CPEN Practice Questions &
Rationales Answers Updated 2026
AnBanxiousBadolescentBpresentsBwithBpalpitations,BaBheartBrateBofB184Bbeats/min,BandBnorm
alBskinBtone.BWhichBofBtheBfollowingBisBtheBPRIORITYBintervention?
A.BObtainBurineBdrugBscreen.
B.BAdministerBIVBadenosineB(Adenocard)Brapidly.
C.BInstructBtheBpatientBtoBbearBdown.
D.BProvideBcomfortBandBreassurance.B-
BAnswerD.BSVTBisBdefinedBasBheartBrateB>220BinBinfantsBandB>180BinBchildren.BThusBputting
BtheBchildBinBSVT.BSearchBandBtreatBtheBcause.BTheBPRIORITYBinterventionBtoBprovideBcomfor
tBandBreassuranceBcouldBlowerBheartBrateBwhileBpreparingBotherBinterventionsBandBassessme
nts.BVagalBmaneuversBwouldBbeBtheBnextBintervention,BfollowedBbyBadenosine.
ContinuousBmonitoringBofBaBchild'sBETCO2BduringBcardiacBarrestBrevealsB8BmmHg.BThisBindica
tesBthatBCPRBis
A.BineffectiveBandBadjustmentsBneedBtoBbeBmadeBtoBcompressions.
B.BnoBlongerBneeded;BthereBisBaBreturnBofBspontaneousBcirculation.
C.BnoBlongerBneeded;BfurtherBresuscitationBisBfutile.
D.BineffectiveBandBadjustmentsBneedBtoBbeBmadeBtoBventilation.B-
BAnswerA.BTheB2010BguidelinesBrecommendedBthatBifBtheBpartialBpressureBofBETCO2BisBconsi
stentlyBlessBthanB15BmmBHgBeffortsBshouldBfocusBonBimprovingBCPRBquality,BparticularlyBimp
rovingBchestBcompressionsBandBensuringBtheBchildBdoesBnotBreceiveBexcessiveBventilations.
ABchildBpresentsBtoBemergencyBdepartmentBwithBsymptomsBofBanaphylaxisBafterBeatingBcooki
esBatBaBbirthdayBparty.BTheBfriend'sBparentBisBaccompanyingBtheBchildBandBisBunableBtoBrea
chBtheBparents.BTheBnurseBrecognizesBthisBlegalBissueBas
A.BinformedBconsent.
B.BimpliedBconsent.
C.BanBEMTALABviolation.
D.BaBHIPPABviolation.B-BAnswerB.BImpliedBConsent
9-month-oldBpresentsBtoBtheBEmergencyBDepartmentBwithBaBmid-
shaftBtibiaBfracture.BWhichBofBtheBfollowingBstatementsBfromBtheBparentBmightBindicateBhisto
ryBofBnon-accidentalBtraumaB(NAT).
A.BPatientBwasBbeingBchangedBonBtopBofBaBtableBandBrolledBoff.
,B.BPatientBwasBanBunrestrainedBpassengerBinBaBmotorBvehicleBcollision.
C.BPatientBwasBcrawlingBonBaBdeckBandBfellBoffBapproximatelyB4Bfeet.
D.BPatientBwasBridingBaBtricycleBandBfellBoffB-
BAnswerD.BTheBpatientBdoesBnotBhaveBtheBdevelopmentBandBcoordinationBtoBrideBaBtricycle.
BAB9-month-
oldBcanBrollBoverBandBitBisBpossibleBtoBfallBandBfractureBtheirBarm.BEvenBthoughBtheBpatient
BwasBunrestrained,BitBmayBnotBinvolveBNAT.BAB9-month-
oldBisBoftenBcrawlingBand,BifBtheBpatientBwasBnotBbeingBwatched,BcouldBhaveBfallenBoffBaBd
eckBandBagainBnotBbeBconsideredBNAT.
WhichBdevelopmentalBtaskBisBexpectedBinBaBtoddler?
A.Bindustry
B.Btrust
C.Binitiative
D.BautonomyB-
BAnswerD.BToddlersBlearnBtoBexerciseBwillBandBdoBthingsBforBthemselves.BDevelopmentalBtask
BofBtoddlerhoodBisBacquiringBaBsenseBofBautonomy.BSeveralBcharacteristics,BespeciallyBnegativi
smBandBritualism,BareBtypicalBofBtoddlers.
FollowingBaBmotorBvehicleBcollision,BaBpatientBisBdiagnosedBwithBaBC7BfractureBandBanteriorB
spinalBcordBsyndrome.BTheBnurseBunderstandsBthisBpatientBwill:
A.BwillBbeBableBtoBambulateBwithBassistance
B.BbeBwheelchairBdependent
C.BwillBregainBmostBfunctionBatBsomeBpoint
D.BbeBventilatorBdependentB-
BAnswerB.BTheBpatientBwillBbeBaBparaplegicBandBmayBbeBableBtoBcompleteBmovementBwithB
theirBarms.BHeBwillBnotBbeBventilatorBdependentBorBbeBableBtoBambulateBindependently.BHe
BwillBbeBevaluatedBindependentlyBbutBwillBbeBunableBtoBwalk
WhichBofBtheBfollowingBisBtheBBESTBmethodBtoBassessBadequacyBofBventilationBduringBproce
duralBsedation?
A.BbreathBsounds
B.BoxygenBsaturation
C.BrespiratoryBrate
D.BcapnographyBvalueB-
BAnswerD.BcapnographyBisBusedBtoBdetermineBadequacyBofBventilation.BOxygenBsaturationBpr
ovidesBtheBpercentageBofBhemoglobinBcarryingBoxygen.BHypoventilationBisBdetectedBmoreBrapi
,dlyBbyBcapnographyBthanBbyBauscultationBofBbreathBsounds,BoxygenBsaturationBorBrespiratory
Brate.
AB2-year-oldBpresentsBtoBtheBemergencyBdepartmentBwithBtonic-
clonicBmovementsBwhichBtheBcaregiversBreportBoccurringBforBoneBminuteBpriorBtoBarrival.BTh
eBpriorityBinterventionBis
A.BpreparingBforBintubation.
B.BadministeringBoxygenBviaBaBnonrebreathingBmask.
C.BturningBpatientBtoBtheBside.
D.BplacingBanBintraosseousBneedle.B-
BAnswerC.BTurningBtheBpatientBtoBaBsideBisBpartBofBtheBinitialBassessmentBtoBreduceBtheBris
kBofBaspirationBandBtongueBobstruction.BThereBisBnoBindicationBforBanBintraosseousBneedleBa
sBmostBantiseizureBmedicationsBcanBbeBgivenBviaBotherBroutes.BCurrently,BthereBisBnoBindicati
onBforBintubation.BOxygenBwillBnotBassistBifBtheBairwayBisBnotBpatent.
ABmotherBrunsBintoBtheBemergencyBdepartmentBscreamingBthatBherBchildBisBchokingBonBaBp
ieceBofBcandy.BTheBnurseBobservesBaBfearfulB5-year-
oldBwithBminimalBairBmovementBandBduskyBinBcolor.BTheBnurse'sBinitialBactionBshouldBbeBto
A.BperformBabdominalBthrusts.
B.BobtainBanBoxygenBsaturationBlevel.
C.BfacilitateBoralBtrachealBintubation.
D.BobtainBaBchestBradiograph.B-
BAnswerA.BABchildBbroughtBtoBtheBEDBwithBsuddenBonsetBofBrespiratoryBdistressBshouldBbeB
evaluatedBforBforeignBbodyBaspirationBifBnoBotherBcauseBisBapparent.BInitially,BaBforeignBbody
BobstructionBproducesBchoking,Bgassing,Bwheezing,BorBcoughing.BIfBtheBobjectBbecomesBlodge
dBinBtheBlarynx,BtheBchildBcannotBspeakBorBbreathe,BForBchildrenB1ByearBorBolder,Babdomina
lBthrustsBshouldBbeBused.
AB2-month-
oldBpresentsBwithBirritabilityBandBisBinconsolable.BWhichBfindingBwouldBleadBtheBemergencyB
nurseBtoBsuspectBshakenBbabyBsyndrome?
A.BUnilateralBretinalBhemorrhage
B.BBruisingBofBtheBlegs.
C.BDecreasedBmovementBofBtheBlegs
D.BBilateralBretinalBhemorrhagesB-
BAnswerD.BShakenBbabyBsyndromeBisBcommonBinBchildrenBlessBthanBoneByearBofBage.BMaleB
caregiversBhaveBaBhigherBrateBofBshakenBbabyBsyndrome.BBilateralBretinalBhemorrhagesBareB
moreBcommonBdueBtoBweakBneckBmusclesBandBlargeBocciput.BTheBinfantBisBusuallyBheldBbyB
, theBarmsBandBshaken.BBruisesBofBtheBarmsBwouldBoccur.BDecreasedBmovementBofBtheBlegsB
wouldBusuallyBbeBaBspinalBcordBinjury.BBruisingBofBtheBlegsBareBnotBindicativeBofBshakenBba
byBsyndrome.
AB2-year-
oldBchildBhasBnotBusedBhisBleftBarmBforBtheBpastBhour.BHisBmotherBreportedBgrabbingBhisBh
andBtoBpreventBhimBfromBfallingBfromBaBslide.BTheBnurseBshouldBsuspect
A.BaBforearmBfracture.
B.BaBsupracondylarBfracture.
C.BshoulderBdislocation.
D.BsubluxationBofBtheBradialBhead.B-
BAnswerD.BSubluxationBofBtheBradialBhead,BorBaBnursemaid'sBelbow,BisBoneBofBtheBmostBco
mmonBinjuriesBseenBinBtoddlers.BResultingBfromBaBsuddenBpullBonBtheBchild'sBarms,BtheBchil
dBrefusesBtoBmoveBorBuseBtheBaffectedBextremity.
AB1-year-oldBpresentsBunconsciousBandBisBbeingBventilatedBwithBaBbag-
maskBdevice.BVentilationBhasBbecomeBprogressivelyBmoreBdifficult.BWhichBofBtheBfollowingBisB
theBPRIORITYBintervention?
A.BInsertBaBnasogastricBtube.
B.BObtainBaBpulseBoximeterBreading.
C.BPlaceBpaddingBunderBtheBshoulders.B-
BAnswerC.BDueBtoBaBlargeBocciput,BoptimalBairwayBpositionBisBachievedBbyBplacingBpaddingB
underBtheBshoulders.BTheBpaddingBprovidesBneutralBalignmentBofBtheBairwayBandBcervicalBspi
ne.BTheBotherBoptionsBneedBtoBoccur,BbutBtheyBareBnotBtheBpriorityBintervention
IfBadministeringBepinephrineBtoBaBpediatricBpatientBhavingBaBsevereBallergicBreaction,BtheBpro
perBdoseBandBconcentrationBshouldBbeBepinephrine
A.B0.10BmL/kgBandB1mg/10BmL
B.B0.01BmL/kgBandB1Bmg/mL
C.B0.01BmL/kgBandB1Bmg/10BmL
D.B0.10BmL/kgBandB1Bmg/mLB-
BAnswerB.BTheBconcentrationBofB1Bmg/mLBisBindicatedBforBallergicBreactionBandBanaphylaxisB
toBbeBadministeredBIM.BTheBconcentrationBofB1Bmg/10BmLBisBforBcardiacBarrestBtreatmentsBt
oBbeBadministeredBIVBorBIO.BTheBcorrectBdosingBofBeitherBconcentrationBisB0.01BmL/kg.
Rationales Answers Updated 2026
AnBanxiousBadolescentBpresentsBwithBpalpitations,BaBheartBrateBofB184Bbeats/min,BandBnorm
alBskinBtone.BWhichBofBtheBfollowingBisBtheBPRIORITYBintervention?
A.BObtainBurineBdrugBscreen.
B.BAdministerBIVBadenosineB(Adenocard)Brapidly.
C.BInstructBtheBpatientBtoBbearBdown.
D.BProvideBcomfortBandBreassurance.B-
BAnswerD.BSVTBisBdefinedBasBheartBrateB>220BinBinfantsBandB>180BinBchildren.BThusBputting
BtheBchildBinBSVT.BSearchBandBtreatBtheBcause.BTheBPRIORITYBinterventionBtoBprovideBcomfor
tBandBreassuranceBcouldBlowerBheartBrateBwhileBpreparingBotherBinterventionsBandBassessme
nts.BVagalBmaneuversBwouldBbeBtheBnextBintervention,BfollowedBbyBadenosine.
ContinuousBmonitoringBofBaBchild'sBETCO2BduringBcardiacBarrestBrevealsB8BmmHg.BThisBindica
tesBthatBCPRBis
A.BineffectiveBandBadjustmentsBneedBtoBbeBmadeBtoBcompressions.
B.BnoBlongerBneeded;BthereBisBaBreturnBofBspontaneousBcirculation.
C.BnoBlongerBneeded;BfurtherBresuscitationBisBfutile.
D.BineffectiveBandBadjustmentsBneedBtoBbeBmadeBtoBventilation.B-
BAnswerA.BTheB2010BguidelinesBrecommendedBthatBifBtheBpartialBpressureBofBETCO2BisBconsi
stentlyBlessBthanB15BmmBHgBeffortsBshouldBfocusBonBimprovingBCPRBquality,BparticularlyBimp
rovingBchestBcompressionsBandBensuringBtheBchildBdoesBnotBreceiveBexcessiveBventilations.
ABchildBpresentsBtoBemergencyBdepartmentBwithBsymptomsBofBanaphylaxisBafterBeatingBcooki
esBatBaBbirthdayBparty.BTheBfriend'sBparentBisBaccompanyingBtheBchildBandBisBunableBtoBrea
chBtheBparents.BTheBnurseBrecognizesBthisBlegalBissueBas
A.BinformedBconsent.
B.BimpliedBconsent.
C.BanBEMTALABviolation.
D.BaBHIPPABviolation.B-BAnswerB.BImpliedBConsent
9-month-oldBpresentsBtoBtheBEmergencyBDepartmentBwithBaBmid-
shaftBtibiaBfracture.BWhichBofBtheBfollowingBstatementsBfromBtheBparentBmightBindicateBhisto
ryBofBnon-accidentalBtraumaB(NAT).
A.BPatientBwasBbeingBchangedBonBtopBofBaBtableBandBrolledBoff.
,B.BPatientBwasBanBunrestrainedBpassengerBinBaBmotorBvehicleBcollision.
C.BPatientBwasBcrawlingBonBaBdeckBandBfellBoffBapproximatelyB4Bfeet.
D.BPatientBwasBridingBaBtricycleBandBfellBoffB-
BAnswerD.BTheBpatientBdoesBnotBhaveBtheBdevelopmentBandBcoordinationBtoBrideBaBtricycle.
BAB9-month-
oldBcanBrollBoverBandBitBisBpossibleBtoBfallBandBfractureBtheirBarm.BEvenBthoughBtheBpatient
BwasBunrestrained,BitBmayBnotBinvolveBNAT.BAB9-month-
oldBisBoftenBcrawlingBand,BifBtheBpatientBwasBnotBbeingBwatched,BcouldBhaveBfallenBoffBaBd
eckBandBagainBnotBbeBconsideredBNAT.
WhichBdevelopmentalBtaskBisBexpectedBinBaBtoddler?
A.Bindustry
B.Btrust
C.Binitiative
D.BautonomyB-
BAnswerD.BToddlersBlearnBtoBexerciseBwillBandBdoBthingsBforBthemselves.BDevelopmentalBtask
BofBtoddlerhoodBisBacquiringBaBsenseBofBautonomy.BSeveralBcharacteristics,BespeciallyBnegativi
smBandBritualism,BareBtypicalBofBtoddlers.
FollowingBaBmotorBvehicleBcollision,BaBpatientBisBdiagnosedBwithBaBC7BfractureBandBanteriorB
spinalBcordBsyndrome.BTheBnurseBunderstandsBthisBpatientBwill:
A.BwillBbeBableBtoBambulateBwithBassistance
B.BbeBwheelchairBdependent
C.BwillBregainBmostBfunctionBatBsomeBpoint
D.BbeBventilatorBdependentB-
BAnswerB.BTheBpatientBwillBbeBaBparaplegicBandBmayBbeBableBtoBcompleteBmovementBwithB
theirBarms.BHeBwillBnotBbeBventilatorBdependentBorBbeBableBtoBambulateBindependently.BHe
BwillBbeBevaluatedBindependentlyBbutBwillBbeBunableBtoBwalk
WhichBofBtheBfollowingBisBtheBBESTBmethodBtoBassessBadequacyBofBventilationBduringBproce
duralBsedation?
A.BbreathBsounds
B.BoxygenBsaturation
C.BrespiratoryBrate
D.BcapnographyBvalueB-
BAnswerD.BcapnographyBisBusedBtoBdetermineBadequacyBofBventilation.BOxygenBsaturationBpr
ovidesBtheBpercentageBofBhemoglobinBcarryingBoxygen.BHypoventilationBisBdetectedBmoreBrapi
,dlyBbyBcapnographyBthanBbyBauscultationBofBbreathBsounds,BoxygenBsaturationBorBrespiratory
Brate.
AB2-year-oldBpresentsBtoBtheBemergencyBdepartmentBwithBtonic-
clonicBmovementsBwhichBtheBcaregiversBreportBoccurringBforBoneBminuteBpriorBtoBarrival.BTh
eBpriorityBinterventionBis
A.BpreparingBforBintubation.
B.BadministeringBoxygenBviaBaBnonrebreathingBmask.
C.BturningBpatientBtoBtheBside.
D.BplacingBanBintraosseousBneedle.B-
BAnswerC.BTurningBtheBpatientBtoBaBsideBisBpartBofBtheBinitialBassessmentBtoBreduceBtheBris
kBofBaspirationBandBtongueBobstruction.BThereBisBnoBindicationBforBanBintraosseousBneedleBa
sBmostBantiseizureBmedicationsBcanBbeBgivenBviaBotherBroutes.BCurrently,BthereBisBnoBindicati
onBforBintubation.BOxygenBwillBnotBassistBifBtheBairwayBisBnotBpatent.
ABmotherBrunsBintoBtheBemergencyBdepartmentBscreamingBthatBherBchildBisBchokingBonBaBp
ieceBofBcandy.BTheBnurseBobservesBaBfearfulB5-year-
oldBwithBminimalBairBmovementBandBduskyBinBcolor.BTheBnurse'sBinitialBactionBshouldBbeBto
A.BperformBabdominalBthrusts.
B.BobtainBanBoxygenBsaturationBlevel.
C.BfacilitateBoralBtrachealBintubation.
D.BobtainBaBchestBradiograph.B-
BAnswerA.BABchildBbroughtBtoBtheBEDBwithBsuddenBonsetBofBrespiratoryBdistressBshouldBbeB
evaluatedBforBforeignBbodyBaspirationBifBnoBotherBcauseBisBapparent.BInitially,BaBforeignBbody
BobstructionBproducesBchoking,Bgassing,Bwheezing,BorBcoughing.BIfBtheBobjectBbecomesBlodge
dBinBtheBlarynx,BtheBchildBcannotBspeakBorBbreathe,BForBchildrenB1ByearBorBolder,Babdomina
lBthrustsBshouldBbeBused.
AB2-month-
oldBpresentsBwithBirritabilityBandBisBinconsolable.BWhichBfindingBwouldBleadBtheBemergencyB
nurseBtoBsuspectBshakenBbabyBsyndrome?
A.BUnilateralBretinalBhemorrhage
B.BBruisingBofBtheBlegs.
C.BDecreasedBmovementBofBtheBlegs
D.BBilateralBretinalBhemorrhagesB-
BAnswerD.BShakenBbabyBsyndromeBisBcommonBinBchildrenBlessBthanBoneByearBofBage.BMaleB
caregiversBhaveBaBhigherBrateBofBshakenBbabyBsyndrome.BBilateralBretinalBhemorrhagesBareB
moreBcommonBdueBtoBweakBneckBmusclesBandBlargeBocciput.BTheBinfantBisBusuallyBheldBbyB
, theBarmsBandBshaken.BBruisesBofBtheBarmsBwouldBoccur.BDecreasedBmovementBofBtheBlegsB
wouldBusuallyBbeBaBspinalBcordBinjury.BBruisingBofBtheBlegsBareBnotBindicativeBofBshakenBba
byBsyndrome.
AB2-year-
oldBchildBhasBnotBusedBhisBleftBarmBforBtheBpastBhour.BHisBmotherBreportedBgrabbingBhisBh
andBtoBpreventBhimBfromBfallingBfromBaBslide.BTheBnurseBshouldBsuspect
A.BaBforearmBfracture.
B.BaBsupracondylarBfracture.
C.BshoulderBdislocation.
D.BsubluxationBofBtheBradialBhead.B-
BAnswerD.BSubluxationBofBtheBradialBhead,BorBaBnursemaid'sBelbow,BisBoneBofBtheBmostBco
mmonBinjuriesBseenBinBtoddlers.BResultingBfromBaBsuddenBpullBonBtheBchild'sBarms,BtheBchil
dBrefusesBtoBmoveBorBuseBtheBaffectedBextremity.
AB1-year-oldBpresentsBunconsciousBandBisBbeingBventilatedBwithBaBbag-
maskBdevice.BVentilationBhasBbecomeBprogressivelyBmoreBdifficult.BWhichBofBtheBfollowingBisB
theBPRIORITYBintervention?
A.BInsertBaBnasogastricBtube.
B.BObtainBaBpulseBoximeterBreading.
C.BPlaceBpaddingBunderBtheBshoulders.B-
BAnswerC.BDueBtoBaBlargeBocciput,BoptimalBairwayBpositionBisBachievedBbyBplacingBpaddingB
underBtheBshoulders.BTheBpaddingBprovidesBneutralBalignmentBofBtheBairwayBandBcervicalBspi
ne.BTheBotherBoptionsBneedBtoBoccur,BbutBtheyBareBnotBtheBpriorityBintervention
IfBadministeringBepinephrineBtoBaBpediatricBpatientBhavingBaBsevereBallergicBreaction,BtheBpro
perBdoseBandBconcentrationBshouldBbeBepinephrine
A.B0.10BmL/kgBandB1mg/10BmL
B.B0.01BmL/kgBandB1Bmg/mL
C.B0.01BmL/kgBandB1Bmg/10BmL
D.B0.10BmL/kgBandB1Bmg/mLB-
BAnswerB.BTheBconcentrationBofB1Bmg/mLBisBindicatedBforBallergicBreactionBandBanaphylaxisB
toBbeBadministeredBIM.BTheBconcentrationBofB1Bmg/10BmLBisBforBcardiacBarrestBtreatmentsBt
oBbeBadministeredBIVBorBIO.BTheBcorrectBdosingBofBeitherBconcentrationBisB0.01BmL/kg.
