CPEN Practice Questions & Rationales (Answered) Correctly To Score A+
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CPEN
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CPEN
CPEN Practice Questions & Rationales (Answered) Correctly To Score A+
An anxious adolescent presents with palpitations, a heart rate of 184 beats/min, and normal skin tone. Which of the following is the PRIORITY intervention?
A. Obtain urine drug screen.
B. Administer IV adenosine (Adenocard) ...
CPEN Practice Questions & Rationales (Answered)
Correctly To Score A+
An anxious adolescent presents with palpitations, a heart rate of 184 beats/min,
and normal skin tone. Which of the following is the PRIORITY intervention?
A. Obtain urine drug screen.
B. Administer IV adenosine (Adenocard) rapidly.
C. Instruct the patient to bear down.
D. Provide comfort and reassurance.
D. SVT is defined as heart rate >220 in infants and >180 in children. Thus putting the
child in SVT. Search and treat the cause. The PRIORITY intervention to provide comfort
and reassurance could lower heart rate while preparing other interventions and
assessments. Vagal maneuvers would be the next intervention, followed by adenosine.
Continuous monitoring of a child's ETCO2 during cardiac arrest reveals 8 mmHg.
This indicates that CPR is
A. ineffective and adjustments need to be made to compressions.
B. no longer needed; there is a return of spontaneous circulation.
C. no longer needed; further resuscitation is futile.
D. ineffective and adjustments need to be made to ventilation.
A. The 2010 guidelines recommended that if the partial pressure of ETCO2 is
consistently less than 15 mm Hg efforts should focus on improving CPR quality,
particularly improving chest compressions and ensuring the child does not receive
excessive ventilations.
A child presents to emergency department with symptoms of anaphylaxis after
eating cookies at a birthday party. The friend's parent is accompanying the child
and is unable to reach the parents. The nurse recognizes this legal issue as
A. informed consent.
B. implied consent.
C. an EMTALA violation.
D. a HIPPA violation.
B. Implied Consent
9-month-old presents to the Emergency Department with a mid-shaft tibia
fracture. Which of the following statements from the parent might indicate history
of non-accidental trauma (NAT).
A. Patient was being changed on top of a table and rolled off.
B. Patient was an unrestrained passenger in a motor vehicle collision.
C. Patient was crawling on a deck and fell off approximately 4 feet.
D. Patient was riding a tricycle and fell off
D. The patient does not have the development and coordination to ride a tricycle. A 9-
month-old can roll over and it is possible to fall and fracture their arm. Even though the
patient was unrestrained, it may not involve NAT. A 9-month-old is often crawling and, if
the patient was not being watched, could have fallen off a deck and again not be
considered NAT.
Which developmental task is expected in a toddler?
A. industry
,B. trust
C. initiative
D. autonomy
D. Toddlers learn to exercise will and do things for themselves. Developmental task of
toddlerhood is acquiring a sense of autonomy. Several characteristics, especially
negativism and ritualism, are typical of toddlers.
Following a motor vehicle collision, a patient is diagnosed with a C7 fracture and
anterior spinal cord syndrome. The nurse understands this patient will:
A. will be able to ambulate with assistance
B. be wheelchair dependent
C. will regain most function at some point
D. be ventilator dependent
B. The patient will be a paraplegic and may be able to complete movement with their
arms. He will not be ventilator dependent or be able to ambulate independently. He will
be evaluated independently but will be unable to walk
Which of the following is the BEST method to assess adequacy of ventilation
during procedural sedation?
A. breath sounds
B. oxygen saturation
C. respiratory rate
D. capnography value
D. capnography is used to determine adequacy of ventilation. Oxygen saturation
provides the percentage of hemoglobin carrying oxygen. Hypoventilation is detected
more rapidly by capnography than by auscultation of breath sounds, oxygen saturation
or respiratory rate.
A 2-year-old presents to the emergency department with tonic-clonic movements
which the caregivers report occurring for one minute prior to arrival. The priority
intervention is
A. preparing for intubation.
B. administering oxygen via a nonrebreathing mask.
C. turning patient to the side.
D. placing an intraosseous needle.
C. Turning the patient to a side is part of the initial assessment to reduce the risk of
aspiration and tongue obstruction. There is no indication for an intraosseous needle as
most antiseizure medications can be given via other routes. Currently, there is no
indication for intubation. Oxygen will not assist if the airway is not patent.
A mother runs into the emergency department screaming that her child is
choking on a piece of candy. The nurse observes a fearful 5-year-old with minimal
air movement and dusky in color. The nurse's initial action should be to
A. perform abdominal thrusts.
B. obtain an oxygen saturation level.
C. facilitate oral tracheal intubation.
D. obtain a chest radiograph.
A. A child brought to the ED with sudden onset of respiratory distress should be
evaluated for foreign body aspiration if no other cause is apparent. Initially, a foreign
body obstruction produces choking, gassing, wheezing, or coughing. If the object
,becomes lodged in the larynx, the child cannot speak or breathe, For children 1 year or
older, abdominal thrusts should be used.
A 2-month-old presents with irritability and is inconsolable. Which finding would
lead the emergency nurse to suspect shaken baby syndrome?
A. Unilateral retinal hemorrhage
B. Bruising of the legs.
C. Decreased movement of the legs
D. Bilateral retinal hemorrhages
D. Shaken baby syndrome is common in children less than one year of age. Male
caregivers have a higher rate of shaken baby syndrome. Bilateral retinal hemorrhages
are more common due to weak neck muscles and large occiput. The infant is usually
held by the arms and shaken. Bruises of the arms would occur. Decreased movement
of the legs would usually be a spinal cord injury. Bruising of the legs are not indicative of
shaken baby syndrome.
A 2-year-old child has not used his left arm for the past hour. His mother reported
grabbing his hand to prevent him from falling from a slide. The nurse should
suspect
A. a forearm fracture.
B. a supracondylar fracture.
C. shoulder dislocation.
D. subluxation of the radial head.
D. Subluxation of the radial head, or a nursemaid's elbow, is one of the most common
injuries seen in toddlers. Resulting from a sudden pull on the child's arms, the child
refuses to move or use the affected extremity.
A 1-year-old presents unconscious and is being ventilated with a bag-mask
device. Ventilation has become progressively more difficult. Which of the
following is the PRIORITY intervention?
A. Insert a nasogastric tube.
B. Obtain a pulse oximeter reading.
C. Place padding under the shoulders.
C. Due to a large occiput, optimal airway position is achieved by placing padding under
the shoulders. The padding provides neutral alignment of the airway and cervical spine.
The other options need to occur, but they are not the priority intervention
If administering epinephrine to a pediatric patient having a severe allergic
reaction, the proper dose and concentration should be epinephrine
A. 0.10 mL/kg and 1mg/10 mL
B. 0.01 mL/kg and 1 mg/mL
C. 0.01 mL/kg and 1 mg/10 mL
D. 0.10 mL/kg and 1 mg/mL
B. The concentration of 1 mg/mL is indicated for allergic reaction and anaphylaxis to be
administered IM. The concentration of 1 mg/10 mL is for cardiac arrest treatments to be
administered IV or IO. The correct dosing of either concentration is 0.01 mL/kg.
An adolescent presents with superficial lacerations to both forearms. She is
tearful and avoids eye contact with staff. Which of the following is the PRIORITY
intervention for this patient?
A. Maintain a safe environment.
, B. Initiate wound care.
C. Notify the police.
D. Order a social work consultation.
A. During the pediatric triage and assessment process, the main concern of the nursing
is to maintain a safe environment for the patient and to foster hopefulness.
A child presents with fever, left eye pain, swelling, and impaired extraocular
movement. The nurse anticipates a workup for
A. orbital cellulitis.
B. uveitis/iritis.
C. conjunctivitis.
D. periorbital cellulitis.
A. Orbital cellulitis is an acute inflammation of the orbital contents posterior to the orbital
septum. It is deeper and more serious infection behind the septum and involving the
posterior eye structures. Periorbital cellulitis is an acute infection and inflammation
involving the eyelid and surrounding tissues anterior to the septum. Both orbital and
periorbital cellulitis are serious conditions because of their proximity to the brain.
What would be the most appropriate intervention for a child with suspected
intussusception?
A. Laxative administration.
B. Barium enema.
C. Nasogastric placement.
D. Air enema.
D. An air enema may reduce the telescoping of the bowel. Barium enemas are used
less often and have higher complication rates due to the potential for perforation and
peritonitis. Administering a laxative is not indicated. Placement of an NG tube will not
assist in this disease process.
A 5-week-old infant is brought in with a 2-day history of profuse vomiting after
every feeding, constant hunger, and decreased wet diaper count. The infant has
sunken eyes and dry mucus membranes. Vital signs:
BP 61/32 HR 184 RR 56 Cap refill 2s
Which of the following is the most appropriate INITIAL IV fluid?
A. D5 0.45 NS
B. 0.9 NS
C. D10 0.9 NS
D. D5 0.25 NS
B. In many cases, rapid restoration of blood volume is the main therapy needed in the
resuscitation of the child in shock. An isotonic crystalloid solution (0.9% normal saline or
lactated Ringer's solution) is usually the first choice for fluid replacement
A 10-year-old presents to the emergency department with abdominal pain,
vomiting and a sudden onset of scrotal pain with swelling. The parent states that
the symptoms started approximately one hour ago while the child was playing
outside. The nurse should anticipate which diagnostic test will be ordered?
A. CT scan
B. urinalysis
C. ultrasound
D. x-ray
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