CPEN Basic Exam 3

Question 1

A 3-year-old is brought in after ingesting an unknown quantity of iron tablets. Which finding is MOST consistent with iron toxicity?

Accepted Answer

Gastrointestinal hemorrhage and metabolic acidosis

Answer

Iron toxicity causes GI bleeding, vomiting, diarrhea, and an anion-gap metabolic acidosis due to free radical damage and cellular toxicity.

Question 2

Which finding on a pediatric ECG is MOST concerning for supraventricular tachycardia (SVT) rather than sinus tachycardia?

Accepted Answer

Heart rate of 220 bpm with narrow QRS and no visible P waves

Answer

SVT typically presents with a fixed rate above 180-220 bpm, a narrow QRS complex, and absent or retrograde P waves.

Question 3

A 7-year-old with known asthma presents with severe respiratory distress, accessory muscle use, SpO2 88%, and a silent chest on auscultation. What does the 'silent chest' indicate?

Accepted Answer

Minimal airflow due to severe obstruction, indicating a critical state

Answer

A silent chest in a severe asthmatic indicates critically reduced airflow; the absence of wheezing is an ominous sign, not reassuring.

Question 4

Which IV fluid is recommended for initial resuscitation of a child in septic shock?

Accepted Answer

Isotonic crystalloid (0.9% NS or Lactated Ringer's)

Answer

Current guidelines recommend isotonic crystalloid (normal saline or Lactated Ringer's) at 20 mL/kg boluses for septic shock resuscitation.

Question 5

A neonate presents at 3 weeks of age with projectile non-bilious vomiting after every feeding and a palpable 'olive-like' mass in the epigastrium. What is the MOST likely diagnosis?

Accepted Answer

Pyloric stenosis

Answer

Pyloric stenosis classically presents at 2–8 weeks with forceful non-bilious vomiting and a palpable pyloric 'olive' mass.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Basic Exam 3