CEN Respiratory Emergencies Practice Questions
Respiratory 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 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. An intubated patient's oxygen saturation suddenly drops, breath sounds are absent on one side and the trachea shifts away from it. What is the priority?
- A.Order a chest CT
- B.Needle decompression
- C.Suction the tube
- D.Increase the tidal volume
Answer: B. These are signs of tension pneumothorax, which kills quickly. Decompression comes before imaging, followed by a chest tube.
2. A tall, thin young man has sudden one-sided chest pain and mild dyspnea at rest. What is the most likely diagnosis?
- A.Lobar pneumonia
- B.Small pleural effusion
- C.Pulmonary embolism
- D.Spontaneous pneumothorax
Answer: D. Primary spontaneous pneumothorax is typical in tall, thin young males, often from a ruptured bleb. A chest x-ray confirms it.
3. A chest tube comes apart from the drainage tubing and cannot be reconnected right away. What is the immediate action?
- A.Put the end in sterile water
- B.Cover it with dry gauze
- C.Clamp it for several hours
- D.Pull the tube out
Answer: A. Placing the open end a couple of centimeters under sterile water recreates a water seal until a new system is attached. Prolonged clamping can cause a tension pneumothorax.
4. A patient's severe asthma attack is not easing after albuterol and steroids. Which IV drug may be added?
- A.Furosemide
- B.Morphine sulfate
- C.Magnesium sulfate
- D.Propranolol
Answer: C. IV magnesium relaxes bronchial smooth muscle and is used in severe asthma not responding to first-line treatment. Beta blockers and opioids can worsen bronchospasm and breathing.
5. Which medication is given first for an acute asthma attack?
- A.Oral montelukast
- B.Salmeterol inhaler
- C.Inhaled albuterol
- D.Inhaled fluticasone
Answer: C. A short-acting beta agonist relaxes airway smooth muscle within minutes. Controller medicines such as inhaled steroids, montelukast and long-acting agonists are not rescue drugs.
6. During an asthma attack, a rising PaCO2 from a low level to normal means what?
- A.The patient is tiring
- B.Oxygen should be stopped
- C.Compensation is improving
- D.The attack is resolving
Answer: A. Early in an attack fast breathing lowers CO2. A normal or rising CO2 in a struggling patient means the respiratory muscles are failing.
7. A patient with long-standing COPD retains CO2 but is at baseline. Which blood gas pattern is expected?
- A.Normal PaCO2, low pH
- B.Low PaCO2, high pH
- C.High PaCO2, very low pH
- D.High PaCO2, near-normal pH
Answer: D. In chronic CO2 retention the kidneys hold bicarbonate, so the pH stays near normal. A sharply low pH with high CO2 means an acute change on top.
8. Which device delivers the most precise oxygen concentration to a patient with COPD?
- A.Nonrebreather mask
- B.Venturi mask
- C.Nasal cannula
- D.Simple face mask
Answer: B. A Venturi mask mixes air and oxygen through a fixed port, giving a set FiO2 regardless of breathing pattern. A cannula's delivered FiO2 varies with the rate and depth of breathing.
9. An older adult with pneumonia has new confusion, a respiratory rate of 32 and a systolic pressure of 86. What do these findings suggest?
- A.An early asthma attack
- B.Pneumonia with sepsis
- C.Mild community pneumonia
- D.Simple dehydration
Answer: B. Confusion, fast breathing and low pressure are markers of severe pneumonia and possible sepsis. Such patients need prompt antibiotics and close monitoring.
10. A patient is having a thoracentesis for a large pleural effusion. How is the patient usually positioned?
- A.Prone with arms raised
- B.Trendelenburg position
- C.Flat on the back
- D.Sitting, leaning over a table
Answer: D. Sitting up and leaning forward over a bedside table spreads the ribs and lets fluid collect at the base, where the needle is placed.
Practice all 24 respiratory 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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