CPEN PEDIATRIC EMERGENCY NURSING
CERTIFICATION TEST PAPER QUESTIONS
AND SOLUTIONS VERIFIED ANSWERS
●● 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. trust
C. initiative
D. autonomy
Answer: D. Toddlers learn to exercise will and do things for themselves.
Developmental task of toddlerhood is acquiring a sense of autonomy.
Several characteristics, especially negativism and ritualism, are typical
of toddlers.
,●● Following a motor vehicle collision, a patient is diagnosed with a C7
fracture and anterior spinal cord syndrome. The nurse understands this
patient will:
A. will be able to ambulate with assistance
B. be wheelchair dependent
C. will regain most function at some point
D. be ventilator dependent
Answer: B. The patient will be a paraplegic and may be able to complete
movement with their arms. He will not be ventilator dependent or be
able to ambulate independently. He will be evaluated independently but
will be unable to walk
●● Which of the following is the BEST method to assess adequacy of
ventilation during procedural sedation?
A. breath sounds
B. oxygen saturation
C. respiratory rate
D. capnography value
Answer: D. capnography is used to determine adequacy of ventilation.
Oxygen saturation provides the percentage of hemoglobin carrying
oxygen. Hypoventilation is detected more rapidly by capnography than
by auscultation of breath sounds, oxygen saturation or respiratory rate.
, ●● A 2-year-old presents to the emergency department with tonic-clonic
movements which the caregivers report occurring for one minute prior to
arrival. The priority intervention is
A. preparing for intubation.
B. administering oxygen via a nonrebreathing mask.
C. turning patient to the side.
D. placing an intraosseous needle.
Answer: C. Turning the patient to a side is part of the initial assessment
to reduce the risk of aspiration and tongue obstruction. There is no
indication for an intraosseous needle as most antiseizure medications can
be given via other routes. Currently, there is no indication for intubation.
Oxygen will not assist if the airway is not patent.
●● 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.
Answer: 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
CERTIFICATION TEST PAPER QUESTIONS
AND SOLUTIONS VERIFIED ANSWERS
●● 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. trust
C. initiative
D. autonomy
Answer: D. Toddlers learn to exercise will and do things for themselves.
Developmental task of toddlerhood is acquiring a sense of autonomy.
Several characteristics, especially negativism and ritualism, are typical
of toddlers.
,●● Following a motor vehicle collision, a patient is diagnosed with a C7
fracture and anterior spinal cord syndrome. The nurse understands this
patient will:
A. will be able to ambulate with assistance
B. be wheelchair dependent
C. will regain most function at some point
D. be ventilator dependent
Answer: B. The patient will be a paraplegic and may be able to complete
movement with their arms. He will not be ventilator dependent or be
able to ambulate independently. He will be evaluated independently but
will be unable to walk
●● Which of the following is the BEST method to assess adequacy of
ventilation during procedural sedation?
A. breath sounds
B. oxygen saturation
C. respiratory rate
D. capnography value
Answer: D. capnography is used to determine adequacy of ventilation.
Oxygen saturation provides the percentage of hemoglobin carrying
oxygen. Hypoventilation is detected more rapidly by capnography than
by auscultation of breath sounds, oxygen saturation or respiratory rate.
, ●● A 2-year-old presents to the emergency department with tonic-clonic
movements which the caregivers report occurring for one minute prior to
arrival. The priority intervention is
A. preparing for intubation.
B. administering oxygen via a nonrebreathing mask.
C. turning patient to the side.
D. placing an intraosseous needle.
Answer: C. Turning the patient to a side is part of the initial assessment
to reduce the risk of aspiration and tongue obstruction. There is no
indication for an intraosseous needle as most antiseizure medications can
be given via other routes. Currently, there is no indication for intubation.
Oxygen will not assist if the airway is not patent.
●● 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.
Answer: 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
