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Quizzes > Health & Medicine

CEN Practice Questions: Test Your Emergency Nursing Knowledge

Quick, free quiz with CEN test questions. Instant results.

Editorial: Review CompletedCreated By: Mohamed MaarofUpdated Aug 27, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for CEN practice questions quiz on a coral background.

Use this quiz to practice with CEN practice questions and find gaps before test day. Work through realistic ER scenarios and see instant scoring and quick feedback to focus your study. If you're also prepping for other exams, try our free cna practice test, cna practice test 60 questions, or NPTE practice exam.

A 56-year-old with crushing chest pain, diaphoresis, BP 78/46, and altered mentation arrives by EMS. What ESI level is most appropriate?
ESI 1 (Explanation: Immediate life-saving intervention is required due to hypotension and altered mental status.)
ESI 2
ESI 3
ESI 4
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In blunt facial trauma with sonorous respirations and suspected cervical spine injury, the best initial airway maneuver is:
Nasopharyngeal airway only
Head-tilt/chin-lift
Oropharyngeal airway without manual maneuvers
Jaw-thrust maneuver (Explanation: Maintains airway while minimizing cervical spine movement.)
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A patient with unstable narrow-complex supraventricular tachycardia and hypotension should receive:
Adenosine rapid IV push
Vagal maneuvers
Amiodarone infusion first
Synchronized cardioversion (Explanation: Unstable tachyarrhythmias require immediate synchronized cardioversion.)
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During shoulder dystocia, the initial maneuver that should be attempted is:
Fundal pressure
Zavanelli maneuver
Episiotomy only
McRoberts positioning with suprapubic pressure (Explanation: First-line maneuvers to free the impacted shoulder.)
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Which lactate value in a septic adult most strongly mandates prompt escalation of resuscitation?
1.8 mmol/L
2.2 mmol/L
4.5 mmol/L (Explanation: Lactate >= 4 mmol/L is associated with high mortality and triggers aggressive resuscitation.)
3.0 mmol/L
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For suspected septic shock in an adult, the initial fluid resuscitation target is:
30 mL/kg isotonic crystalloid within the first 3 hours (Explanation: Surviving Sepsis guidelines recommend 30 mL/kg promptly.)
Colloid bolus 20 mL/kg
10 mL/kg isotonic crystalloid over 6 hours
250 mL bolus followed by vasopressors
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Where is the preferred site for needle decompression of a tension pneumothorax in adults according to current guidance?
1st intercostal space anterior axillary line
6th intercostal space midclavicular line
2nd intercostal space midclavicular line with a short angiocatheter
4th or 5th intercostal space at the anterior to mid-axillary line (Explanation: Lateral approach reduces risk of major vascular injury and improves success.)
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Prior to IV thrombolysis in acute ischemic stroke, the blood pressure target is:
No blood pressure management needed before thrombolysis
Reduce to and maintain below 185/110 mm Hg (Explanation: BP must be controlled to <185/110 before alteplase.)
Reduce to below 200/120 mm Hg
Reduce to below 160/90 mm Hg
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A 22-kg child with anaphylaxis requires IM epinephrine (1 mg/mL, 1:1000). The correct dose is:
0.05 mg IM
1 mg IM
0.5 mg IM
0.22 mg IM (Explanation: 0.01 mg/kg of 1 mg/mL = 0.22 mg, usually rounded to 0.2 mg.)
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A farmer presents with salivation, lacrimation, miosis, bronchorrhea, and bradycardia after pesticide exposure. The priority antidotal treatment is:
Physostigmine
Pralidoxime before atropine
Atropine (Explanation: Atropine rapidly antagonizes muscarinic effects; pralidoxime follows.)
Beta-blocker
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A 70-kg adult with 30% TBSA partial-thickness burns arrives 1 hour after injury. Using the Parkland formula, how much fluid should be given in the first 8 hours from time of injury?
4,200 mL of lactated Ringer (Explanation: 4 mL x 70 kg x 30% = 8,400 mL in 24 h; half, 4,200 mL, in first 8 h from time of injury.)
6,000 mL of D5NS
2,100 mL of normal saline
8,400 mL of lactated Ringer
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The preferred initial treatment for ischemic priapism in the ED is:
Immediate surgical shunt
Cold packs alone
Oral pseudoephedrine
Aspiration with intracavernosal phenylephrine (Explanation: First-line definitive ED therapy.)
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For classic exertional heat stroke, the most effective definitive cooling strategy in the ED is:
Cooling blankets alone
IV acetaminophen
Rapid cold-water immersion when feasible (Explanation: Delivers fastest core cooling; alternative is aggressive evaporative cooling.)
Ice packs to groin and axillae only
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First-line rate control for symptomatic thyroid storm in the ED is:
Amiodarone only
Digoxin monotherapy
Propylthiouracil first, no beta-blocker
Esmolol or propranolol (Explanation: Beta blockade for adrenergic symptoms; give thionamide then iodine, plus steroids.)
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A patient on warfarin presents with intracranial hemorrhage. The most appropriate reversal strategy is:
Protamine sulfate
Fresh frozen plasma only
Oral vitamin K only
4-factor PCC plus IV vitamin K (Explanation: PCC rapidly reverses INR; give vitamin K to sustain reversal.)
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Thrombolysis for suspected ischemic stroke may be given without brain imaging if the exam is classic.
False
True
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Antibiotics for open fractures should be delayed until after operative debridement.
False
True
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For a chemical burn with dry lime on the skin, immediate copious irrigation is the first step.
False
True
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A patient with suspected pulmonary embolism is hypotensive with signs of shock. The most appropriate immediate therapy is:
Empiric antibiotics
Diuretics and nitrates
Start anticoagulation and wait 24 hours
Consider systemic thrombolysis if no contraindications (Explanation: Massive PE with shock warrants thrombolysis.)
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A patient with suspected caustic ingestion is drooling and stridorous. The most appropriate immediate action is:
Immediate endoscopy before airway
Neutralize with weak base or acid
Secure the airway with cautious approach (Explanation: Airway compromise is the priority; avoid inducing vomiting.)
Gastric lavage
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Study Outcomes

  1. Understand CEN Exam Structure -

    Gain insight into the types of questions, topic distribution, and timing used in free CEN practice questions to mirror the real exam experience.

  2. Analyze Practice Question Performance -

    Review your answers and score reports from the cen practice questions to pinpoint specific areas for improvement and refine your study plan.

  3. Apply Strategic Test-Taking Techniques -

    Learn and implement time management, critical thinking, and question-prioritization methods tailored to cen practice test questions.

  4. Identify Knowledge Gaps -

    Use results from the cen practice exam to detect strengths and weaknesses across core emergency nursing topics and guide targeted review.

  5. Build Exam-Day Confidence -

    Enhance readiness and reduce anxiety by familiarizing yourself with free cen practice questions and cen review questions before the official CEN exam.

Cheat Sheet

  1. ABCDE Primary Survey for Triage -

    When tackling cen practice questions on patient triage, remember the ABCDE mnemonic (Airway, Breathing, Circulation, Disability, Exposure) endorsed by the Emergency Nurses Association. This systematic approach (ENA, 2023) ensures you identify life threats quickly and prioritize interventions under pressure.

  2. ECG Interpretation Essentials -

    ECG interpretation often appears in cen review questions and cen study questions; start by identifying rate, rhythm, axis, and ST-segment changes. For example, ST elevation in leads II, III, and aVF signals an inferior STEMI (AHA ACLS guidelines), so practice reading tracings in free cen practice questions to build confidence.

  3. Pediatric Weight-Based Medication Dosing -

    Weight-based dosing (mg/kg) is a staple of cen practice exam and pediatric cen practice test questions; use the Broselow tape or formula (dose = weight × drug dose/kg). A quick mnemonic is "DIP" (Drug, Indication, Pediatric weight) to avoid calculation errors in emergencies (Journal of Emergency Nursing, 2022).

  4. ACLS Drug Algorithms in Arrest -

    ACLS drug protocols appear frequently in free cen practice questions; memorize the cardiac arrest cycle: epinephrine every 3 - 5 minutes, amiodarone after the third shock, and consider advanced airway placement. Refer to the American Heart Association's latest guidelines for dosage and timing to score high on cen practice questions online free.

  5. Trauma Shock Classifications -

    Trauma assessment and shock classification frequently appear in cen practice test questions; know the four classes of hemorrhagic shock (I - IV) with corresponding vital signs and fluid requirements. Using the "MARCH" mnemonic (Massive hemorrhage, Airway, Respiration, Circulation, Head injury) from military guidelines can help you nail these cen review questions.

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