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Test Number : CEN
Test Name : Certified Emergency Nurse
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The CEN test is for nurses in the emergency department setting who want to demonstrate their expertise, knowledge and versatility in emergency nursing.

Killexams is the only source for emergency nursing professionals and their employers to obtain recognized certification with proven results for greater knowledge and performance. Enhance your knowledge, your career, and patient care with specialty certification in emergency nursing.

One of the more common questions they get from their customers is about the difference between a certification and a certificate. Here is the difference in a nutshell:

A certificate comes from an educational program where a certificate is awarded after the individual successfully completes the offering. Examples of certificates are Advanced Cardiac Life Support (ACLS) or Trauma Nursing Core Course (TNCC).

A certification, like the Certified Emergency Nurse (CEN) is an earned credential that demonstrates the individuals specialized knowledge and skills. Certification is awarded by a third-party organization, such as Board of Certification for Emergency Nursing. Individuals receive their certification after meeting strict eligibility requirements and successfully completing the required examination. In addition, certifications have ongoing requirements that must be meant to maintain the credential, ensuring the holder has maintained their level of expertise in the specialty area. Certifications are nationally recognized and are often utilized as part of the earners signature.

Earning professional certifications such as the CEN, CPEN, CFRN, CTRN and TCRN offered by BCEN, and completing certificate programs such as ACLS, PALS, ENCP and TNCC, are critical to the work emergency nurses do, but there are significant differences.
1. Cardiovascular Emergencies 20
A. Acute coronary syndrome
B. Aneurysm/dissection
C. Cardiopulmonary arrest
D. Dysrhythmias
E. Endocarditis
F. Heart failure
G. Hypertension
H. Pericardial tamponade
I. Pericarditis
J. Peripheral vascular disease (e.g., arterial, venous)
K. Thromboembolic disease (e.g., deep vein thrombosis [DVT])
L. Trauma
M. Shock (cardiogenic and obstructive)
2. Respiratory Emergencies 16
A. Aspiration
B. Asthma
C. Chronic obstructive pulmonary disease (COPD)
D. Infections
E. Inhalation injuries
F. Obstruction
G. Pleural effusion
H. Pneumothorax
I. Pulmonary edema, noncardiac
J. Pulmonary embolus
K. Respiratory distress syndrome
L. Trauma
3. Neurological Emergencies 16
A. Alzheimer's disease/dementia
B. Chronic neurological disorders (e.g., multiple sclerosis, myasthenia gravis)
C. Guillain-Barr syndrome
D. Headache (e.g., temporal arteritis,migraine)
E. Increased intracranial pressure (ICP)
F. Meningitis
G. Seizure disorders
H. Shunt dysfunctions
I. Spinal cord injuries, including neurogenic shock
J. Stroke (ischemic or hemorrhagic)
K. Transient ischemic attack (TIA)
L. Trauma
4. Gastrointestinal, Genitourinary, Gynecology, and Obstetrical Emergencies 21
A. Gastrointestinal
1. Acute abdomen (e.g., peritonitis, appendicitis)
2. Bleeding
3. Cholecystitis
4. Cirrhosis
5. Diverticulitis
6. Esophageal varices
7. Esophagitis
8. Foreign bodies
9. Gastritis
10. Gastroenteritis
11. Hepatitis
12. Hernia
13. Inflammatory bowel disease
14. Intussusception
15. Obstructions
16. Pancreatitis
17. Trauma
18. Ulcers
B. Genitourinary
1. Foreign bodies
2. Infection (e.g., urinary tract infection, pyelonephritis, epididymitis, orchiitis, STDs)
3. Priapism
4. Renal calculi
5. Testicular torsion
6. Trauma
7. Urinary retention
C. Gynecology
1. Bleeding/dysfunction (vaginal)
2. Foreign bodies
3. Hemorrhage
4. Infection (e.g., discharge, pelvic inflammatory disease, STDs)
5. Ovarian cyst
6. Sexual assault/battery
7. Trauma
D. Obstetrical
1. Abruptio placenta
2. Ectopic pregnancy
3. Emergent delivery
4. Hemorrhage (e.g., postpartum bleeding)
5. Hyperemesis gravidarum
6. Neonatal resuscitation
7. Placenta previa
8. Postpartum infection
9. Preeclampsia, eclampsia, HELLP syndrome
10. Preterm labor
11. Threatened/spontaneous abortion
12. Trauma
5. Psychosocial and Medical Emergencies 25
A. Psychosocial
1. Abuse and neglect
2. Aggressive/violent behavior
3. Anxiety/panic
4. Bipolar disorder
5. Depression
6. Homicidal ideation
7. Psychosis
8. Situational crisis (e.g., job loss, relationship issues, unexpected death)
9. Suicidal ideation
B. Medical
1. Allergic reactions and anaphylaxis
2. Blood dyscrasias
a. Hemophilia
b. Other coagulopathies (e.g., anticoagulant medications, thrombocytopenia)
c. Leukemia
d. Sickle cell crisis
3. Disseminated intravascular coagulation (DIC)
4. Electrolyte/fluid imbalance
5. Endocrine conditions:
a. Adrenal
b. Glucose related conditions
c. Thyroid
6. Fever
7. Immunocompromise (e.g., HIV/AIDS, patients receiving chemotherapy)
8. Renal failure
9. Sepsis and septic shock
6. Maxillofacial, Ocular, Orthopedic and Wound Emergencies 21
A. Maxillofacial
1. Abscess (i.e., peritonsillar)
2. Dental conditions
3. Epistaxis
4. Facial nerve disorders (e.g., Bells palsy, trigeminal neuralgia)
5. Foreign bodies
6. Infections (e.g., Ludwig'sangina, otitis, sinusitis, mastoiditis)
7. Acute vestibular dysfunction (e.g., labrinthitis, Mnire's disease)
8. Ruptured tympanic membrane
9. Temporomandibular joint (TMJ) dislocation
10. Trauma
B. Ocular
1. Abrasions
2. Burns
3. Foreign bodies
4. Glaucoma
5. Infections (e.g., conjunctivitis, iritis)
6. Retinal artery occlusion
7. Retinal detachment
8. Trauma (e.g., hyphema, laceration, globe rupture)
9. Ulcerations/keratitis
C. Orthopedic
1. Amputation
2. Compartment syndrome
3. Contusions
4. Costochondritis
5. Foreign bodies
6. Fractures/dislocations
7. Inflammatory conditions
8. Joint effusion
9. Low back pain
10. Osteomyelitis
11. Strains/sprains
12. Trauma (e.g., Achilles tendon rupture, blast injuries)
D. Wound
1. Abrasions
2. Avulsions
3. Foreign bodies
4. Infections
5. Injection injuries (e.g., grease gun, paintgun)
6. Lacerations
7. Missile injuries (e.g., guns, nail guns)

8. Pressure ulcers
9. Puncture wounds
10. Trauma (i.e., including degloving injuries)
7. Environment and Toxicology Emergencies, and Communicable Diseases 15
A. Environment
1. Burns
2. Chemical exposure (e.g., organophosphates, cleaning agents)
3. Electrical injuries
4. Envenomation emergencies (e.g., spiders, snakes, aquatic organisms)
5. Food poisoning
6. Parasite and fungal infestations (e.g., giardia, ringworm, scabies)
7. Radiation exposure
8. Submersion injury
9. Temperature-related emergencies (e.g., heat, cold, and systemic)
10. Vector borne illnesses:
a. Rabies
b. Tick-borne illness (e.g., Lyme disease, Rocky Mountain spotted fever)
B. Toxicology
1. Acids and alkalis
2. Carbon monoxide
3. Cyanide
4. Drug interactions (includingalternative therapies)
5. Overdose and ingestions
6. Substance abuse
7. Withdrawal syndrome
C. Communicable Diseases
1. C. Difficile
2. Childhood diseases (e.g., measles, mumps, pertussis, chicken pox,
diphtheria)
3. Herpes zoster
4. Mononucleosis
5. Multi-drug resistant organisms (e.g., MRSA, VRE)
6. Tuberculosis

8. Professional Issues 16
A. Nurse
1. Critical Incident Stress Management
2. Ethical dilemmas
3. Evidence-based practice
4. Lifelong learning
5. Research
B. Patient
1. Discharge planning
2. End of life issues:
a. Organ and tissue donation
b. Advance directives
c. Family presence
d. Withholding, withdrawing, and palliative care
3. Forensic evidence collection
4. Pain management and procedural sedation
5. Patient safety
6. Patient satisfaction
7. Transfer and stabilization
8. Transitions of care
a. external handoffs
b. internal handoffs
c. patient boarding
d. shift reporting
9. cultural considerations (e.g., interpretive services, privacy, decision making)
C. System
1. Delegation of tasks to assistive personnel
2. Disaster management (i.e., preparedness, mitigation, response, and recovery)
3. Federal regulations (e.g., HIPAA, EMTALA)
4. Patient consent for treatment Performance improvement
6. Risk management
7. Symptom surveillance
a. recognizing symptom clusters
b. mandatory reporting of diseases
D. Triage



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After a sexual assault, the place can you get a scientific and forensic examination? | CEN Dumps and real questions

assessments are free for patients reporting any form of sexual assault and any licensed clinical issuer can perform one, but doing one neatly requires working towards that goes past the scope of common nursing and clinical faculty, advocates and survivors say. there's a global of difference, they say, between a person studying equipment guidance for the primary time and an experienced examiner.

“Of all the individuals I encountered right through the procedure — all over the fitness care system and the justice gadget — the SANE nurse was the one least traumatizing adult,” Griffin talked about.

An examination achieved by way of a trained issuer moves on the patient’s pace: they can take breaks, bypass any part and choose no matter if evidence and pictures are gathered. It specializes in getting them the health care they need and the substances to make suggested future choices about their assault.

whereas sexual violence can affect any individual, the gadget through which victims are searching for support and justice has a superior burden on marginalized communities — from individuals of colour to LGBTQ americans, intercourse employees and other groups, observed Monika Johnson-Hostler, president of the country wide Alliance to conclusion Sexual Violence. “It’s the consequences after that assault, it really is the place they see the disproportionate have an effect on: the inability of entry to health care, the inability of assist jogging through the crook criminal device.”

“for most survivors who go to the emergency branch or have an evidence collection package completed, it be their first step. a lot of them go to the clinic earlier than they even call a hotline,” Johnson-Hostler spoke of, including that how they are handled there'll have an effect on everything that follows, regardless of if they choose to document to legislation enforcement.

That’s why examiner practicing is so critical, mentioned Shandra Witherspoon, who coordinates and supports SANEs for the Ohio Alliance to conclusion Sexual Violence. “The added practicing a SANE goes via — knowing trauma and how it relates to a sexual assault survivor — is important to giving the entire power back to the survivor.”

That practicing covers everything from trauma-informed care to a way to testify as an expert witness in a crook trial. It typically comprises as a minimum forty hours of instruction plus extra scientific adventure. working towards is essentially run via nonprofits or universities — most use the working towards model of Nash’s organization or one identical, but some states have wonderful necessities.

probably the most greatest challenges across the nation is for nurses to get ample medical apply. in many places, they can attend per week-long practising or do IAFN’s online direction to get lecture room event, but when they work at a rural clinic that sees few sexual assault patients, they may additionally no longer put that working towards into practice for months or even years.

A nurse conducts a forensic test all the way through a 2019 SANE practising in Colorado Springs.NBC news

“There’s no exact region to apply what they’ve discovered within the school room,” stated Monie Johnson of her state. Johnson runs the Arkansas Coalition towards Sexual Assault and conducts SANE trainings in Arkansas.

Retention is the largest difficulty, she noted. After her corporation bought a federal grant in 2015, it informed forty eight SANEs over three years. Few went on to comprehensive their scientific hours, and even less are still training. Of those 48 nurses, today simplest four are practising SANEs in Arkansas.

Full-time SANE jobs are few and much between, meaning most educated examiners take on the responsibility to be on name to conduct checks apart from their usual work hours.

Even states with strong govt involvement fight with examiner retention and burnout. Maine has had a state-huge program for 17 years. but it surely has all the time struggled with turnover among SANEs. No clinic has 24/7 features, though a brand new partnership between the state program and the college of new England nursing college could exchange that with the aid of expanding training.

“We’re seeing growth around the state,” spoke of Polly Campbell, the scientific director of the SANE application on the institution of latest England. “we can do that since the state helps it.”

most of the examiners NBC news spoke to noted it is annoying but moneymaking work, made greater complex by using the inability of full-time jobs.

“Most hospitals, most amenities, most SANE programs — it’s now not a main job for individuals. It’s customarily a secondary job for them,” spoke of Megan Lechner, the director of Colorado’s biggest SANE software and main training provider. “every now and then it looks like taking on further patients during a shift. on occasion it’s being on call 24 hours a day.”

There’s the medical professional in Maui who has been the leading examiner for the island for the remaining 30 years; the nurse who situated a nonprofit that sends on-name SANEs to hospitals right through an awful lot of northern Louisiana who still works full-time at a medical institution; the Alaska forensic knowledgeable who continuously flies to remote parts of the state to educate examiners and first responders and is accessible for consultation 24/7.

Given the stress of the job, sticking with it takes a lot of ardour, mentioned Broder of Oregon. “if you’re the handiest nurse in a whole county, that’s a big quantity of drive for one person. ... There has to be a plan in location to help these SANEs.”

After Griffin’s adventure in 2014, she contacted her senator, Patty Murray, D-Wash. Murray commissioned a executive Accountability office record on test availability, which discovered advice lacking nationwide. Researchers closely examined six states, discovering that there have been constrained training opportunities in rural states, susceptible monetary guide from hospitals and excessive burnout rates amongst SANEs as a result of the traumatic nature of the work.

Murray proposed a bill soon after to start addressing the tips and support gaps. If handed, it could provide national funding to study the scarcity, set up a practicing application, advance nationwide necessities for sexual assault exams and expand health care access for survivors. even though it changed into first proposed in 2016 and has bipartisan sponsorship, the invoice has yet to get a listening to or a vote.

NBC information spoke to organizations in all 50 states first in late 2019, then again in June, in an effort to answer a question on the core of Murray’s invoice: where can someone go to get an examination from a qualified provider?

every state organizes its forensic test device in a different way. Some state sexual assault coalitions had publications about tests and lists of providers on their websites. Many did not. In just a few, executive companies tracked the place programs were found via constantly up to date online lists. In others, the only lists had been maintained by volunteer nurses. In a small quantity, there was no tracking. Some state certified spoke of staffing tiers at hospitals change so frequently that victims may still be directed to local rape crisis centers, which be aware of where the closest providers are.

The Covid-19 pandemic did not affect their potential to behavior assessments, suppliers around the nation told NBC news, but in March and April, there turned into a pointy reduce in the variety of people inquiring for tests. They attributed the lower to people involved about risking exposure to the coronavirus by way of going to a hospital emergency room or pondering capabilities had stopped during a stay-at-domestic order. Some programs adapted with the aid of directing examination patients to health center entrances faraway from emergency departments and and even establishing new examination sites at pressing care or baby advocacy facilities. Most states saw requests for exams climb back towards regular frequency as reside-at-domestic orders began to lift, but worry that subject over coronavirus might retain some victims from seeking health care.

all the way through the nation, examiners began donning more very own protective device and advocates were in many circumstances quickly now not allowed to accompany patients, as an alternative participating by telephone or video call. With commute discouraged, the pandemic spurred a few states that have telenursing courses, such as Alaska with its many far off villages, to push forward with expanding these features to greater rural communities.

The department of Justice has funded state efforts to conduct greater examiner trainings and boost test entry considering the fact that 2005. Many states have got further DOJ funds towards these efforts in the last six years as a part of gives you to overhaul their sexual assault kits. software coordinators and advocates around the nation say issues are enhancing, however they nevertheless need more examiners, greater funding and greater help to hold classes open and examiners around.

“each year there’s progress made. here's a local that we’ve definitely considered relatively consistent circulation on,” noted Annie Hightower, the director of legislations and policy for the Idaho Coalition towards Sexual and home Violence.

Idaho these days funded a SANE position at the state police to coordinate Idaho’s examiner training and has begun to coach more nurses. Yet, Hightower mentioned, the state nonetheless has areas where somebody could need to trip as a good deal as 90 miles for an exam.

In areas the place SANEs are few and much between, states are adopting ingenious solutions. Regional cellular SANE programs will send on-call SANEs to treat a person at their nearest facility. In some underserved areas, new telenursing courses join native clinical providers with experienced SANEs via cozy video conference to guide them via checks. in many areas, elements are shared. Maine, Pennsylvania and Washington have regional agreements between hospitals to share SANEs as essential.

Harborview health center in Seattle, the place Griffin changed into treated, is a part of 1 of those agreements. Its center for Sexual Assault and hectic Stress has 24/7 staffing and sends SANEs to six other local hospitals. it's the greatest SANE application within the state, also offering trainings round Washington. The software has grown in fresh years, expanding from having one SANE on call per shift in 2014, when Griffin become treated, to two, so as to cut back wait instances, a spokesperson told NBC news.

Swedish clinical center — the clinic equipment that owns the first ER Griffin went to — is one of those companions, even though Harborview doesn't ship SANEs to the place Griffin went to. When requested about Griffin's experience, Amy Dodgion, a social worker at Swedish, instructed NBC news she couldn’t touch upon an individual case, but insisted it has protocols in area to ensure rape victims get examined by means of in particular informed nurses, regardless of which ER they discuss with.

“We don't turn americans away. They don't tell them to head in different places,” talked about Dodgion.

in the years on account that Griffin stepped into an ER, she has turn into an activist for expanding entry to sexual assault forensic checks, championing Murray’s bill as well as half a dozen different sexual assault-related bills in Washington state. She serves on a statewide sexual assault forensic test task force, has testified a lot of times on the state capitol and has lobbied legislators in Washington, D.C. — even attending the State of the Union with Murray in 2018.

“I couldn’t get justice,” she noted, “however I want to make a gadget the place individuals can.”

Passing Murray’s bill is the subsequent step towards that intention. “it is going to imply that, for the first time, we’ll have a constitution in region to begin to clear up this difficulty,” she mentioned.

newshounds contacted each statewide coalition in opposition t sexual assault, state agencies, legislations enforcement offices, tuition training courses and dozens of software coordinators and individual examiners so as to be mindful the provision of sexual assault forensic assessments across the country, first in December 2019, then in June.

That availability varies widely state to state, as does the structure of coaching classes, laws and executive oversight. Most states didn't have always up-to-date databases tracking where SANEs work and what amenities have courses. NBC news consulted advocates and administrators in states with minimal monitoring on how choicest to map what is commonplace in regards to the state’s substances. A summary of each state’s features and any further notes on how facts changed into accumulated appears with each and every state.

Adiel Kaplan and Wilson Wong stated from big apple metropolis; Alexa Keyes and Catie Beck stated from Seattle.


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