CPEN Practice Exam Prep Questions &
Rationales 2024.
1. 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.
2. 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.
3. 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
4. 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.
,5. 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.
6. Following a motor vehicle collision, a patient is diagnosed with a C7 fracture
and anterior spinal cord syndrome. The nurse understands this patient will-
ANSWER-
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
7. Which of the following is the BEST method to assess adequacy of ventila-
tion during procedural sedation?
A. breath sounds
B. oxygen saturation
C. respiratory rate
D. capnography value-ANSWER- D. capnography is used to determine
adequacy of venti- lation. 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.
8. A 2-year-old presents to the emergency department with tonic-clonic move-
ments 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.
9. 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
Rationales 2024.
1. 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.
2. 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.
3. 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
4. 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.
,5. 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.
6. Following a motor vehicle collision, a patient is diagnosed with a C7 fracture
and anterior spinal cord syndrome. The nurse understands this patient will-
ANSWER-
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
7. Which of the following is the BEST method to assess adequacy of ventila-
tion during procedural sedation?
A. breath sounds
B. oxygen saturation
C. respiratory rate
D. capnography value-ANSWER- D. capnography is used to determine
adequacy of venti- lation. 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.
8. A 2-year-old presents to the emergency department with tonic-clonic move-
ments 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.
9. 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
