Certified Emergency Nurse

Reviewed March 2024

Reviewed January 2024 de Quervain Tenosynovitis Sample question: A 20-year-old man who is employed in construction presents with pain to his thumb and wrist for 4 months. He states that the pain worsens while he is working. Examination reveals pain along the radial surface of the wrist with forced ulnar abduction. What management is indicated?

Reviewed February 2024 Kawasaki Disease Sample question: A 4-year-old boy presents to the emergency department with his parents because of a rash and fever for 7 days. His temperature is 102.9°F (39.4°C) and heart rate is 120 bpm. Physical examination demonstrates bilateral conjunctival injection, an erythematous tongue, and anterior cervical lymphadenopathy. The patient has a read more…

Reviewed March 2024 Wernicke Encephalopathy Sample question: A 53-year-old woman with chronic alcohol use disorder presents with confusion and blurred vision. Her vital signs are within normal limits. Physical examination reveals a wide-based gait, inability to abduct her right eye fully, nystagmus, and difficulty with memory. Her alcohol level is 0.0 mg/dL. Which of the read more…

Reviewed February 2024 Achalasia Sample question: A 60-year-old man comes to the clinic with reports of difficulty swallowing, heartburn, chest pain, and mild weight loss. He has difficulty swallowing solids and liquids and often regurgitates undigested food. He has no significant past medical history and takes no medications. He reports no travel-related infection. Esophageal manometry read more…

Reviewed January 2024 Tetralogy of Fallot Sample question: A 1-year-old girl presents to the emergency room after her mother noticed that she became blue while crying. The patient subsequently squatted on the ground and the mother noticed a resolution in the cyanosis. On physical exam, the patient is now calm and vital signs are normal. A loud read more…

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Reviewed January 2024 Chlamydia Cervicitis

Reviewed February 2024 Cushing Syndrome Sample question: A 35-year-old woman presents to the clinic with decreased libido, weight gain, and menstrual irregularities. She says she has gained 35 pounds in the past three months without any changes in her diet. She has also noticed her face has become more round. Examination shows a dorsal fat read more…

Reviewed February 2024 Hypercalcemia Sample question: A 62-year-old woman with nephrolithiasis presents to the emergency department with muscle weakness, nausea, and confusion. ECG reveals bradycardia with a shortened QT interval. Laboratory findings include a total calcium of 14.7 mg/dL. In addition to starting intravenous isotonic saline at 200 mL/hour, which of the following is the read more…

Reviewed February 2024 Pertussis (Whooping Cough) Sample Question: A 2-year-old boy presents to the emergency department with a cough. For the past week, he has had a low-grade fever, cough, and a runny nose with itchy, red eyes. These symptoms have progressed to recurrent episodes of more severe coughing. The child is observed to have read more…

Reviewed February 2024 Acanthosis Nigricans Sample question: A 39-year-old woman presents for evaluation of darkening areas on the back of her neck. She has a history of hypertension and hypothyroidism. Her current medications include oral contraceptives, levothyroxine 125 mcg, and lisinopril 10 mg. Her vital signs are body mass index of 35.2 kg/m2, temperature of 97.7°F, read more…

Reviewed March 2024 Subdural Hematoma Sample question: A 68-year-old man presents to the ED after a fall down 12 stairs. On physical exam, you note a large parietal scalp hematoma. His noncontrast computed tomography scan of the head shows a crescent-shaped hematoma. Which of the following is the most likely diagnosis?

Reviewed January 2024 Ankylosing Spondylitis (Radiographic Axial Spondyloarthritis) Sample question: A 51-year-old man presents with low back pain that has been worsening over the past several years. Radiographs of the spine demonstrate fusion of the sacroiliac joints and a “bamboo spine.” Blood tests reveal that he is human leukocyte antigen B27 positive. Which of the following findings read more…

Reviewed January 2024 Von Willebrand disease Sample question: A 27-year-old woman presents to the emergency department with vaginal bleeding. She states that the bleeding is sporadic throughout the month and her periods last up to 8–10 days. She is otherwise healthy and has no other concerns. She notes that her mother and sister have always had long read more…

Reviewed February 2024 Hypothyroidism Sample Question: A 30-year-old woman presents to the clinic with hair loss, fatigue, weight gain, and constipation. She also reports symptoms of arthralgia. Her heart rate is 50 bpm. Physical examination reveals cool, rough, dry skin, periorbital puffiness, and pallor. A beta-hCG test shows a negative result. Which of the following read more…

Reviewed January 2024 Hyphema Sample Question: A 13-year-old boy is brought to the urgent care clinic by his mother. He was struck in the eye with a baseball while playing with classmates during recess. He complains of blurred vision and excruciating eye pain. Examination of the eye reveals decreased visual acuity, miosis, photophobia, and grossly visible read more…

Reviewed February 2024 Ménière Disease Sample Question: A 28-year-old man presents to his primary care physician for evaluation of intermittent episodes of left ear tinnitus, fullness, and hearing loss over the past 6 months. He reports no history of loud noise exposure or recent ear or upper respiratory tract infections. On two occasions without any read more…

Reviewed February 2024 Osgood-Schlatter Disease Sample question: A 15-year-old boy presents to the ED with right knee pain for the last 2 weeks. He is the point guard on his high-school basketball team. The pain is worse after basketball practice or a game. He does not specifically remember injuring his knee. On examination, he is tender read more…

Reviewed February 2024 Myasthenia Gravis Sample Question: A 27-year-old woman presents to the clinic concerned about eye strain. Her vision is sometimes blurry after working at a computer all day. Her boyfriend has noticed that one of her eyelids sometimes droops. Her symptoms are absent in the morning but develop and worsen as the day read more…