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CPEN PRACTICE 2025 QUESTIONS AND ANSWERS
1. A child with a ventriculoperitoneal shunt complains of
headache and vomiting. The nurse should prepare to
A. administer a fluid bolus.
B. obtain an electroencephalogram.
C. administer an antiemetic.
D. send the child for imaging. - correct answer - D. Imaging is
the only choice that investigates the given signs of increased
ICP. Administering and antiemetic and administering a fluid
bolus are needed for patient comfort are not the priority. An
EEG is not indicated for this child since the child is not
seizing and a delay in treatment could lead to shunt
malfunction.
2. An 8-year-old presents to the emergency department with a
snake bite. The right arm is edematous. IV fluids are started in
the left dorsal forearm. The physician reports the pressure in
the extremity to be greater than 30mmHg. The nurse should
anticipate
A. preparation for a fasciotomy.
B. compression dressing to the extremity.
C. elevation of the extremity above the heart.
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D. administration of antivenom. - correct answer - D. Antivenom
will decrease the swelling resulting in a decrease in pressure
in the extremity. A fasciotomy is rarely performed. Elevating
the extremity and a compression dressing would push the
venom towards the heart potentially resulting in death.
3. A 4-year child presents with abdominal pain and is crying.
Which pain scale would be most appropriate for the nurse to
use?
A. Numeric scale
B. CRIES scale
C. Faces scale
D. FLACC scale - correct answer - C. The Faces scale would be
the most appropriate pain scale to use on a 4-year old. The
Numeric scale can be used in children as young as 5 years old
as long as the child can count and understand the concept of
numbers in relation to other numbers. Both the CRIES scale
and FLACC scale are behavioral pain scales that are often
used to assess pain in infants or non-verbal patients.
4. A toddler presents with circumferential burns to their legs from a
scald injury. Apart from wound care, which intervention would be
most appropriate for the nurse to advocate for in this situation?
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A. Placement of wet/dry dressings
B. Administration of tetanus immunization
C. Complete skeletal x-rays
D. Placement of indwelling urinary catheter - correct answer -
C. Based on one study 33% of patients with burn
maltreatment injuries will have a positive skeletal survey.
Placement of wet/dry dressings is not a recommended
practice. An indwelling urinary catheter in a toddler may not
be indicated if weighing diapers possible. If the patient's
shots are up to date, a tetanus immunization may not be
required
5. A 6-month-old presents to the Emergency Department
displaying tachypnea with retractions, pharyngitis, rhinorrhea
and copious secretions. The caregiver states that the patient
just started daycare last week. The nurse suspects:
A. Respiratory Syncytial Virus (RSV)
B. Bacterial tracheitis
C. Laryngotracheobronchitis
D. Asthma - correct answer - A. RSV
6. A toddler with a history of hypoplastic left heart syndrome
presents with a fever and tachypnea. The child's oxygen
saturation is 76% on room air. The nurse's FIRST priority is to
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A. prepare for intubation.
B. begin bag-mask ventilation.
C. determine baseline oxygen saturation.
D. administer high-flow oxygen. - correct answer - C.
Knowledge of the baseline status of the child with special
health care needs as described by the caregiver will help
the nurse determine changes that are significant.
Supplemental oxygen should be used cautiously in this
patient population
7. In a 6-year-old child presenting with fever and a history of a
known congenital heart defect, the most concerning
contributing factor is
A. recent return from a summer camp.
B. immunization for varicella.
C. attendance at a new daycare.
D. noncompliance with dental care. - correct answer - D. Oral
hygiene is important to prevent endocarditis with congenital
heart defect. The other factors are less concerning for the
fever.
8. A preschool child presents for possible sexual abuse. The
MOST appropriate guideline when obtaining a history is to
A. offer the child stickers before the interview.
CPEN PRACTICE 2025 QUESTIONS AND ANSWERS
1. A child with a ventriculoperitoneal shunt complains of
headache and vomiting. The nurse should prepare to
A. administer a fluid bolus.
B. obtain an electroencephalogram.
C. administer an antiemetic.
D. send the child for imaging. - correct answer - D. Imaging is
the only choice that investigates the given signs of increased
ICP. Administering and antiemetic and administering a fluid
bolus are needed for patient comfort are not the priority. An
EEG is not indicated for this child since the child is not
seizing and a delay in treatment could lead to shunt
malfunction.
2. An 8-year-old presents to the emergency department with a
snake bite. The right arm is edematous. IV fluids are started in
the left dorsal forearm. The physician reports the pressure in
the extremity to be greater than 30mmHg. The nurse should
anticipate
A. preparation for a fasciotomy.
B. compression dressing to the extremity.
C. elevation of the extremity above the heart.
, Page | 2
D. administration of antivenom. - correct answer - D. Antivenom
will decrease the swelling resulting in a decrease in pressure
in the extremity. A fasciotomy is rarely performed. Elevating
the extremity and a compression dressing would push the
venom towards the heart potentially resulting in death.
3. A 4-year child presents with abdominal pain and is crying.
Which pain scale would be most appropriate for the nurse to
use?
A. Numeric scale
B. CRIES scale
C. Faces scale
D. FLACC scale - correct answer - C. The Faces scale would be
the most appropriate pain scale to use on a 4-year old. The
Numeric scale can be used in children as young as 5 years old
as long as the child can count and understand the concept of
numbers in relation to other numbers. Both the CRIES scale
and FLACC scale are behavioral pain scales that are often
used to assess pain in infants or non-verbal patients.
4. A toddler presents with circumferential burns to their legs from a
scald injury. Apart from wound care, which intervention would be
most appropriate for the nurse to advocate for in this situation?
, Page | 3
A. Placement of wet/dry dressings
B. Administration of tetanus immunization
C. Complete skeletal x-rays
D. Placement of indwelling urinary catheter - correct answer -
C. Based on one study 33% of patients with burn
maltreatment injuries will have a positive skeletal survey.
Placement of wet/dry dressings is not a recommended
practice. An indwelling urinary catheter in a toddler may not
be indicated if weighing diapers possible. If the patient's
shots are up to date, a tetanus immunization may not be
required
5. A 6-month-old presents to the Emergency Department
displaying tachypnea with retractions, pharyngitis, rhinorrhea
and copious secretions. The caregiver states that the patient
just started daycare last week. The nurse suspects:
A. Respiratory Syncytial Virus (RSV)
B. Bacterial tracheitis
C. Laryngotracheobronchitis
D. Asthma - correct answer - A. RSV
6. A toddler with a history of hypoplastic left heart syndrome
presents with a fever and tachypnea. The child's oxygen
saturation is 76% on room air. The nurse's FIRST priority is to
, Page | 4
A. prepare for intubation.
B. begin bag-mask ventilation.
C. determine baseline oxygen saturation.
D. administer high-flow oxygen. - correct answer - C.
Knowledge of the baseline status of the child with special
health care needs as described by the caregiver will help
the nurse determine changes that are significant.
Supplemental oxygen should be used cautiously in this
patient population
7. In a 6-year-old child presenting with fever and a history of a
known congenital heart defect, the most concerning
contributing factor is
A. recent return from a summer camp.
B. immunization for varicella.
C. attendance at a new daycare.
D. noncompliance with dental care. - correct answer - D. Oral
hygiene is important to prevent endocarditis with congenital
heart defect. The other factors are less concerning for the
fever.
8. A preschool child presents for possible sexual abuse. The
MOST appropriate guideline when obtaining a history is to
A. offer the child stickers before the interview.
