ESTUDYR
CPEN BCEN TIMED #1 UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED SUCCESS
WITH DETAILED RATIONALES
1. A 1-year-old is unconscious and ventilated with a bag-mask device. Ventilation becomes
progressively more difficult. What is the PRIORITY intervention?
A. Insert an endotracheal tube
B. Begin chest compressions
C. Place padding under the shoulders
D. Increase oxygen flow
Answer: C. Rationale: Infants have large occiputs; shoulder padding opens the airway by
aligning airway axes and often improves bag-mask ventilation.
2. An intubated trauma patient is difficult to ventilate and has absent left breath sounds.
EMS performed needle decompression. The nurse anticipates the PRIORITY next step is:
A. Emergent thoracotomy
B. Noninvasive ventilation trial
C. Insert a chest tube
D. Repeat needle decompression
Answer: C. Rationale: After needle decompression for suspected tension
pneumothorax, tube thoracostomy is definitive to evacuate air and restore ventilation.
3. An infant with feeding intolerance, sunken fontanel, hypotonia, BP 66/30, HR 198.
Which shock type is most likely?
A. Hypovolemic
B. Cardiogenic
C. Distributive
D. Obstructive
Answer: C. Rationale: Warm tachycardia with low BP and altered mental status in
infants can indicate distributive (septic) shock; context of preceding illness supports it.
4. Which presentation requires the MOST emergent evaluation?
A. 5-year-old with cough
B. 8-year-old with ankle sprain
C. 3-year-old whose head is on father’s shoulder with vomiting, pale skin, and tachypnea
D. 10-year-old with sore throat
Answer: C. Rationale: Vomiting plus pallor and tachypnea in a young child with head
positioning suggests possible intracranial injury or increased ICP—urgent.
5. Best method to assess adequacy of ventilation during procedural sedation:
A. Pulse ox only
,ESTUDYR
B. Respiratory rate observation
C. Capnography (ETCO₂)
D. Chest auscultation
Answer: C. Rationale: Capnography detects hypoventilation/apnea earlier than pulse
oximetry.
6. Adolescent with burns to face/hands, hoarse voice, awake & alert. Priority:
A. Dress wounds and discharge
B. Give analgesia and observe
C. Apply cool compresses
D. Prepare for intubation
Answer: D. Rationale: Hoarseness after thermal injury suggests upper airway edema;
early airway protection is critical.
7. Highest PRIORITY for heat stroke patient:
A. Antipyretic medication
B. IV antibiotics
C. Continuous core temperature monitoring
D. Nutritional support
Answer: C. Rationale: Core temp measurement guides active cooling and prevents
rebound hypothermia.
8. Adolescent who ingested 4 × 500 mg acetaminophen stating suicidal intent — nurse
should anticipate:
A. Immediate discharge
B. Referral to psychiatric services (after medical stabilization)
C. No psychiatric referral if tox screen negative
D. Only family counseling
Answer: B. Rationale: Suicidal ingestion requires psychiatric evaluation once medically
stable.
9. Unresponsive 2-year-old with gurgling respirations and retractions, pulse 80 bpm.
Priority intervention:
A. Start chest compressions
B. Begin IV fluids
C. Suction the airway
D. Apply oxygen by mask
Answer: C. Rationale: Gurgling indicates airway obstruction from secretions —
suctioning restores airway and ventilation.
10. Which federal regulation ensures a medical screening exam for emergent conditions?
A. HIPAA
B. EMTALA (Emergency Medical Treatment and Active Labor Act)
, ESTUDYR
C. OSHA
D. CMS rule on billing
Answer: B. Rationale: EMTALA mandates ED screening and stabilization of emergent
patients.
11. Which age group are preoperational thinkers and deal developmentally with initiative
vs. guilt?
A. Infants
B. School-age
C. Preschool
D. Adolescents
Answer: C. Rationale: Preschoolers (approx. 3–5 years) are in Piaget’s preoperational
stage and Erikson’s initiative vs. guilt.
12. Stridor at rest can be normal in which condition?
A. Epiglottitis
B. Tracheomalacia
C. Croup
D. Foreign body aspiration
Answer: B. Rationale: Tracheomalacia causes inspiratory stridor that may persist at rest
due to floppy tracheal walls.
13. Improperly restrained rear-seat passenger with diffuse abdominal pain and tachycardia
after head-on collision — nurse should most suspect:
A. Liver laceration
B. Pancreatic injury
C. Small bowel injury
D. Renal contusion
Answer: C. Rationale: Deceleration and seatbelt forces commonly injure the small
bowel; tachycardia and abdominal pain are concerning.
14. Appropriate method of tick removal within 24 hours:
A. Burn it off
B. Apply petroleum jelly
C. Pull in a steady slow motion with fine tweezers
D. Twist and jerk it out
Answer: C. Rationale: Gentle steady traction removes the tick and reduces risk of
leaving mouthparts.
15. School-age child with hydrocephalus may present with:
A. Microcephaly
B. Papilledema
C. Increased activity
CPEN BCEN TIMED #1 UPDATED EXAM WITH MOST TESTED
QUESTIONS AND ANSWERS | GRADED A+ | ASSURED SUCCESS
WITH DETAILED RATIONALES
1. A 1-year-old is unconscious and ventilated with a bag-mask device. Ventilation becomes
progressively more difficult. What is the PRIORITY intervention?
A. Insert an endotracheal tube
B. Begin chest compressions
C. Place padding under the shoulders
D. Increase oxygen flow
Answer: C. Rationale: Infants have large occiputs; shoulder padding opens the airway by
aligning airway axes and often improves bag-mask ventilation.
2. An intubated trauma patient is difficult to ventilate and has absent left breath sounds.
EMS performed needle decompression. The nurse anticipates the PRIORITY next step is:
A. Emergent thoracotomy
B. Noninvasive ventilation trial
C. Insert a chest tube
D. Repeat needle decompression
Answer: C. Rationale: After needle decompression for suspected tension
pneumothorax, tube thoracostomy is definitive to evacuate air and restore ventilation.
3. An infant with feeding intolerance, sunken fontanel, hypotonia, BP 66/30, HR 198.
Which shock type is most likely?
A. Hypovolemic
B. Cardiogenic
C. Distributive
D. Obstructive
Answer: C. Rationale: Warm tachycardia with low BP and altered mental status in
infants can indicate distributive (septic) shock; context of preceding illness supports it.
4. Which presentation requires the MOST emergent evaluation?
A. 5-year-old with cough
B. 8-year-old with ankle sprain
C. 3-year-old whose head is on father’s shoulder with vomiting, pale skin, and tachypnea
D. 10-year-old with sore throat
Answer: C. Rationale: Vomiting plus pallor and tachypnea in a young child with head
positioning suggests possible intracranial injury or increased ICP—urgent.
5. Best method to assess adequacy of ventilation during procedural sedation:
A. Pulse ox only
,ESTUDYR
B. Respiratory rate observation
C. Capnography (ETCO₂)
D. Chest auscultation
Answer: C. Rationale: Capnography detects hypoventilation/apnea earlier than pulse
oximetry.
6. Adolescent with burns to face/hands, hoarse voice, awake & alert. Priority:
A. Dress wounds and discharge
B. Give analgesia and observe
C. Apply cool compresses
D. Prepare for intubation
Answer: D. Rationale: Hoarseness after thermal injury suggests upper airway edema;
early airway protection is critical.
7. Highest PRIORITY for heat stroke patient:
A. Antipyretic medication
B. IV antibiotics
C. Continuous core temperature monitoring
D. Nutritional support
Answer: C. Rationale: Core temp measurement guides active cooling and prevents
rebound hypothermia.
8. Adolescent who ingested 4 × 500 mg acetaminophen stating suicidal intent — nurse
should anticipate:
A. Immediate discharge
B. Referral to psychiatric services (after medical stabilization)
C. No psychiatric referral if tox screen negative
D. Only family counseling
Answer: B. Rationale: Suicidal ingestion requires psychiatric evaluation once medically
stable.
9. Unresponsive 2-year-old with gurgling respirations and retractions, pulse 80 bpm.
Priority intervention:
A. Start chest compressions
B. Begin IV fluids
C. Suction the airway
D. Apply oxygen by mask
Answer: C. Rationale: Gurgling indicates airway obstruction from secretions —
suctioning restores airway and ventilation.
10. Which federal regulation ensures a medical screening exam for emergent conditions?
A. HIPAA
B. EMTALA (Emergency Medical Treatment and Active Labor Act)
, ESTUDYR
C. OSHA
D. CMS rule on billing
Answer: B. Rationale: EMTALA mandates ED screening and stabilization of emergent
patients.
11. Which age group are preoperational thinkers and deal developmentally with initiative
vs. guilt?
A. Infants
B. School-age
C. Preschool
D. Adolescents
Answer: C. Rationale: Preschoolers (approx. 3–5 years) are in Piaget’s preoperational
stage and Erikson’s initiative vs. guilt.
12. Stridor at rest can be normal in which condition?
A. Epiglottitis
B. Tracheomalacia
C. Croup
D. Foreign body aspiration
Answer: B. Rationale: Tracheomalacia causes inspiratory stridor that may persist at rest
due to floppy tracheal walls.
13. Improperly restrained rear-seat passenger with diffuse abdominal pain and tachycardia
after head-on collision — nurse should most suspect:
A. Liver laceration
B. Pancreatic injury
C. Small bowel injury
D. Renal contusion
Answer: C. Rationale: Deceleration and seatbelt forces commonly injure the small
bowel; tachycardia and abdominal pain are concerning.
14. Appropriate method of tick removal within 24 hours:
A. Burn it off
B. Apply petroleum jelly
C. Pull in a steady slow motion with fine tweezers
D. Twist and jerk it out
Answer: C. Rationale: Gentle steady traction removes the tick and reduces risk of
leaving mouthparts.
15. School-age child with hydrocephalus may present with:
A. Microcephaly
B. Papilledema
C. Increased activity
