CPEN Practice Questions & Rationales and
Answers Verified by Experts
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. 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 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 cord injury. Bruising of the legs are not indicative of shaken
baby syndrome.
A 2-year-old child has not used his left arm for the past hour. His mother reported grabbing his
hand to prevent him from falling from a slide. The nurse should suspect
A. a forearm fracture.
B. a supracondylar fracture.
C. shoulder dislocation.
D. subluxation of the radial head. D. Subluxation of the radial head, or a nursemaid's
elbow, is one of the most common injuries seen in toddlers. Resulting from a sudden pull on the
child's arms, the child refuses to move or use the affected extremity.
A 1-year-old presents unconscious and is being ventilated with a bag-mask device. Ventilation
has become progressively more difficult. Which of the following is the PRIORITY intervention?
,A. Insert a nasogastric tube.
B. Obtain a pulse oximeter reading.
C. Place padding under the shoulders. C. Due to a large occiput, optimal airway position
is achieved by placing padding under the shoulders. The padding provides neutral alignment of
the airway and cervical spine. The other options need to occur, but they are not the priority
intervention
If administering epinephrine to a pediatric patient having a severe allergic reaction, the proper
dose and concentration should be epinephrine
A. 0.10 mL/kg and 1mg/10 mL
B. 0.01 mL/kg and 1 mg/mL
C. 0.01 mL/kg and 1 mg/10 mL
D. 0.10 mL/kg and 1 mg/mL B. The concentration of 1 mg/mL is indicated for allergic
reaction and anaphylaxis to be administered IM. The concentration of 1 mg/10 mL is for cardiac
arrest treatments to be administered IV or IO. The correct dosing of either concentration is 0.01
mL/kg.
An adolescent presents with superficial lacerations to both forearms. She is tearful and avoids
eye contact with staff. Which of the following is the PRIORITY intervention for this patient?
, A. Maintain a safe environment.
B. Initiate wound care.
C. Notify the police.
D. Order a social work consultation. A. During the pediatric triage and assessment
process, the main concern of the nursing is to maintain a safe environment for the patient and
to foster hopefulness.
A child presents with fever, left eye pain, swelling, and impaired extraocular movement. The
nurse anticipates a workup for
A. orbital cellulitis.
B. uveitis/iritis.
C. conjunctivitis.
D. periorbital cellulitis. A. Orbital cellulitis is an acute inflammation of the orbital contents
posterior to the orbital septum. It is deeper and more serious infection behind the septum and
involving the posterior eye structures. Periorbital cellulitis is an acute infection and
inflammation involving the eyelid and surrounding tissues anterior to the septum. Both orbital
and periorbital cellulitis are serious conditions because of their proximity to the brain.
What would be the most appropriate intervention for a child with suspected intussusception?
Answers Verified by Experts
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. 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 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 cord injury. Bruising of the legs are not indicative of shaken
baby syndrome.
A 2-year-old child has not used his left arm for the past hour. His mother reported grabbing his
hand to prevent him from falling from a slide. The nurse should suspect
A. a forearm fracture.
B. a supracondylar fracture.
C. shoulder dislocation.
D. subluxation of the radial head. D. Subluxation of the radial head, or a nursemaid's
elbow, is one of the most common injuries seen in toddlers. Resulting from a sudden pull on the
child's arms, the child refuses to move or use the affected extremity.
A 1-year-old presents unconscious and is being ventilated with a bag-mask device. Ventilation
has become progressively more difficult. Which of the following is the PRIORITY intervention?
,A. Insert a nasogastric tube.
B. Obtain a pulse oximeter reading.
C. Place padding under the shoulders. C. Due to a large occiput, optimal airway position
is achieved by placing padding under the shoulders. The padding provides neutral alignment of
the airway and cervical spine. The other options need to occur, but they are not the priority
intervention
If administering epinephrine to a pediatric patient having a severe allergic reaction, the proper
dose and concentration should be epinephrine
A. 0.10 mL/kg and 1mg/10 mL
B. 0.01 mL/kg and 1 mg/mL
C. 0.01 mL/kg and 1 mg/10 mL
D. 0.10 mL/kg and 1 mg/mL B. The concentration of 1 mg/mL is indicated for allergic
reaction and anaphylaxis to be administered IM. The concentration of 1 mg/10 mL is for cardiac
arrest treatments to be administered IV or IO. The correct dosing of either concentration is 0.01
mL/kg.
An adolescent presents with superficial lacerations to both forearms. She is tearful and avoids
eye contact with staff. Which of the following is the PRIORITY intervention for this patient?
, A. Maintain a safe environment.
B. Initiate wound care.
C. Notify the police.
D. Order a social work consultation. A. During the pediatric triage and assessment
process, the main concern of the nursing is to maintain a safe environment for the patient and
to foster hopefulness.
A child presents with fever, left eye pain, swelling, and impaired extraocular movement. The
nurse anticipates a workup for
A. orbital cellulitis.
B. uveitis/iritis.
C. conjunctivitis.
D. periorbital cellulitis. A. Orbital cellulitis is an acute inflammation of the orbital contents
posterior to the orbital septum. It is deeper and more serious infection behind the septum and
involving the posterior eye structures. Periorbital cellulitis is an acute infection and
inflammation involving the eyelid and surrounding tissues anterior to the septum. Both orbital
and periorbital cellulitis are serious conditions because of their proximity to the brain.
What would be the most appropriate intervention for a child with suspected intussusception?
