CPEN Nursing Certification Exam
CPEN Nursing Certified Exam – 100% Correct Questions
and Answers | Graded A+
An anxious adolescent presents with palpitations, a heart rate of 184 beats/min, and normal skin
tone. Which of the following is the PRIORITY intervention?
A. Obtain urine drug screen.
B. Administer IV adenosine (Adenocard) rapidly.
C. Instruct the patient to bear down.
D. Provide comfort and reassurance. - Correct Answer- D. SVT is defined as heart rate >220 in
infants and >180 in children. Thus putting the child in SVT. Search and treat the cause. The
PRIORITY intervention to provide comfort and reassurance could lower heart rate while
preparing other interventions and assessments. Vagal maneuvers would be the next intervention,
followed by adenosine.
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. - Correct 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.
1
,CPEN Nursing Certification Exam
D. a HIPPA violation. - Correct 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 - Correct 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 - Correct 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 - Correct 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
2
,CPEN Nursing Certification Exam
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 - Correct 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. - Correct 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. - Correct 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 larynx, the child cannot speak or breathe, For children 1 year
or older, abdominal thrusts should be used.
3
, CPEN Nursing Certification Exam
A 2-month-old presents with irritability and is inconsolable. Which finding would lead the
emergency nurse to suspect shaken baby syndrome?
A. Unilateral retinal hemorrhage
B. Bruising of the legs.
C. Decreased movement of the legs
D. Bilateral retinal hemorrhages - Correct Answer- D. Shaken baby syndrome is common in
children less than one year of age. Male caregivers have a higher rate of shaken baby syndrome.
Bilateral retinal hemorrhages are more common due to weak neck muscles and large occiput.
The infant is usually held by the arms and shaken. Bruises of the arms would occur. Decreased
movement of the legs would usually be a spinal cord injury. Bruising of the legs are not
indicative of shaken baby syndrome.
A 2-year-old child has not used his left arm for the past hour. His mother reported grabbing his
hand to prevent him from falling from a slide. The nurse should suspect
A. a forearm fracture.
B. a supracondylar fracture.
C. shoulder dislocation.
D. subluxation of the radial head. - Correct Answer- D. Subluxation of the radial head, or a
nursemaid's elbow, is one of the most common injuries seen in toddlers. Resulting from a sudden
pull on the child's arms, the child refuses to move or use the affected extremity.
A 1-year-old presents unconscious and is being ventilated with a bag-mask device. Ventilation
has become progressively more difficult. Which of the following is the PRIORITY intervention?
A. Insert a nasogastric tube.
B. Obtain a pulse oximeter reading.
C. Place padding under the shoulders. - Correct Answer- C. Due to a large occiput, optimal
airway position is achieved by placing padding under the shoulders. The padding provides
neutral alignment of the airway and cervical spine. The other options need to occur, but they are
not the priority intervention
If administering epinephrine to a pediatric patient having a severe allergic reaction, the proper
dose and concentration should be epinephrine
4
CPEN Nursing Certified Exam – 100% Correct Questions
and Answers | Graded A+
An anxious adolescent presents with palpitations, a heart rate of 184 beats/min, and normal skin
tone. Which of the following is the PRIORITY intervention?
A. Obtain urine drug screen.
B. Administer IV adenosine (Adenocard) rapidly.
C. Instruct the patient to bear down.
D. Provide comfort and reassurance. - Correct Answer- D. SVT is defined as heart rate >220 in
infants and >180 in children. Thus putting the child in SVT. Search and treat the cause. The
PRIORITY intervention to provide comfort and reassurance could lower heart rate while
preparing other interventions and assessments. Vagal maneuvers would be the next intervention,
followed by adenosine.
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. - Correct 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.
1
,CPEN Nursing Certification Exam
D. a HIPPA violation. - Correct 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 - Correct 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 - Correct 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 - Correct 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
2
,CPEN Nursing Certification Exam
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 - Correct 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. - Correct 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. - Correct 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 larynx, the child cannot speak or breathe, For children 1 year
or older, abdominal thrusts should be used.
3
, CPEN Nursing Certification Exam
A 2-month-old presents with irritability and is inconsolable. Which finding would lead the
emergency nurse to suspect shaken baby syndrome?
A. Unilateral retinal hemorrhage
B. Bruising of the legs.
C. Decreased movement of the legs
D. Bilateral retinal hemorrhages - Correct Answer- D. Shaken baby syndrome is common in
children less than one year of age. Male caregivers have a higher rate of shaken baby syndrome.
Bilateral retinal hemorrhages are more common due to weak neck muscles and large occiput.
The infant is usually held by the arms and shaken. Bruises of the arms would occur. Decreased
movement of the legs would usually be a spinal cord injury. Bruising of the legs are not
indicative of shaken baby syndrome.
A 2-year-old child has not used his left arm for the past hour. His mother reported grabbing his
hand to prevent him from falling from a slide. The nurse should suspect
A. a forearm fracture.
B. a supracondylar fracture.
C. shoulder dislocation.
D. subluxation of the radial head. - Correct Answer- D. Subluxation of the radial head, or a
nursemaid's elbow, is one of the most common injuries seen in toddlers. Resulting from a sudden
pull on the child's arms, the child refuses to move or use the affected extremity.
A 1-year-old presents unconscious and is being ventilated with a bag-mask device. Ventilation
has become progressively more difficult. Which of the following is the PRIORITY intervention?
A. Insert a nasogastric tube.
B. Obtain a pulse oximeter reading.
C. Place padding under the shoulders. - Correct Answer- C. Due to a large occiput, optimal
airway position is achieved by placing padding under the shoulders. The padding provides
neutral alignment of the airway and cervical spine. The other options need to occur, but they are
not the priority intervention
If administering epinephrine to a pediatric patient having a severe allergic reaction, the proper
dose and concentration should be epinephrine
4
