Exam Flashcards
7 cards from real CPEN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Exam flashcards as text
A 16-year-old presents with acute scrotal pain that began 3 hours ago. The affected testicle is elevated and horizontal, with absent cremasteric reflex. What is the priority nursing action?
Answer: Notify the provider for urgent surgical consultation
Testicular torsion is a surgical emergency; the cremasteric reflex absent and acute onset indicate immediate urological surgery is needed within 4-6 hours to save the testicle.
A 2-year-old is brought in by EMS after being found face-down in a backyard pool. Resuscitation is in progress. Which temperature management consideration is important in pediatric submersion victims?
Answer: Cold water submersion may be protective; do not declare death until normothermic
Cold water submersion can provide neuroprotection; the principle 'not dead until warm and dead' applies, and resuscitation should continue until the patient is rewarmed to near-normal temperature.
A nurse is performing a pain assessment on a 2-year-old after a laceration repair. Which validated pain scale is most appropriate?
Answer: FLACC Scale
The FLACC (Face, Legs, Activity, Cry, Consolability) scale is a validated behavioral pain tool designed for children aged 2 months to 7 years who cannot self-report pain.
A 13-year-old is brought in after a motor vehicle collision with suspected pelvic fracture and hemodynamic instability. The nurse anticipates which massive transfusion protocol ratio?
Answer: 1:1:1 PRBCs to FFP to platelets
Massive transfusion protocols utilize a 1:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets to mimic whole blood and reduce coagulopathy.
A 7-year-old with type 1 diabetes presents with Kussmaul respirations, fruity breath, a glucose of 480 mg/dL, and a bicarbonate of 10. Which intervention must be completed BEFORE starting insulin therapy?
Answer: Ensure adequate fluid resuscitation is initiated
Fluid resuscitation must begin before insulin in DKA because insulin shifts potassium into cells and fluids help correct hypovolemia and dilute glucose.
A 15-year-old reveals to the nurse that she has been self-harming but denies suicidal intent. Under mandatory reporting guidelines, what is the nurse's obligation?
Answer: Notify the provider and initiate a psychiatric safety evaluation
Non-suicidal self-injury requires immediate provider notification and psychiatric evaluation to assess safety; confidentiality has limits when patient safety is at risk.
A 3-month-old is brought in with a history of 'fussiness' and is found to have multiple rib fractures at different stages of healing. The nurse's priority action is to:
Answer: Document the findings and notify the provider for a child abuse evaluation
Multiple rib fractures in different stages of healing in an infant are highly suspicious for non-accidental trauma (child abuse) and mandate immediate provider notification and abuse evaluation.