10 free, exam-style Certified Pediatric Emergency Nurse (CPEN) practice questions with answers and explanations. No signup required. Work through them below, then take the full free CPEN practice test to study every exam domain.
A triage nurse performs the Pediatric Assessment Triangle (PAT) from the doorway on a 9-month-old. The infant is limp with a vacant stare and has pale, mottled skin, but breathing is unlabored with no retractions, flaring, or abnormal airway sounds. Based on the PAT, which physiologic problem is MOST consistent with these findings?
Correct answer: A - Decompensated (hypoperfusion) shock
An 8-year-old with a severe asthma exacerbation has been receiving continuous albuterol. The child now appears calmer with diminished wheezing and fewer retractions, but the SpO2 has fallen from 92% to 86% and the child is becoming drowsy. Which interpretation is correct?
Correct answer: D - The child is tiring and progressing to respiratory failure
A 6-month-old presents with poor feeding and irritability. The monitor shows a narrow-complex tachycardia at 290 bpm with no visible P waves. The infant is alert with a normal blood pressure and a capillary refill of 2 seconds. After applying oxygen and obtaining IV access, which intervention should the nurse anticipate FIRST?
Correct answer: C - Apply a bag of ice water to the infant's face
A 3-year-old (15 kg) has been seizing for 8 minutes. The nurse administered IV lorazepam 0.1 mg/kg, and after an appropriate interval the child continues to seize. IV access is patent and the blood glucose is normal. Which medication should the nurse prepare to administer NEXT?
Correct answer: B - Levetiracetam 60 mg/kg IV
A 10-year-old in diabetic ketoacidosis (DKA) has just received an isotonic fluid bolus. Initial laboratory results show a serum potassium of 3.2 mEq/L. Before starting the insulin infusion, the nurse should expect to:
Correct answer: A - Replace potassium and delay insulin until the level is acceptable
A 5-year-old (20 kg) develops diffuse hives, audible wheezing, and vomiting within minutes of eating a cashew. The blood pressure is at the low end of normal for age. Which is the FIRST medication the nurse should administer?
Correct answer: D - Epinephrine 0.01 mg/kg IM to the anterolateral thigh
A 4-year-old is brought in after being found in a shed where pesticides are stored. The child has pinpoint pupils, copious oral secretions, wheezing, bradycardia, and muscle twitching. After airway management, which antidote should the nurse anticipate?
Correct answer: B - Atropine with pralidoxime
A 3-month-old is brought to the emergency department for fussiness. During assessment, the nurse notes bruising on the infant's cheek and upper arm. The caregiver states the infant 'rolled into the crib rails,' but the infant is not yet able to roll over. Which action is MOST appropriate?
Correct answer: C - Report the suspected abuse and ensure the child's safety
A nurse is assessing pain in a 4-year-old who is alert and talking but cannot yet count reliably. Which pain assessment tool is MOST appropriate?
Correct answer: A - Wong-Baker FACES scale
A family arrives at the emergency department with a child who has abdominal pain. Before any assessment, a staff member asks the family about their insurance coverage and ability to pay. Under EMTALA, this practice is problematic because the hospital must FIRST:
Correct answer: D - Provide a medical screening examination
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