CPEN PRACTICE EXAM SCRIPT 2026 FULL
SOLUTION PRACTICE
◉ EMS arrives with a 6-year-old who was an improperly restrained
rear-seat passenger in a head-on collision. The patient complains of
diffuse abdominal pain, nausea, and is tachycardic. Which injury
should the nurse MOST suspect?
A. liver laceration
B. small bowel injury
C. lumbar spine injury
D. spleen injury Answer: B. Force applied to the abdomen from the
lap belt compresses the small bowel between the abdominal wall
and spine and can cause a rupture of the bowel or hematoma.
Sudden deceleration forces can cause tearing of the small bowel at
its fixed points. Assessment findings include tachycardia and
rebound tenderness.
◉ When discharging a patient home with maxillomandibular
fixation in place, the nurse recognizes the MOST important item for
the caregivers to keep with them at all times is:
A. Ice packs
B. Wire cutters
C. Pain medication
,D. Wound care supplies Answer: B. Patients with maxillomandibular
fixation will need wire cutters at the bedside in case of vomiting or
airway issues. With maxillomandibular fixation, the patient's mouth
is wired shut. While pain control is important, pain medication is not
the MOST important item to have readily available. Wound care
supplies and ice packs may be needed for home care, but the wire
cutters are imperative to airway emergencies.
◉ A nurse caring for a child with a traumatic brain injury observes
drainage from the child's nose. The nurse should suspect the
drainage is cerebral spinal fluid if
A. a dark ring forms around a light ring when drainage is placed on
gauze.
B. the drainage tests positive for glucose.
C. there is a copious amount of drainage.
D. the nasal drainage is serosanguineous. Answer: B. CSF contains
glucose, where tears, mucus, and wound drainage do not contain
glucose. If suspected CSF is placed on gauze, it will produce a dark
inner ring surrounded by a lighter outer ring. Serosanguineous fluid
is not indicative of CSF. CSF leaks do not produce large amount of
drainage.
◉ Post-tonsillectomy bleeding is
A. most common 5-10 days after surgery
B. most common 1-2 days after surgery.
,C. most common 2-3 weeks after surgery.
D. expected and not a cause for concern. Answer: A. Following a
tonsillectomy, scabs form where the former tonsil tissues were
removed. They develop after surgery when the bleeding stops.
During the recovery phase, the scabs fall off over the course of 5-10
days. This is the time period when bleeding may occur.
◉ Which of the following assessment findings should the nurse find
worrisome?
A. an infant who does not respond to soothing
B. a toddler who insists upon holding their blanket during a painful
procedure
C. a school-age child who appears modest and does not want to get
undressed
D. a preschooler who wants to help put on their own bandage
Answer: A. In the younger infant, because of limited vocabulary and
verbal skills, the nurse must depend upon the parent and subtle
clues from the child for history. A child's response to illness or injury
depends on his/her current developmental stage. Toddlers cling to
parents, whereas adolescents are more independent.
◉ Following a diagnosis of hyphema, discharge instructions to the
care giver should include
A. lay flat to prevent eye pressure.
B. re-bleeding may occur.
, C. continue with regular activity.
D. use ibuprofen for pain. Answer: B. In hyphema, re-bleeding can
occur in approximately 20% of the patients. Ibuprofen may increase
the risk of bleeding. Lying flat has been shown to increase
intraocular pressure. Regular activity may slow the healing process.
◉ A 5-day-old patient presents with feeding intolerance, lethargy,
temperature instability, and apnea. The nurse has a high suspicion
for
A. neonatal sepsis
B. brief resolved unexplained event.
C. viral infection.
D. congenital heart disease. Answer: A. All neonates presenting with
temperature instability should be considered a septic workup.
Neonatal sepsis is a clinical syndrome of systemic illness
accompanied by bacteremia occurring in the first month of life. The
common sites of infection are blood, cerebral spinal fluid, and lungs.
◉ A patient with a head injury is receiving mannitol at an
appropriate dose. The nurse anticipates monitoring the:
A. magnesium level
B. glucose level
C. potassium level
D. calcium level Answer: C. Potassium would be the most important
as mannitol causes increased urinary output and may lead to
SOLUTION PRACTICE
◉ EMS arrives with a 6-year-old who was an improperly restrained
rear-seat passenger in a head-on collision. The patient complains of
diffuse abdominal pain, nausea, and is tachycardic. Which injury
should the nurse MOST suspect?
A. liver laceration
B. small bowel injury
C. lumbar spine injury
D. spleen injury Answer: B. Force applied to the abdomen from the
lap belt compresses the small bowel between the abdominal wall
and spine and can cause a rupture of the bowel or hematoma.
Sudden deceleration forces can cause tearing of the small bowel at
its fixed points. Assessment findings include tachycardia and
rebound tenderness.
◉ When discharging a patient home with maxillomandibular
fixation in place, the nurse recognizes the MOST important item for
the caregivers to keep with them at all times is:
A. Ice packs
B. Wire cutters
C. Pain medication
,D. Wound care supplies Answer: B. Patients with maxillomandibular
fixation will need wire cutters at the bedside in case of vomiting or
airway issues. With maxillomandibular fixation, the patient's mouth
is wired shut. While pain control is important, pain medication is not
the MOST important item to have readily available. Wound care
supplies and ice packs may be needed for home care, but the wire
cutters are imperative to airway emergencies.
◉ A nurse caring for a child with a traumatic brain injury observes
drainage from the child's nose. The nurse should suspect the
drainage is cerebral spinal fluid if
A. a dark ring forms around a light ring when drainage is placed on
gauze.
B. the drainage tests positive for glucose.
C. there is a copious amount of drainage.
D. the nasal drainage is serosanguineous. Answer: B. CSF contains
glucose, where tears, mucus, and wound drainage do not contain
glucose. If suspected CSF is placed on gauze, it will produce a dark
inner ring surrounded by a lighter outer ring. Serosanguineous fluid
is not indicative of CSF. CSF leaks do not produce large amount of
drainage.
◉ Post-tonsillectomy bleeding is
A. most common 5-10 days after surgery
B. most common 1-2 days after surgery.
,C. most common 2-3 weeks after surgery.
D. expected and not a cause for concern. Answer: A. Following a
tonsillectomy, scabs form where the former tonsil tissues were
removed. They develop after surgery when the bleeding stops.
During the recovery phase, the scabs fall off over the course of 5-10
days. This is the time period when bleeding may occur.
◉ Which of the following assessment findings should the nurse find
worrisome?
A. an infant who does not respond to soothing
B. a toddler who insists upon holding their blanket during a painful
procedure
C. a school-age child who appears modest and does not want to get
undressed
D. a preschooler who wants to help put on their own bandage
Answer: A. In the younger infant, because of limited vocabulary and
verbal skills, the nurse must depend upon the parent and subtle
clues from the child for history. A child's response to illness or injury
depends on his/her current developmental stage. Toddlers cling to
parents, whereas adolescents are more independent.
◉ Following a diagnosis of hyphema, discharge instructions to the
care giver should include
A. lay flat to prevent eye pressure.
B. re-bleeding may occur.
, C. continue with regular activity.
D. use ibuprofen for pain. Answer: B. In hyphema, re-bleeding can
occur in approximately 20% of the patients. Ibuprofen may increase
the risk of bleeding. Lying flat has been shown to increase
intraocular pressure. Regular activity may slow the healing process.
◉ A 5-day-old patient presents with feeding intolerance, lethargy,
temperature instability, and apnea. The nurse has a high suspicion
for
A. neonatal sepsis
B. brief resolved unexplained event.
C. viral infection.
D. congenital heart disease. Answer: A. All neonates presenting with
temperature instability should be considered a septic workup.
Neonatal sepsis is a clinical syndrome of systemic illness
accompanied by bacteremia occurring in the first month of life. The
common sites of infection are blood, cerebral spinal fluid, and lungs.
◉ A patient with a head injury is receiving mannitol at an
appropriate dose. The nurse anticipates monitoring the:
A. magnesium level
B. glucose level
C. potassium level
D. calcium level Answer: C. Potassium would be the most important
as mannitol causes increased urinary output and may lead to
