CEN Practice Test

CEN Cardiovascular Emergencies Practice Questions

Cardiovascular Emergencies makes up 6 of every 50 questions on a Tigertest CEN practice test. Here are 10 of the 24 questions on it, each with the answer and the reason.

Updated 2026-11-14 by the Tigertest team. Based on the BCEN CEN Examination Content Outline effective July 2026. Original questions; 50 per test, weighted like the real exam. Not affiliated with BCEN.

1. 1. A patient with chest pain arrives in the emergency department. Within how many minutes of arrival should a 12-lead ECG be done?

   • A.5 minutes after labs
   • B.10 minutes
   • C.30 minutes
   • D.60 minutes

   Answer: B. A 12-lead ECG within 10 minutes of arrival lets the team spot an ST-elevation MI quickly and start reperfusion. Waiting for lab results delays that decision.

2. 2. A 12-lead ECG shows ST elevation in leads II, III and aVF. Which wall of the heart is most likely injured?

   • A.Lateral wall
   • B.Septal wall
   • C.Anterior wall
   • D.Inferior wall

   Answer: D. Leads II, III and aVF look at the inferior surface, which is usually supplied by the right coronary artery. Anterior changes show in V3 and V4.

3. 3. A patient with an inferior MI may also have right ventricular infarction. Which ECG lead best shows it?

   • A.Lead V4R
   • B.Lead I
   • C.Lead aVL
   • D.Lead V1 only

   Answer: A. A right-sided ECG places V4 on the right chest; ST elevation in V4R points to right ventricular infarction. Those patients are preload dependent, so nitrates are used with care.

4. 4. A patient describes sudden tearing chest pain that radiates to the back, with a 30 mmHg difference in arm blood pressures. What does this most suggest?

   • A.Acute pericarditis
   • B.Esophageal spasm
   • C.Aortic dissection
   • D.Stable angina

   Answer: C. Tearing pain into the back and a pressure gap between the arms point to dissection of the aorta. Anticoagulants and thrombolytics are dangerous until it is ruled out.

5. 5. For a suspected acute aortic dissection, what is the first goal of medication therapy?

   • A.Raise preload with fluids
   • B.Increase cardiac contractility
   • C.Lower heart rate and pressure
   • D.Dissolve the clot quickly

   Answer: C. Beta blockade is started first to slow the heart and reduce the force on the aortic wall, then pressure is lowered further. This limits extension of the tear.

6. 6. During CPR, how long may compressions pause for a rhythm or pulse check?

   • A.No more than 10 seconds
   • B.About 1 minute
   • C.As long as needed
   • D.Up to 30 seconds

   Answer: A. Pauses cut coronary and brain blood flow, so rhythm and pulse checks are kept under 10 seconds.

7. 7. During CPR the monitor shows ventricular fibrillation. What is the priority action?

   • A.Give synchronized cardioversion
   • B.Give epinephrine first
   • C.Start transcutaneous pacing
   • D.Defibrillate right away

   Answer: D. Ventricular fibrillation is a shockable rhythm, and survival falls with every minute without a shock. Pacing has no role in VF, and synchronized shocks need a QRS to sync to.

8. 8. A patient in cardiac arrest is in asystole. Which intervention is appropriate?

   • A.Adenosine IV push
   • B.CPR and epinephrine
   • C.Immediate defibrillation
   • D.Synchronized cardioversion

   Answer: B. Asystole is not shockable. Treatment is high-quality CPR, epinephrine and a search for reversible causes.

9. 9. A stable patient has a narrow, regular tachycardia at 190 beats per minute. Vagal maneuvers fail. Which drug is usually given next?

   • A.Digoxin
   • B.Adenosine
   • C.Amiodarone
   • D.Atropine

   Answer: B. Adenosine briefly blocks the AV node and often ends reentrant SVT. Warn the patient that it can cause a brief pause in the heartbeat and a sense of chest pressure.

10. 10. How should adenosine be given for supraventricular tachycardia?

    • A.Infusion over 1 hour
    • B.Deep intramuscular injection
    • C.Slow push over 5 minutes
    • D.Rapid IV push with a flush

    Answer: D. Adenosine has a half-life of seconds, so a slow push is cleared before it reaches the heart. A rapid push followed at once by a saline flush is used.