's triad?
A. Rising jugular venous pressure is evidenced by distended jugular veins while in a non-supine position.
B. The fall in systolic pressure results when the fluid in the pericardial cavity accumulates to a degree that it impairs ventricular stretch.
C. The suppressed heart sounds occur due to the muffling effects of the sounds passing through the fluid surrounding the heart.
D. Pain and tingling in fingers after exposure to cold.
Which of the following is not a cause of Right Axis Deviation?
A. Left ventricular hypertrophy
B. Chronic lung disease even without pulmonary hypertension
C. Anterolateral myocardial infarction
D. Pulmonary embolus
Which of the following matches the definition: cycles of gradually increasing tidal volume followed by gradually decreasing tidal volume, usually separated by brief periods of apnea?
A. Cheyne-Stokes Respiration
B. Biot's Respiration
D. Kussmaul's breathing
Which of the following changes is not found with hypokalaemia?
A. Small or absent T waves
B. Wide QRS
C. First or second degree AV block
D. Slight depression of the ST segment
Describe the Green Color of Triage?
A. Delayed care / can delay up to three hours
B. Urgent care / can delay up to one hour
C. Immediate care / life-threatening
D. Victim is dead / no care required
Which of the following is not a chart eristic of Mitral Stenosis?
A. There is atrial fibrillation.
B. No P waves are visible.
C. The rhythm is irregularly irregular (random).
D. Left axis deviation
Which of the following matches the definition: minute, pinpoint hemorrhages into the skin, mucosal or serosal surfaces?
1. Answer: B - The normal intraocular pressure of the eye is 10 to 21 mm Hg. The test used to measure intraocular pressure is called a tonometry. This is how glaucoma is diagnosed. A patient with glaucoma would have an intraocular pressure of 30 to 70 mm Hg.
2. Answer: A
The clinical picture of this patient is that of an anaphylactic reaction to bee stings which is potentially life-threatening. The onset of symptoms within 1 hour after exposure to the allergen is particularly worrisome as are the laryngeal and pulmonary signs. The airway must be established with intubation often necessary; high-flow oxygen, cardiac monitoring, and intravenous fluids are basics. Epinephrine given intramuscularly is the most rapidly acting agent and should be given as soon as possible after the diagnosis of anaphylaxis and every 5 to 15 minutes thereafter as needed. Steroids and antihistamines are slower acting than epinephrine but are often given to alleviate itching, angioedema, and hives. There is no indication for antibiotics in this clinical situation unless further signs and symptoms develop.
3. Answer: B
A fracture is a break or disruption in a bone, generally divided into closed (no break in the skin) and open (protrusion of the bone through the skin). Fractures may take different anatomic patterns, depending on the bone location, the nature of the trauma and the bone density (may be diminished with osteoporosis). Compression fractures are most common in the spine in which a fracture of one or more vertebral bodies leads to a collapse of the spine at that location. An avulsion fracture reflects a forceful contraction of muscle mass, which pulls a bone fragment to break away at the tendon's insertion site. This type of fracture is often seen with severe joint strains. This patient has a comminuted fracture in which the trauma causes more than two separated portions of the bone. Often, several small bony fragments are seen at the site of the break.
4. Answer: D
This patient has fever and neutropenia after chemotherapy. Neutropenia is defined as an absolute neutrophil count (ANC) under 1000/mm3, and a severe neutropenia less than 500/mm3 is particularly dangerous. These patients must be worked up quickly and antibiotic and possibly additional therapy started as soon as possible since the situation may be life-threatening. While myelosuppressive drugs differ in the length of time between administration and the nadir of the ANC, 10 to 14 days is typical. Multiple cultures from different possible sites of origin for sepsis must be done along with chest x-ray and other imaging as indicated by examination. Broad-spectrum antibiotics, such as ceftazidime or imipenem/cilastatin, should be started after cultures are obtained. She should be asked if she has been receiving G-CSF (Neupogen, Neulasta). WBC transfusions are rarely used today since they have a very short shelf life, do not last long in the circulation, and may cause allergic reactions.
5. Answer: B