CEN Medical Emergencies Practice Questions
Medical 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 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. Fifteen minutes into a blood transfusion, a patient has fever, chills and low back pain. What is the first action?
- A.Flush the line with D5W
- B.Stop the transfusion
- C.Slow the rate by half
- D.Give acetaminophen and go on
Answer: B. These signs suggest an acute hemolytic reaction. The transfusion is stopped at once, the line kept open with saline, and the blood bank notified.
2. A patient has tongue and lip swelling without hives. Which drug class most often causes this type of angioedema?
- A.Statins
- B.Loop diuretics
- C.Beta blockers
- D.ACE inhibitors
Answer: D. ACE inhibitors raise bradykinin and can cause angioedema even after years of use. It responds poorly to antihistamines, and the airway is watched closely.
3. A patient with anaphylaxis takes a beta blocker and does not respond to repeated epinephrine. Which drug may help?
- A.Glucagon
- B.Vasopressin only
- C.Atropine
- D.Flumazenil
Answer: A. Glucagon raises cyclic AMP without using beta receptors, so it can improve heart rate and pressure when beta blockade blunts epinephrine.
4. A child with sickle cell disease suddenly turns pale, the spleen enlarges and the hemoglobin falls sharply. What is this?
- A.Iron deficiency
- B.Acute chest syndrome
- C.Splenic sequestration
- D.Vaso-occlusive crisis
Answer: C. In splenic sequestration, blood pools in the spleen and can cause shock. It needs prompt fluids and transfusion.
5. A patient with sickle cell disease has chest pain, fever and a new infiltrate on x-ray. What is this?
- A.Stable angina
- B.Viral pleurisy
- C.Acute chest syndrome
- D.Simple pneumonia only
Answer: C. Acute chest syndrome is a leading cause of death in sickle cell disease. It needs oxygen, antibiotics, pain control and sometimes transfusion.
6. A patient on warfarin has an INR of 9 and is bleeding heavily. Which treatments reverse it quickly?
- A.Vitamin K and PCC
- B.Aspirin and fluids
- C.Heparin infusion
- D.Protamine sulfate
Answer: A. Life-threatening warfarin bleeding is treated with IV vitamin K and a prothrombin complex concentrate, or plasma when PCC is not available. Protamine reverses heparin.
7. A patient's cheek twitches when the facial nerve is tapped. Which electrolyte problem does this suggest?
- A.Low phosphate
- B.High sodium
- C.High potassium
- D.Low calcium
Answer: D. Chvostek's sign shows the neuromuscular irritability of hypocalcemia. Trousseau's sign, carpal spasm under a blood pressure cuff, is another.
8. Which treatment shifts potassium into cells in hyperkalemia?
- A.Magnesium sulfate
- B.Insulin with glucose
- C.Calcium gluconate
- D.Normal saline bolus
Answer: B. Insulin drives potassium into cells; glucose is given with it to prevent hypoglycemia. Nebulized albuterol also shifts potassium.
9. A patient has a sodium of 112 mEq/L and is having seizures. What is the treatment?
- A.Fluid restriction only
- B.Hypertonic saline
- C.Free water by mouth
- D.Rapid D5W infusion
Answer: B. Severe symptomatic hyponatremia is treated with small boluses of hypertonic saline. The overall rise is limited to prevent osmotic demyelination.
10. During DKA treatment, when is dextrose usually added to the IV fluids?
- A.Before insulin starts
- B.Only after discharge
- C.Once the pH is normal
- D.At a glucose near 250
Answer: D. Insulin is still needed to close the anion gap after glucose falls. Adding dextrose at about 200 to 250 mg/dL lets insulin continue without hypoglycemia.
Practice all 20 medical emergencies questions, and the rest of the 200-question bank, in the free CEN training sets. Questions you miss come back until you have mastered them.
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