CPEN – Certified Pediatric Emergency Nurse
Certification Questions with Answers & Detailed
Rationales Pediatric Emergency Nursing |
Pediatric Trauma | Emergency Assessment |
Certification Review
Question 1
A 4-year-old child is brought to the emergency department with a fever of 104°F,
lethargy, and a petechial rash. The child's heart rate is 160 bpm, respiratory rate is
40 breaths/min, and blood pressure is 80/50 mmHg. Which of the following is the
priority nursing action?
A) Administer antipyretics
B) Obtain blood cultures and administer antibiotics
C) Apply a cooling blanket
D) Administer IV fluids
Answer: B) Obtain blood cultures and administer antibiotics
Rationale: The combination of fever, petechial rash, lethargy, tachycardia, and
hypotension is concerning for sepsis, possibly meningococcemia. The priority is to
obtain blood cultures and administer antibiotics promptly. Antipyretics (A) and
cooling (C) are important but should not delay antibiotics. IV fluids (D) may be
needed but antibiotics are the priority.
Question 2
A 2-year-old child is brought to the emergency department after a choking episode.
The child is now coughing forcefully and has stridor. Which of the following is the
most appropriate nursing action?
A) Perform the Heimlich maneuver
B) Administer oxygen
,C) Perform a finger sweep
D) Allow the child to remain in a position of comfort and monitor
Answer: D) Allow the child to remain in a position of comfort and monitor
Rationale: A child who is coughing forcefully and has stridor indicates partial
airway obstruction with good air exchange. The child should be allowed to remain
in a position of comfort and monitored. The Heimlich maneuver (A) is for
complete obstruction. Finger sweeps (C) can push the object further into the
airway.
Question 3
A 6-month-old infant is brought to the emergency department with a temperature
of 102°F and a bulging fontanelle. The infant is irritable and refuses to feed. Which
of the following is the priority diagnostic test?
A) Complete blood count
B) Urinalysis
C) Lumbar puncture
D) Chest X-ray
Answer: C) Lumbar puncture
Rationale: A bulging fontanelle with fever and irritability in an infant is
concerning for meningitis. A lumbar puncture is the priority diagnostic test to
obtain cerebrospinal fluid. CBC (A), urinalysis (B), and chest X-ray (D) may be
indicated but do not diagnose meningitis.
Question 4
A 3-year-old child presents with a barking cough, stridor, and respiratory distress.
The child's symptoms are worse at night. Which of the following is the most likely
diagnosis?
A) Epiglottitis
B) Croup
,C) Foreign body aspiration
D) Asthma
Answer: B) Croup
Rationale: Croup (laryngotracheobronchitis) presents with a barking cough,
stridor, and respiratory distress that is worse at night. Epiglottitis (A) presents with
fever, drooling, and a "tripod" position. Foreign body aspiration (C) presents with
sudden onset. Asthma (D) typically presents with wheezing.
Question 5
A 10-year-old child is brought to the emergency department after a bicycle
accident. The child is alert and oriented but complains of abdominal pain. The
nurse notes seatbelt marks on the child's abdomen. Which of the following is the
priority nursing action?
A) Apply ice to the abdomen
B) Prepare for a CT scan of the abdomen
C) Administer pain medication
D) Notify the trauma team
Answer: D) Notify the trauma team
Rationale: Seatbelt marks on the abdomen after a significant mechanism of injury
(bicycle accident) raise concern for intra-abdominal injury. The trauma team
should be notified for a comprehensive evaluation. CT scan (B) may be ordered
but the trauma team should be involved. Pain medication (C) should not be given
until the trauma evaluation is complete.
Question 6
A 2-week-old infant is brought to the emergency department with poor feeding,
lethargy, and vomiting. The infant's weight is below birth weight. Which of the
following is the priority nursing action?
, A) Administer IV fluids
B) Obtain a complete blood count
C) Assess the infant's blood glucose
D) Perform a sepsis workup
Answer: C) Assess the infant's blood glucose
Rationale: A 2-week-old infant with poor feeding, lethargy, and failure to gain
weight is at risk for hypoglycemia. Blood glucose assessment is the priority. IV
fluids (A), CBC (B), and sepsis workup (D) may be indicated but blood glucose is
the most immediate concern.
Question 7
A 5-year-old child is brought to the emergency department with a fever of 103°F,
drooling, and a tripod position. The child is refusing to swallow. Which of the
following is the priority nursing action?
A) Examine the throat with a tongue depressor
B) Prepare for emergent intubation
C) Administer antibiotics
D) Obtain a throat culture
Answer: B) Prepare for emergent intubation
Rationale: Fever, drooling, tripod position, and refusal to swallow are classic
signs of epiglottitis, which can rapidly progress to airway obstruction. The priority
is to prepare for emergent intubation. Examining the throat (A) can precipitate
complete airway obstruction. Antibiotics (C) and throat culture (D) are important
but should not delay airway management.
Question 8
A 1-year-old child is brought to the emergency department after a fall from a
changing table. The child is crying but has no obvious injuries. Which of the
following is the most appropriate nursing action?
Certification Questions with Answers & Detailed
Rationales Pediatric Emergency Nursing |
Pediatric Trauma | Emergency Assessment |
Certification Review
Question 1
A 4-year-old child is brought to the emergency department with a fever of 104°F,
lethargy, and a petechial rash. The child's heart rate is 160 bpm, respiratory rate is
40 breaths/min, and blood pressure is 80/50 mmHg. Which of the following is the
priority nursing action?
A) Administer antipyretics
B) Obtain blood cultures and administer antibiotics
C) Apply a cooling blanket
D) Administer IV fluids
Answer: B) Obtain blood cultures and administer antibiotics
Rationale: The combination of fever, petechial rash, lethargy, tachycardia, and
hypotension is concerning for sepsis, possibly meningococcemia. The priority is to
obtain blood cultures and administer antibiotics promptly. Antipyretics (A) and
cooling (C) are important but should not delay antibiotics. IV fluids (D) may be
needed but antibiotics are the priority.
Question 2
A 2-year-old child is brought to the emergency department after a choking episode.
The child is now coughing forcefully and has stridor. Which of the following is the
most appropriate nursing action?
A) Perform the Heimlich maneuver
B) Administer oxygen
,C) Perform a finger sweep
D) Allow the child to remain in a position of comfort and monitor
Answer: D) Allow the child to remain in a position of comfort and monitor
Rationale: A child who is coughing forcefully and has stridor indicates partial
airway obstruction with good air exchange. The child should be allowed to remain
in a position of comfort and monitored. The Heimlich maneuver (A) is for
complete obstruction. Finger sweeps (C) can push the object further into the
airway.
Question 3
A 6-month-old infant is brought to the emergency department with a temperature
of 102°F and a bulging fontanelle. The infant is irritable and refuses to feed. Which
of the following is the priority diagnostic test?
A) Complete blood count
B) Urinalysis
C) Lumbar puncture
D) Chest X-ray
Answer: C) Lumbar puncture
Rationale: A bulging fontanelle with fever and irritability in an infant is
concerning for meningitis. A lumbar puncture is the priority diagnostic test to
obtain cerebrospinal fluid. CBC (A), urinalysis (B), and chest X-ray (D) may be
indicated but do not diagnose meningitis.
Question 4
A 3-year-old child presents with a barking cough, stridor, and respiratory distress.
The child's symptoms are worse at night. Which of the following is the most likely
diagnosis?
A) Epiglottitis
B) Croup
,C) Foreign body aspiration
D) Asthma
Answer: B) Croup
Rationale: Croup (laryngotracheobronchitis) presents with a barking cough,
stridor, and respiratory distress that is worse at night. Epiglottitis (A) presents with
fever, drooling, and a "tripod" position. Foreign body aspiration (C) presents with
sudden onset. Asthma (D) typically presents with wheezing.
Question 5
A 10-year-old child is brought to the emergency department after a bicycle
accident. The child is alert and oriented but complains of abdominal pain. The
nurse notes seatbelt marks on the child's abdomen. Which of the following is the
priority nursing action?
A) Apply ice to the abdomen
B) Prepare for a CT scan of the abdomen
C) Administer pain medication
D) Notify the trauma team
Answer: D) Notify the trauma team
Rationale: Seatbelt marks on the abdomen after a significant mechanism of injury
(bicycle accident) raise concern for intra-abdominal injury. The trauma team
should be notified for a comprehensive evaluation. CT scan (B) may be ordered
but the trauma team should be involved. Pain medication (C) should not be given
until the trauma evaluation is complete.
Question 6
A 2-week-old infant is brought to the emergency department with poor feeding,
lethargy, and vomiting. The infant's weight is below birth weight. Which of the
following is the priority nursing action?
, A) Administer IV fluids
B) Obtain a complete blood count
C) Assess the infant's blood glucose
D) Perform a sepsis workup
Answer: C) Assess the infant's blood glucose
Rationale: A 2-week-old infant with poor feeding, lethargy, and failure to gain
weight is at risk for hypoglycemia. Blood glucose assessment is the priority. IV
fluids (A), CBC (B), and sepsis workup (D) may be indicated but blood glucose is
the most immediate concern.
Question 7
A 5-year-old child is brought to the emergency department with a fever of 103°F,
drooling, and a tripod position. The child is refusing to swallow. Which of the
following is the priority nursing action?
A) Examine the throat with a tongue depressor
B) Prepare for emergent intubation
C) Administer antibiotics
D) Obtain a throat culture
Answer: B) Prepare for emergent intubation
Rationale: Fever, drooling, tripod position, and refusal to swallow are classic
signs of epiglottitis, which can rapidly progress to airway obstruction. The priority
is to prepare for emergent intubation. Examining the throat (A) can precipitate
complete airway obstruction. Antibiotics (C) and throat culture (D) are important
but should not delay airway management.
Question 8
A 1-year-old child is brought to the emergency department after a fall from a
changing table. The child is crying but has no obvious injuries. Which of the
following is the most appropriate nursing action?
