CPEN Practice Exam Questions With 100% Verified Correct
Answers |2026 Updated Guaranteed Pass.
A child with a head injury presents with altered mentation, nausea and vomiting. They are
afebrile. The nurse places the head midline with the head of bed elevated 30 degrees. The
nurse should prioritize administration of:
A. furosemide (Lasix).
B. 3% sodium chloride.
C. levetiracetam (Keppra).
D. D5 ½ normal saline. - Answer -B. 3% sodium chloride will pull fluid from the brain to the
plasma. Furosemide will increase urine production but will not pull fluid off the brain. D5 ½
normal saline would not help to resolve the symptoms of intracranial pressure and
Levetiracetam (Keppra) is used for seizure management/prevention.
A child with a large ventricular septal defect may display
A. cool lower extremities and hypotension.
B. congestive heart failure
C. cyanosis that increases with crying.
D. widened pulse pressure and bounding pulses. - Answer -B. In a large ventricular septal defect,
there is increased blood flow through the defect causing pulmonary hypertension. Right
ventricular and atrial enlargement may lead to increased work load.
The nurse should anticipate notifying the proper authorities for which of the following patients?
A. 10-year-old with a straddle injury
1
B. 6-year-old with positive gonorrhea
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, C. 6-month-old with labial adhesions
D. 16-month-old with a yeast infection - Answer -B. Sexually transmitted infections are not
expected in children and are suggestive of sexual abuse. This finding is reportable to child
protective services and/or appropriate legal authorities for your state.
Which of the following is the PRIORITY intervention for a 2 day old with jaundice?
A. Prepare for exchange transfusion.
B. Give the neonate nothing by mouth.
C. Expose the neonate's skin to sunlight.
D. Prepare for phototherapy. - Answer -D. When production of bilirubin exceeds the neonate
capacity to conjugate, plasma levels begin to rise. Free bilirubin can cross the blood-brain-
barrier and cause kernicterus, which is acute bilirubin encephalopathy. The clinical symptoms
are lethargy or irritability, hypotonia, and posturing. Long term effects if no immediate
intervention could include hearing loss and intellectual deficits.
A child with hemophilia presents with pain and swelling to the elbow. Factor replacement was
administered by the caregivers prior to arrival. Pain is rated as 8 out of 10. The nurse's MOST
appropriate intervention is to
A. obtain an order for an x-ray.
B. apply heat packs to the site.
C. obtain an order for a narcotic analgesic.
D. obtain an order for a NSAID. - Answer -C. Hemarthrosis due to hemophilia can be treat with
narcotics and non-narcotics but aspirin and NSAIDs should be avoided as they can prolong. Cold,
not heat can also help. There is no indication that an xray is needed.
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, A child with cellulitis of the lower leg is being discharged. Which of the following statements
indicates the parents understand the discharge instructions?
A. "We will bring our child back to the emergency department if the leg continues to swell."
B. "We will follow up with the pediatrician in one week."
C. "We will stop antibiotics when the leg is better."
D. "We will elevate the leg if our child is experiencing pain." - Answer -A. Increased swelling
indicates the leg is getting worse or potentially compartment syndrome may be occurring.
Antibiotics need to be completed. The child will need early follow up even if it is in the ED.
A 7-month-old child presents with vomiting and diarrhea. The child's weight is down
approximately 2 kilograms from a previous visit one month ago. The parents relate they have
been diluting the formula due to an inability to obtain formula. After stabilization of the child,
what is the priority?
A. Assess for developmental milestones.
B. Obtain a social services consult.
C. Give the caregivers a box of formula.
D. Provide written information about formula dilution. - Answer -B. RN's are mandated
reporters of possible neglect and abuse. Due to the weight loss, further investigation is needed.
Social services may help get the caregivers assistance to provide the child with needed food if
this is deemed to be a financial/supply constraint. If this is determined to be actual neglect and
withholding of food, the nurse would need to follow mandated reporting guidelines. Giving the
caregivers a limited supply of formula is not an appropriate choice. Assessing for milestones is
not a priority that is appropriate at this time. The caregivers already admitted to diluting the
formula. They were aware of the correct mixing of formula.
The discharge instructions that should be reinforced to the parents of a breast feeding infant
diagnosed with otitis media are
3
A. "You should follow up in three weeks with the pediatrician."
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3|Page
, B. "Continue to allow the child to nurse as before."
C. "You can continue to smoke as long as you do it outside."
D. "You can stop the medication when the symptoms subside. - Answer -B. Mastoiditis is a risk
for children with otitis media. Increasing the risk are smoking, bottle propping, and pacifier use
along with being unvaccinated. Follow-up with the pediatrician should take place within 1-2
weeks.
A mother arrives with her three children. The children present with sudden onset of vomiting,
diarrhea, abdominal pain, and rhinorrhea. The mother states that they were playing in the yard
and shed earlier in the day. Which of the following is the BEST next intervention for the nurse?
A. Notify the supervisor while isolating the family in the triage area.
B. Escort the family outside to the decontamination area.
C. Escort the family to a room with negative pressure.
D. Complete the assessment for each child and then place each in a separate area of the waiting
room. - Answer -B. The presenting symptoms clearly indicate an organophosphate exposure.
The organophosphate exposed individual is at significant risk for contaminating others. Perform
resuscitation and decontamination in a well-ventilated, isolated area. All people coming into
contact with the poisoned individual require full personal protective equipment, including
gloves and goggles.
Which of the following is a common sign of meningococcal meningitis?
A. hypothermia
B. petechiae
C. photophobia
D. vomiting - Answer -B. A petechial or purpuric rash is a sign of meningococcal disease.
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Answers |2026 Updated Guaranteed Pass.
A child with a head injury presents with altered mentation, nausea and vomiting. They are
afebrile. The nurse places the head midline with the head of bed elevated 30 degrees. The
nurse should prioritize administration of:
A. furosemide (Lasix).
B. 3% sodium chloride.
C. levetiracetam (Keppra).
D. D5 ½ normal saline. - Answer -B. 3% sodium chloride will pull fluid from the brain to the
plasma. Furosemide will increase urine production but will not pull fluid off the brain. D5 ½
normal saline would not help to resolve the symptoms of intracranial pressure and
Levetiracetam (Keppra) is used for seizure management/prevention.
A child with a large ventricular septal defect may display
A. cool lower extremities and hypotension.
B. congestive heart failure
C. cyanosis that increases with crying.
D. widened pulse pressure and bounding pulses. - Answer -B. In a large ventricular septal defect,
there is increased blood flow through the defect causing pulmonary hypertension. Right
ventricular and atrial enlargement may lead to increased work load.
The nurse should anticipate notifying the proper authorities for which of the following patients?
A. 10-year-old with a straddle injury
1
B. 6-year-old with positive gonorrhea
Page
1|Page
, C. 6-month-old with labial adhesions
D. 16-month-old with a yeast infection - Answer -B. Sexually transmitted infections are not
expected in children and are suggestive of sexual abuse. This finding is reportable to child
protective services and/or appropriate legal authorities for your state.
Which of the following is the PRIORITY intervention for a 2 day old with jaundice?
A. Prepare for exchange transfusion.
B. Give the neonate nothing by mouth.
C. Expose the neonate's skin to sunlight.
D. Prepare for phototherapy. - Answer -D. When production of bilirubin exceeds the neonate
capacity to conjugate, plasma levels begin to rise. Free bilirubin can cross the blood-brain-
barrier and cause kernicterus, which is acute bilirubin encephalopathy. The clinical symptoms
are lethargy or irritability, hypotonia, and posturing. Long term effects if no immediate
intervention could include hearing loss and intellectual deficits.
A child with hemophilia presents with pain and swelling to the elbow. Factor replacement was
administered by the caregivers prior to arrival. Pain is rated as 8 out of 10. The nurse's MOST
appropriate intervention is to
A. obtain an order for an x-ray.
B. apply heat packs to the site.
C. obtain an order for a narcotic analgesic.
D. obtain an order for a NSAID. - Answer -C. Hemarthrosis due to hemophilia can be treat with
narcotics and non-narcotics but aspirin and NSAIDs should be avoided as they can prolong. Cold,
not heat can also help. There is no indication that an xray is needed.
2
Page
2|Page
, A child with cellulitis of the lower leg is being discharged. Which of the following statements
indicates the parents understand the discharge instructions?
A. "We will bring our child back to the emergency department if the leg continues to swell."
B. "We will follow up with the pediatrician in one week."
C. "We will stop antibiotics when the leg is better."
D. "We will elevate the leg if our child is experiencing pain." - Answer -A. Increased swelling
indicates the leg is getting worse or potentially compartment syndrome may be occurring.
Antibiotics need to be completed. The child will need early follow up even if it is in the ED.
A 7-month-old child presents with vomiting and diarrhea. The child's weight is down
approximately 2 kilograms from a previous visit one month ago. The parents relate they have
been diluting the formula due to an inability to obtain formula. After stabilization of the child,
what is the priority?
A. Assess for developmental milestones.
B. Obtain a social services consult.
C. Give the caregivers a box of formula.
D. Provide written information about formula dilution. - Answer -B. RN's are mandated
reporters of possible neglect and abuse. Due to the weight loss, further investigation is needed.
Social services may help get the caregivers assistance to provide the child with needed food if
this is deemed to be a financial/supply constraint. If this is determined to be actual neglect and
withholding of food, the nurse would need to follow mandated reporting guidelines. Giving the
caregivers a limited supply of formula is not an appropriate choice. Assessing for milestones is
not a priority that is appropriate at this time. The caregivers already admitted to diluting the
formula. They were aware of the correct mixing of formula.
The discharge instructions that should be reinforced to the parents of a breast feeding infant
diagnosed with otitis media are
3
A. "You should follow up in three weeks with the pediatrician."
Page
3|Page
, B. "Continue to allow the child to nurse as before."
C. "You can continue to smoke as long as you do it outside."
D. "You can stop the medication when the symptoms subside. - Answer -B. Mastoiditis is a risk
for children with otitis media. Increasing the risk are smoking, bottle propping, and pacifier use
along with being unvaccinated. Follow-up with the pediatrician should take place within 1-2
weeks.
A mother arrives with her three children. The children present with sudden onset of vomiting,
diarrhea, abdominal pain, and rhinorrhea. The mother states that they were playing in the yard
and shed earlier in the day. Which of the following is the BEST next intervention for the nurse?
A. Notify the supervisor while isolating the family in the triage area.
B. Escort the family outside to the decontamination area.
C. Escort the family to a room with negative pressure.
D. Complete the assessment for each child and then place each in a separate area of the waiting
room. - Answer -B. The presenting symptoms clearly indicate an organophosphate exposure.
The organophosphate exposed individual is at significant risk for contaminating others. Perform
resuscitation and decontamination in a well-ventilated, isolated area. All people coming into
contact with the poisoned individual require full personal protective equipment, including
gloves and goggles.
Which of the following is a common sign of meningococcal meningitis?
A. hypothermia
B. petechiae
C. photophobia
D. vomiting - Answer -B. A petechial or purpuric rash is a sign of meningococcal disease.
4
Page
4|Page
