Certified Pediatric Emergency Nurse
(CPEN) Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant
Download Pdf
1. A 4-year-old presents with sudden onset of high fever, drooling,
and stridor. What is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Asthma
D. Bronchiolitis
Epiglottitis typically presents with high fever, drooling, and stridor. It
is a life-threatening emergency requiring airway management.
2. Which of the following is the most appropriate first step in
managing a child with suspected septic shock?
A. Administer broad-spectrum antibiotics
B. Start vasopressors immediately
C. Establish vascular access and begin fluid resuscitation
D. Obtain blood cultures
Early fluid resuscitation is critical in pediatric septic shock to maintain
perfusion, even before antibiotics or cultures are obtained.
3. A 2-year-old ingested a small amount of acetaminophen. Which
test is most important to order?
A. Liver function tests
,B. Serum acetaminophen level
C. CBC
D. Electrolytes
Serum acetaminophen levels guide the need for antidote therapy (N-
acetylcysteine) and timing is critical based on ingestion time.
4. Which of the following is the most sensitive sign of increased
intracranial pressure (ICP) in a child?
A. Headache
B. Altered mental status
C. Vomiting
D. Bradycardia
Changes in mental status, such as irritability or decreased
responsiveness, are often the earliest and most sensitive indicators of
increased ICP in children.
5. A child with a history of asthma presents with wheezing and mild
respiratory distress. What is the first-line treatment?
A. IV corticosteroids
B. Inhaled short-acting beta-agonist (albuterol)
C. Oxygen via non-rebreather
D. Leukotriene inhibitors
Short-acting beta-agonists are first-line therapy for acute asthma
exacerbations in children.
6. Which type of shock is most likely in a 6-year-old with a history
of severe diarrhea and vomiting?
A. Cardiogenic
B. Hypovolemic
,C. Septic
D. Anaphylactic
Hypovolemic shock results from fluid loss, commonly due to diarrhea
and vomiting, leading to decreased circulating volume.
7. A 3-year-old presents with a laceration to the forehead. What is
the recommended maximum number of sutures for a child under
sedation without general anesthesia?
A. 2
B. 4
C. 5–7
D. 10
Short lacerations can typically be closed with a few sutures under
local or minimal sedation; longer or complex wounds may require
general anesthesia.
8. Which of the following is the hallmark of Kawasaki disease?
A. Fever and cough
B. Rash and jaundice
C. Prolonged fever and conjunctivitis
D. Diarrhea and dehydration
Kawasaki disease presents with prolonged fever, conjunctivitis,
mucocutaneous changes, and risk of coronary artery aneurysms.
9. Which assessment finding is most concerning in a 7-year-old with
suspected meningitis?
A. Mild headache
B. Neck stiffness and photophobia
, C. Low-grade fever
D. Fatigue
Neck stiffness and photophobia are classic signs of meningitis, which
requires urgent evaluation and empiric antibiotics.
10. A 10-year-old presents with sudden right-sided weakness and
slurred speech. What is the priority intervention?
A. Obtain a chest X-ray
B. Administer antipyretics
C. Activate stroke protocol and obtain neuroimaging
D. Give IV antibiotics
Pediatric stroke is rare but requires rapid recognition and immediate
neuroimaging to guide management.
11. What is the preferred route for rapid fluid resuscitation in a 2-
year-old in shock?
A. Oral
B. Intraosseous or IV
C. Subcutaneous
D. Intramuscular
In children in shock, intraosseous (IO) access is used if IV access is not
quickly achievable.
12. Which of the following signs suggests impending respiratory
failure in a child with asthma?
A. Mild wheezing
B. Silent chest
C. Cough
D. Nasal flaring
(CPEN) Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2025/2026 Q&A | Instant
Download Pdf
1. A 4-year-old presents with sudden onset of high fever, drooling,
and stridor. What is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Asthma
D. Bronchiolitis
Epiglottitis typically presents with high fever, drooling, and stridor. It
is a life-threatening emergency requiring airway management.
2. Which of the following is the most appropriate first step in
managing a child with suspected septic shock?
A. Administer broad-spectrum antibiotics
B. Start vasopressors immediately
C. Establish vascular access and begin fluid resuscitation
D. Obtain blood cultures
Early fluid resuscitation is critical in pediatric septic shock to maintain
perfusion, even before antibiotics or cultures are obtained.
3. A 2-year-old ingested a small amount of acetaminophen. Which
test is most important to order?
A. Liver function tests
,B. Serum acetaminophen level
C. CBC
D. Electrolytes
Serum acetaminophen levels guide the need for antidote therapy (N-
acetylcysteine) and timing is critical based on ingestion time.
4. Which of the following is the most sensitive sign of increased
intracranial pressure (ICP) in a child?
A. Headache
B. Altered mental status
C. Vomiting
D. Bradycardia
Changes in mental status, such as irritability or decreased
responsiveness, are often the earliest and most sensitive indicators of
increased ICP in children.
5. A child with a history of asthma presents with wheezing and mild
respiratory distress. What is the first-line treatment?
A. IV corticosteroids
B. Inhaled short-acting beta-agonist (albuterol)
C. Oxygen via non-rebreather
D. Leukotriene inhibitors
Short-acting beta-agonists are first-line therapy for acute asthma
exacerbations in children.
6. Which type of shock is most likely in a 6-year-old with a history
of severe diarrhea and vomiting?
A. Cardiogenic
B. Hypovolemic
,C. Septic
D. Anaphylactic
Hypovolemic shock results from fluid loss, commonly due to diarrhea
and vomiting, leading to decreased circulating volume.
7. A 3-year-old presents with a laceration to the forehead. What is
the recommended maximum number of sutures for a child under
sedation without general anesthesia?
A. 2
B. 4
C. 5–7
D. 10
Short lacerations can typically be closed with a few sutures under
local or minimal sedation; longer or complex wounds may require
general anesthesia.
8. Which of the following is the hallmark of Kawasaki disease?
A. Fever and cough
B. Rash and jaundice
C. Prolonged fever and conjunctivitis
D. Diarrhea and dehydration
Kawasaki disease presents with prolonged fever, conjunctivitis,
mucocutaneous changes, and risk of coronary artery aneurysms.
9. Which assessment finding is most concerning in a 7-year-old with
suspected meningitis?
A. Mild headache
B. Neck stiffness and photophobia
, C. Low-grade fever
D. Fatigue
Neck stiffness and photophobia are classic signs of meningitis, which
requires urgent evaluation and empiric antibiotics.
10. A 10-year-old presents with sudden right-sided weakness and
slurred speech. What is the priority intervention?
A. Obtain a chest X-ray
B. Administer antipyretics
C. Activate stroke protocol and obtain neuroimaging
D. Give IV antibiotics
Pediatric stroke is rare but requires rapid recognition and immediate
neuroimaging to guide management.
11. What is the preferred route for rapid fluid resuscitation in a 2-
year-old in shock?
A. Oral
B. Intraosseous or IV
C. Subcutaneous
D. Intramuscular
In children in shock, intraosseous (IO) access is used if IV access is not
quickly achievable.
12. Which of the following signs suggests impending respiratory
failure in a child with asthma?
A. Mild wheezing
B. Silent chest
C. Cough
D. Nasal flaring
