CEN Practice Test

CEN Gastrointestinal Emergencies Practice Questions

Gastrointestinal Emergencies makes up 5 of every 50 questions on a Tigertest CEN practice test. Here are 10 of the 20 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's abdominal pain began around the navel and moved to the right lower quadrant, with nausea and low fever. What is most likely?

   • A.Diverticulitis
   • B.Appendicitis
   • C.Cholecystitis
   • D.Pancreatitis

   Answer: B. Periumbilical pain that migrates to McBurney's point is classic for appendicitis. Tenderness there, anorexia and a raised white count support it.

2. 2. A patient with appendicitis suddenly reports relief of pain, then develops a rigid abdomen and high fever. What has most likely happened?

   • A.Bowel obstruction
   • B.Gastroenteritis
   • C.Spontaneous resolution
   • D.Perforation

   Answer: D. Pain can ease briefly when an inflamed appendix ruptures, then peritonitis sets in. A board-like abdomen and fever mean urgent surgery.

3. 3. A patient has right upper quadrant pain after a fatty meal and stops breathing in when the area is pressed. What is this sign?

   • A.Murphy's sign
   • B.Psoas sign
   • C.Rovsing's sign
   • D.Cullen's sign

   Answer: A. Murphy's sign, a catch in breath when the gallbladder is palpated, points to cholecystitis. Ultrasound is the usual first imaging test.

4. 4. A patient with heavy alcohol use has severe epigastric pain radiating to the back. Which lab finding supports pancreatitis?

   • A.A high potassium
   • B.A low white count
   • C.A lipase 3 times normal
   • D.A low serum amylase

   Answer: C. Lipase above three times the upper limit, with typical pain, supports acute pancreatitis. Lipase is more specific than amylase.

5. 5. A patient with pancreatitis has bluish discoloration around the navel. What does this suggest?

   • A.Bowel obstruction
   • B.Simple skin bruising
   • C.Retroperitoneal bleeding
   • D.Acute liver failure

   Answer: C. Cullen's sign (around the navel) and Grey Turner's sign (on the flanks) suggest hemorrhagic pancreatitis with retroperitoneal bleeding.

6. 6. A patient vomits bright red blood and has a history of cirrhosis. What is the most likely source?

   • A.Esophageal varices
   • B.Diverticulosis
   • C.Internal hemorrhoids
   • D.A duodenal ulcer

   Answer: A. Portal hypertension in cirrhosis dilates veins in the esophagus, which can bleed heavily. Octreotide, antibiotics and urgent endoscopy are standard.

7. 7. Which medication is commonly given to reduce portal pressure in bleeding esophageal varices?

   • A.Loperamide
   • B.Metoclopramide
   • C.Ondansetron
   • D.Octreotide

   Answer: D. Octreotide reduces splanchnic blood flow and portal pressure. Antibiotic prophylaxis is also given to patients with cirrhosis and GI bleeding.

8. 8. A patient has black, tarry stools. Where is the bleeding most likely coming from?

   • A.The anal canal
   • B.Upper GI tract
   • C.The rectum
   • D.The sigmoid colon

   Answer: B. Melena usually comes from bleeding above the ligament of Treitz, digested as it passes through the gut. Bright red blood usually comes from lower down.

9. 9. A patient with cirrhosis and a tense abdomen has fever and new abdominal tenderness. What should the nurse suspect?

   • A.Acute cholecystitis
   • B.Infected ascites (SBP)
   • C.Simple ascites
   • D.Hepatic encephalopathy

   Answer: B. Infection of ascitic fluid without a surgical source is common in cirrhosis. A diagnostic paracentesis guides antibiotic treatment.

10. 10. A patient has crampy abdominal pain, vomiting, distension and no flatus. Bowel sounds are high pitched. What is most likely?

    • A.Irritable bowel syndrome
    • B.Hepatitis A infection
    • C.Acute gastritis
    • D.Small bowel obstruction

    Answer: D. Colicky pain, vomiting, distension and high-pitched sounds point to obstruction, often from adhesions after surgery. A nasogastric tube decompresses the stomach.