CPEN UPDATED 2026 EXAM SCRIPT QUESTIONS AND
ANSWERS RATED A+
✔✔Lower Airway - ✔✔Begins at the opening of the trachea and ends at the alveoli.
Common disorders affect the large and small bronchiole tubes and the alveoli
themselves. Common disorders include asthma, pneumonia, and other respiratory
infections. Typically cause difficulty breathing/wheezing lung sounds.
✔✔Meningitis - ✔✔Potentially life-threatening infection of the lining of the brain and
spinal cord (the meninges) Commonly seen in children 1 month to 5 years old.
✔✔Neglect - ✔✔The failure of a caretaker to provide for basic needs, such as food,
clothing, or love.
✔✔Pediatric Assessment Triangle (PAT) - ✔✔Method of pediatric assessment from
both the general impression formed as you approach the child ("from the doorway") and
from the remainder of the primary assessment. Triangle made up of appearance, work
of breathing, and the circulation to skin.
✔✔Pediatric - ✔✔Of or pertaining to a patient who has yet to reach puberty.
✔✔Physical Abuse - ✔✔Abuse causing physical damage to the victim.
✔✔Preschool - ✔✔3 to 6 years of age.
✔✔Psychological Abuse - ✔✔Emotionally harming a person by threatening, scaring,
humiliating, intimidating, isolating, insulting, or treating him or her as a child; also
includes verbal abuse.
✔✔Retractions - ✔✔Pulling in of the skin and soft tissue between the ribs when
breathing. This is typically a sign of respiratory distress in the child.
✔✔School Age - ✔✔6 to 12 years of age.
✔✔Seizures - ✔✔A sudden change in sensation, behavior, or movement. Most
commonly caused by a feven in infants and children.
✔✔Sexual Abuse - ✔✔Ranges from adults exposing themselves to children to sexual
intercourse or sexual torture. Often accompanied by physical or emotional injury.
✔✔Shunt - ✔✔A drainage device that runs from the brain to the abdomen to relieve
excess cerebrospinal fluid. Reservoirs will be on either side of the skull.
✔✔Toddlers - ✔✔1 to 3 years of age.
,✔✔Upper Airway - ✔✔Starts at the mouth and nose and ends at the trachea. Common
disorders affecting this area include foreign body obstructions, trauma, and swelling
from burns and infections. (Commonly identified by stridor or difficulty breathing)
✔✔In children and infants, their tongues are proportionally larger than the tongue of an
adult. What is the potential impact on assessment and care? - ✔✔tongue is more likely
to partially obstruct the airway
✔✔Children and infants have smaller airway structures, which could result in..... -
✔✔the airway being more easily blocked.
✔✔The abundant secretions in children and infants can cause... - ✔✔a blocked airway
✔✔Decidous (baby) teeth in children and infants can be... - ✔✔easily dislodged, which
could block the airway
✔✔Children and infants have a flat nose and face, which makes it difficult to... -
✔✔obtain a good face mask seal
✔✔The head of a child is heavier relative to body and less-developed neck structures
and muscles. What is the potential impact on assessment and care? - ✔✔Head may be
propelled more forcefully than the body, creating a higher incidence of head injury
✔✔Infants and some children have fontanelle and open structures (soft spots) palpable
on top of their head. What is the significance of both a sunken and bulging fontanelle? -
✔✔Bulging fontanelle can be a sign of intracranial pressure.
Sunken fontanelle may indicate dehydration
✔✔Since children and infants have a thinner, softer brain tissue, they are more
susceptible to....... - ✔✔serious brain trauma
✔✔What are the hazards of the children's/infant's head being so large in proportion to
their bodies? - ✔✔Head tips forward when supine, causing flexion of the neck, making
neutral alignment of spine and airway difficult
✔✔The shorter, narrower, and more elastic trachea can result in : - ✔✔the trachea
closing off with hyperextension of the neck
✔✔The children/infant's short neck makes it difficult to... - ✔✔stabilize or immobilize
, ✔✔What type of breathers are children and infants, and what does it mean? - ✔✔They
are abdominal breathers. they depend on their diaphragm for breathing which makes it
difficult to evaluate
✔✔What is the significance of children/infant's faster respiratory rate? - ✔✔muscles
easily fatigue or get tired, causing respiratory distress
✔✔Newborns/Infants are typically nose breathers. What is the danger in this? -
✔✔Nasal obstruction can impair breathing
✔✔Since children/infant's have a larger body surface relative to their body mass, they
are more prone to what? - ✔✔hypothermia
✔✔The softer bones in pediatric patients results in ... - ✔✔the bones being more flexible
and less eaily fractured
however, traumatic forces may be transmitted to and injure vital organs without
fracturing ribs and other bones
✔✔The spleen and liver are more exposed in a children's and infant's body... which
makes injury likely with significant force to......... - ✔✔abdomen
✔✔Normal pulse rate for a newborn - ✔✔120-160
✔✔Normal pulse rate for an infant 0-5 months - ✔✔90-140
✔✔Normal pulse rate for an infant 6-12 months - ✔✔80-140
✔✔Normal pulse rate for a toddler 1-3 years - ✔✔80-130
✔✔Normal pulse rate for a preschooler 3-5 years - ✔✔80-120
✔✔Normal pulse rate for a school age child 6-12 years - ✔✔70-110
✔✔Normal pulse rate for an adolescent 13-18 years - ✔✔60-105
✔✔Normal respiration rate for a newborn - ✔✔30-50
✔✔Normal respiration rate for an infant 0-5 months - ✔✔25-40
✔✔Normal respiration rate for an infant 6-12 months - ✔✔20-30
✔✔Normal respiration rate for a toddler 1-3 years - ✔✔20-30
ANSWERS RATED A+
✔✔Lower Airway - ✔✔Begins at the opening of the trachea and ends at the alveoli.
Common disorders affect the large and small bronchiole tubes and the alveoli
themselves. Common disorders include asthma, pneumonia, and other respiratory
infections. Typically cause difficulty breathing/wheezing lung sounds.
✔✔Meningitis - ✔✔Potentially life-threatening infection of the lining of the brain and
spinal cord (the meninges) Commonly seen in children 1 month to 5 years old.
✔✔Neglect - ✔✔The failure of a caretaker to provide for basic needs, such as food,
clothing, or love.
✔✔Pediatric Assessment Triangle (PAT) - ✔✔Method of pediatric assessment from
both the general impression formed as you approach the child ("from the doorway") and
from the remainder of the primary assessment. Triangle made up of appearance, work
of breathing, and the circulation to skin.
✔✔Pediatric - ✔✔Of or pertaining to a patient who has yet to reach puberty.
✔✔Physical Abuse - ✔✔Abuse causing physical damage to the victim.
✔✔Preschool - ✔✔3 to 6 years of age.
✔✔Psychological Abuse - ✔✔Emotionally harming a person by threatening, scaring,
humiliating, intimidating, isolating, insulting, or treating him or her as a child; also
includes verbal abuse.
✔✔Retractions - ✔✔Pulling in of the skin and soft tissue between the ribs when
breathing. This is typically a sign of respiratory distress in the child.
✔✔School Age - ✔✔6 to 12 years of age.
✔✔Seizures - ✔✔A sudden change in sensation, behavior, or movement. Most
commonly caused by a feven in infants and children.
✔✔Sexual Abuse - ✔✔Ranges from adults exposing themselves to children to sexual
intercourse or sexual torture. Often accompanied by physical or emotional injury.
✔✔Shunt - ✔✔A drainage device that runs from the brain to the abdomen to relieve
excess cerebrospinal fluid. Reservoirs will be on either side of the skull.
✔✔Toddlers - ✔✔1 to 3 years of age.
,✔✔Upper Airway - ✔✔Starts at the mouth and nose and ends at the trachea. Common
disorders affecting this area include foreign body obstructions, trauma, and swelling
from burns and infections. (Commonly identified by stridor or difficulty breathing)
✔✔In children and infants, their tongues are proportionally larger than the tongue of an
adult. What is the potential impact on assessment and care? - ✔✔tongue is more likely
to partially obstruct the airway
✔✔Children and infants have smaller airway structures, which could result in..... -
✔✔the airway being more easily blocked.
✔✔The abundant secretions in children and infants can cause... - ✔✔a blocked airway
✔✔Decidous (baby) teeth in children and infants can be... - ✔✔easily dislodged, which
could block the airway
✔✔Children and infants have a flat nose and face, which makes it difficult to... -
✔✔obtain a good face mask seal
✔✔The head of a child is heavier relative to body and less-developed neck structures
and muscles. What is the potential impact on assessment and care? - ✔✔Head may be
propelled more forcefully than the body, creating a higher incidence of head injury
✔✔Infants and some children have fontanelle and open structures (soft spots) palpable
on top of their head. What is the significance of both a sunken and bulging fontanelle? -
✔✔Bulging fontanelle can be a sign of intracranial pressure.
Sunken fontanelle may indicate dehydration
✔✔Since children and infants have a thinner, softer brain tissue, they are more
susceptible to....... - ✔✔serious brain trauma
✔✔What are the hazards of the children's/infant's head being so large in proportion to
their bodies? - ✔✔Head tips forward when supine, causing flexion of the neck, making
neutral alignment of spine and airway difficult
✔✔The shorter, narrower, and more elastic trachea can result in : - ✔✔the trachea
closing off with hyperextension of the neck
✔✔The children/infant's short neck makes it difficult to... - ✔✔stabilize or immobilize
, ✔✔What type of breathers are children and infants, and what does it mean? - ✔✔They
are abdominal breathers. they depend on their diaphragm for breathing which makes it
difficult to evaluate
✔✔What is the significance of children/infant's faster respiratory rate? - ✔✔muscles
easily fatigue or get tired, causing respiratory distress
✔✔Newborns/Infants are typically nose breathers. What is the danger in this? -
✔✔Nasal obstruction can impair breathing
✔✔Since children/infant's have a larger body surface relative to their body mass, they
are more prone to what? - ✔✔hypothermia
✔✔The softer bones in pediatric patients results in ... - ✔✔the bones being more flexible
and less eaily fractured
however, traumatic forces may be transmitted to and injure vital organs without
fracturing ribs and other bones
✔✔The spleen and liver are more exposed in a children's and infant's body... which
makes injury likely with significant force to......... - ✔✔abdomen
✔✔Normal pulse rate for a newborn - ✔✔120-160
✔✔Normal pulse rate for an infant 0-5 months - ✔✔90-140
✔✔Normal pulse rate for an infant 6-12 months - ✔✔80-140
✔✔Normal pulse rate for a toddler 1-3 years - ✔✔80-130
✔✔Normal pulse rate for a preschooler 3-5 years - ✔✔80-120
✔✔Normal pulse rate for a school age child 6-12 years - ✔✔70-110
✔✔Normal pulse rate for an adolescent 13-18 years - ✔✔60-105
✔✔Normal respiration rate for a newborn - ✔✔30-50
✔✔Normal respiration rate for an infant 0-5 months - ✔✔25-40
✔✔Normal respiration rate for an infant 6-12 months - ✔✔20-30
✔✔Normal respiration rate for a toddler 1-3 years - ✔✔20-30
