CEN Mental Health Emergencies Practice Questions
Mental Health Emergencies makes up 4 of every 50 questions on a Tigertest CEN practice test. Here are 10 of the 16 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. A patient says they plan to overdose on saved pills tonight. What is the nurse's first action?
- A.Discharge with a phone number
- B.Keep the patient observed
- C.Leave to call the family
- D.Promise to keep it secret
Answer: B. A patient with a plan and means is at high risk. Constant observation and a safe environment come first while a full assessment is arranged.
2. When screening for suicide risk, how should the nurse ask about it?
- A.Ask only the family
- B.Wait for the patient to raise it
- C.Avoid the word suicide
- D.Ask directly about suicide
Answer: D. Asking directly does not plant the idea and gives the patient permission to talk. Screening tools use plain questions about thoughts, plans and past attempts.
3. A patient is pacing, shouting and clenching fists. What is the first approach?
- A.Calm verbal de-escalation
- B.Turn away and ignore
- C.Immediate four-point restraint
- D.Argue the facts firmly
Answer: A. Speaking calmly, giving space and offering choices often prevents violence. Restraint is the last resort when others are at immediate risk.
4. When physical restraints are used on an agitated patient, what is required?
- A.A standing order for all shifts
- B.Checks once a shift
- C.Frequent monitoring and review
- D.Restraint until discharge
Answer: C. Restraint is the least restrictive measure that keeps people safe, needs a timely order and is reassessed often, with release as soon as possible.
5. A patient has sudden chest tightness, a racing heart, tingling hands and fear of dying. The ECG is normal. What is most likely?
- A.Schizophrenia
- B.Bipolar mania
- C.Panic attack
- D.Acute MI
Answer: C. A panic attack peaks within minutes with physical symptoms. Medical causes are ruled out first, then the patient is coached to slow breathing.
6. A patient who takes lithium starts a new drug for joint pain and becomes toxic. Which drug most likely raised the level?
- A.Ibuprofen
- B.Topical capsaicin
- C.Oral glucosamine
- D.Acetaminophen
Answer: A. NSAIDs reduce lithium clearance by the kidneys, raising the level. Thiazide diuretics, ACE inhibitors and dehydration do the same.
7. A patient on haloperidol has high fever, muscle rigidity and fluctuating blood pressure. What is most likely?
- A.Anticholinergic toxicity
- B.Serotonin syndrome
- C.Malignant hyperthermia
- D.Neuroleptic malignant syndrome
Answer: D. NMS follows antipsychotic use and causes fever, lead-pipe rigidity, autonomic instability and altered mental status. The drug is stopped and the patient cooled.
8. Which finding helps tell serotonin syndrome apart from neuroleptic malignant syndrome?
- A.Fast heart rate
- B.Clonus and hyperreflexia
- C.High fever
- D.Altered mental status
Answer: B. Serotonin syndrome brings clonus, hyperreflexia and a fast onset. NMS causes slow-onset lead-pipe rigidity with reduced reflexes; both can cause fever and confusion.
9. A patient with schizophrenia says voices are telling him to hurt his neighbor. What is the priority concern?
- A.Social withdrawal
- B.Command hallucinations
- C.A flat affect
- D.Poor personal hygiene
Answer: B. Voices that order harm raise the risk of violence. The nurse asks what the voices say and makes sure staff and others are safe.
10. A patient took an unknown number of acetaminophen tablets 4 hours ago and feels well. What is the next step?
- A.Induce vomiting
- B.Give activated charcoal at 12 hours
- C.Discharge since symptoms are absent
- D.Draw a 4-hour acetaminophen level
Answer: D. Early acetaminophen poisoning has few symptoms. A level at 4 hours or later is plotted on the nomogram to decide on N-acetylcysteine.
Practice all 16 mental health 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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