CPEN Practice Questions & Rationales

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. t