CPEN Practice Questions & Rationales 2024

CPEN Practice Questions & Rationales 2024 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. -Answer-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. -Answer-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. -Answer-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 -Answer-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 -Answer-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 -Answer-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 -Answer-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. -Answer-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. -Answer-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 -Answer-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 co