CPEN Practice Questions & Rationales Updated 2026

CPEN Practice Questions &
Rationales Updated 2026
AnManxiousMadolescentMpresentsMwithMpalpitations,MaMheartMrateMofM184Mbeats/min,Ma
ndMnormalMskinMtone.MWhichMofMtheMfollowingMisMtheMPRIORITYMintervention?

A.MObtainMurineMdrugMscreen.

B.MAdministerMIVMadenosineM(Adenocard)Mrapidly.

C.MInstructMtheMpatientMtoMbearMdown.

D.MProvideMcomfortMandMreassurance.M-
MAnswerMD.MSVTMisMdefinedMasMheartMrateM>220MinMinfantsMandM>180MinMchildren.M
ThusMputtingMtheMchildMinMSVT.MSearchMandMtreatMtheMcause.MTheMPRIORITYMintervent
ionMtoMprovideMcomfortMandMreassuranceMcouldMlowerMheartMrateMwhileMpreparingMot
herMinterventionsMandMassessments.MVagalMmaneuversMwouldMbeMtheMnextMintervention,
MfollowedMbyMadenosine.



ContinuousMmonitoringMofMaMchild'sMETCO2MduringMcardiacMarrestMrevealsM8MmmHg.MT
hisMindicatesMthatMCPRMis

A.MineffectiveMandMadjustmentsMneedMtoMbeMmadeMtoMcompressions.

B.MnoMlongerMneeded;MthereMisMaMreturnMofMspontaneousMcirculation.

C.MnoMlongerMneeded;MfurtherMresuscitationMisMfutile.

D.MineffectiveMandMadjustmentsMneedMtoMbeMmadeMtoMventilation.M-
MAnswerMA.MTheM2010MguidelinesMrecommendedMthatMifMtheMpartialMpressureMofMETC
O2MisMconsistentlyMlessMthanM15MmmMHgMeffortsMshouldMfocusMonMimprovingMCPRMq
uality,MparticularlyMimprovingMchestMcompressionsMandMensuringMtheMchildMdoesMnotMre
ceiveMexcessiveMventilations.



AMchildMpresentsMtoMemergencyMdepartmentMwithMsymptomsMofManaphylaxisMafterMeati
ngMcookiesMatMaMbirthdayMparty.MTheMfriend'sMparentMisMaccompanyingMtheMchildMand
MisMunableMtoMreachMtheMparents.MTheMnurseMrecognizesMthisMlegalMissueMas

A.MinformedMconsent.

B.MimpliedMconsent.

C.ManMEMTALAMviolation.

D.MaMHIPPAMviolation.M-MAnswerMB.MImpliedMConsent



9-month-oldMpresentsMtoMtheMEmergencyMDepartmentMwithMaMmid-
shaftMtibiaMfracture.MWhichMofMtheMfollowingMstatementsMfromMtheMparentMmightMindi
cateMhistoryMofMnon-accidentalMtraumaM(NAT).

,A.MPatientMwasMbeingMchangedMonMtopMofMaMtableMandMrolledMoff.

B.MPatientMwasManMunrestrainedMpassengerMinMaMmotorMvehicleMcollision.

C.MPatientMwasMcrawlingMonMaMdeckMandMfellMoffMapproximatelyM4Mfeet.

D.MPatientMwasMridingMaMtricycleMandMfellMoffM-
MAnswerMD.MTheMpatientMdoesMnotMhaveMtheMdevelopmentMandMcoordinationMtoMride
MaMtricycle.MAM9-month-
oldMcanMrollMoverMandMitMisMpossibleMtoMfallMandMfractureMtheirMarm.MEvenMthough
MtheMpatientMwasMunrestrained,MitMmayMnotMinvolveMNAT.MAM9-month-
oldMisMoftenMcrawlingMand,MifMtheMpatientMwasMnotMbeingMwatched,McouldMhaveMfalle
nMoffMaMdeckMandMagainMnotMbeMconsideredMNAT.



WhichMdevelopmentalMtaskMisMexpectedMinMaMtoddler?

A.Mindustry

B.Mtrust

C.Minitiative

D.MautonomyM-
MAnswerMD.MToddlersMlearnMtoMexerciseMwillMandMdoMthingsMforMthemselves.MDevelop
mentalMtaskMofMtoddlerhoodMisMacquiringMaMsenseMofMautonomy.MSeveralMcharacteristic
s,MespeciallyMnegativismMandMritualism,MareMtypicalMofMtoddlers.



FollowingMaMmotorMvehicleMcollision,MaMpatientMisMdiagnosedMwithMaMC7MfractureMand
ManteriorMspinalMcordMsyndrome.MTheMnurseMunderstandsMthisMpatientMwill:

A.MwillMbeMableMtoMambulateMwithMassistance

B.MbeMwheelchairMdependent

C.MwillMregainMmostMfunctionMatMsomeMpoint

D.MbeMventilatorMdependentM-
MAnswerMB.MTheMpatientMwillMbeMaMparaplegicMandMmayMbeMableMtoMcompleteMmov
ementMwithMtheirMarms.MHeMwillMnotMbeMventilatorMdependentMorMbeMableMtoMambu
lateMindependently.MHeMwillMbeMevaluatedMindependentlyMbutMwillMbeMunableMtoMwalk



WhichMofMtheMfollowingMisMtheMBESTMmethodMtoMassessMadequacyMofMventilationMduri
ngMproceduralMsedation?

A.MbreathMsounds

B.MoxygenMsaturation

C.MrespiratoryMrate

,D.McapnographyMvalueM-
MAnswerMD.McapnographyMisMusedMtoMdetermineMadequacyMofMventilation.MOxygenMsat
urationMprovidesMtheMpercentageMofMhemoglobinMcarryingMoxygen.MHypoventilationMisMd
etectedMmoreMrapidlyMbyMcapnographyMthanMbyMauscultationMofMbreathMsounds,Moxyge
nMsaturationMorMrespiratoryMrate.



AM2-year-oldMpresentsMtoMtheMemergencyMdepartmentMwithMtonic-
clonicMmovementsMwhichMtheMcaregiversMreportMoccurringMforMoneMminuteMpriorMtoMa
rrival.MTheMpriorityMinterventionMis

A.MpreparingMforMintubation.

B.MadministeringMoxygenMviaMaMnonrebreathingMmask.

C.MturningMpatientMtoMtheMside.

D.MplacingManMintraosseousMneedle.M-
MAnswerMC.MTurningMtheMpatientMtoMaMsideMisMpartMofMtheMinitialMassessmentMtoMr
educeMtheMriskMofMaspirationMandMtongueMobstruction.MThereMisMnoMindicationMforMan
MintraosseousMneedleMasMmostMantiseizureMmedicationsMcanMbeMgivenMviaMotherMroute
s.MCurrently,MthereMisMnoMindicationMforMintubation.MOxygenMwillMnotMassistMifMtheMai
rwayMisMnotMpatent.



AMmotherMrunsMintoMtheMemergencyMdepartmentMscreamingMthatMherMchildMisMchoking
MonMaMpieceMofMcandy.MTheMnurseMobservesMaMfearfulM5-year-
oldMwithMminimalMairMmovementMandMduskyMinMcolor.MTheMnurse'sMinitialMactionMsho
uldMbeMto

A.MperformMabdominalMthrusts.

B.MobtainManMoxygenMsaturationMlevel.

C.MfacilitateMoralMtrachealMintubation.

D.MobtainMaMchestMradiograph.M-
MAnswerMA.MAMchildMbroughtMtoMtheMEDMwithMsuddenMonsetMofMrespiratoryMdistress
MshouldMbeMevaluatedMforMforeignMbodyMaspirationMifMnoMotherMcauseMisMapparent.MI
nitially,MaMforeignMbodyMobstructionMproducesMchoking,Mgassing,Mwheezing,MorMcoughing.
MIfMtheMobjectMbecomesMlodgedMinMtheMlarynx,MtheMchildMcannotMspeakMorMbreathe,
MForMchildrenM1MyearMorMolder,MabdominalMthrustsMshouldMbeMused.



AM2-month-
oldMpresentsMwithMirritabilityMandMisMinconsolable.MWhichMfindingMwouldMleadMtheMem
ergencyMnurseMtoMsuspectMshakenMbabyMsyndrome?

A.MUnilateralMretinalMhemorrhage

B.MBruisingMofMtheMlegs.

, C.MDecreasedMmovementMofMtheMlegs

D.MBilateralMretinalMhemorrhagesM-
MAnswerMD.MShakenMbabyMsyndromeMisMcommonMinMchildrenMlessMthanMoneMyearMof
Mage.MMaleMcaregiversMhaveMaMhigherMrateMofMshakenMbabyMsyndrome.MBilateralMretin
alMhemorrhagesMareMmoreMcommonMdueMtoMweakMneckMmusclesMandMlargeMocciput.M
TheMinfantMisMusuallyMheldMbyMtheMarmsMandMshaken.MBruisesMofMtheMarmsMwouldM
occur.MDecreasedMmovementMofMtheMlegsMwouldMusuallyMbeMaMspinalMcordMinjury.MBr
uisingMofMtheMlegsMareMnotMindicativeMofMshakenMbabyMsyndrome.



AM2-year-
oldMchildMhasMnotMusedMhisMleftMarmMforMtheMpastMhour.MHisMmotherMreportedMgra
bbingMhisMhandMtoMpreventMhimMfromMfallingMfromMaMslide.MTheMnurseMshouldMsuspe
ct

A.MaMforearmMfracture.

B.MaMsupracondylarMfracture.

C.MshoulderMdislocation.

D.MsubluxationMofMtheMradialMhead.M-
MAnswerMD.MSubluxationMofMtheMradialMhead,MorMaMnursemaid'sMelbow,MisMoneMofMt
heMmostMcommonMinjuriesMseenMinMtoddlers.MResultingMfromMaMsuddenMpullMonMthe
Mchild'sMarms,MtheMchildMrefusesMtoMmoveMorMuseMtheMaffectedMextremity.



AM1-year-oldMpresentsMunconsciousMandMisMbeingMventilatedMwithMaMbag-
maskMdevice.MVentilationMhasMbecomeMprogressivelyMmoreMdifficult.MWhichMofMtheMfoll
owingMisMtheMPRIORITYMintervention?

A.MInsertMaMnasogastricMtube.

B.MObtainMaMpulseMoximeterMreading.

C.MPlaceMpaddingMunderMtheMshoulders.M-
MAnswerMC.MDueMtoMaMlargeMocciput,MoptimalMairwayMpositionMisMachievedMbyMplacin
gMpaddingMunderMtheMshoulders.MTheMpaddingMprovidesMneutralMalignmentMofMtheMair
wayMandMcervicalMspine.MTheMotherMoptionsMneedMtoMoccur,MbutMtheyMareMnotMtheM
priorityMintervention



IfMadministeringMepinephrineMtoMaMpediatricMpatientMhavingMaMsevereMallergicMreaction,
MtheMproperMdoseMandMconcentrationMshouldMbeMepinephrine

A.M0.10MmL/kgMandM1mg/10MmL

B.M0.01MmL/kgMandM1Mmg/mL

C.M0.01MmL/kgMandM1Mmg/10MmL