CPEN Exam 4 — Questions and Answers
Question 1: A 5-year-old is found unresponsive. The nurse confirms no pulse and begins CPR. What is the correct compression-to-ventilation ratio for a single rescuer?
- 15:2
- 30:2 (Correct answer)
- 5:1
- 30:1
Correct answer: 30:2
A single rescuer performing CPR on a child uses a 30:2 compression-to-ventilation ratio, consistent with adult BLS guidelines.
Question 2: A 14-year-old athlete collapses during practice and has no pulse. The AED identifies a shockable rhythm. What is the correct initial energy dose for a pediatric defibrillation?
- 1 J/kg
- 2 J/kg (Correct answer)
- 4 J/kg
- 360 J
Correct answer: 2 J/kg
The initial pediatric defibrillation dose is 2 J/kg, with subsequent shocks at 4 J/kg if the initial shock is unsuccessful.
Question 3: A 3-year-old presents with stridor at rest, a barking cough, and mild retractions. The nurse assigns a croup score of 3. Which initial treatment is most appropriate?
- Nebulized albuterol
- IV dexamethasone and racemic epinephrine nebulization
- Oral dexamethasone only (Correct answer)
- Immediate intubation
Correct answer: Oral dexamethasone only
Mild to moderate croup (scores 1-5) is managed with a single oral dose of dexamethasone, which reduces airway inflammation.
Question 4: A nurse is caring for a child with a suspected spinal injury after a diving accident. Which cervical immobilization device is most appropriate for initial prehospital stabilization?
- Soft cervical collar
- Rigid cervical collar and backboard (Correct answer)
- Manual inline stabilization only
- Halo brace
Correct answer: Rigid cervical collar and backboard
A rigid cervical collar combined with spinal backboard immobilization provides the best initial stabilization for suspected cervical spine injury in the prehospital setting.
Question 5: A 6-year-old with known peanut allergy develops urticaria, throat tightness, and hypotension after eating at a restaurant. What is the FIRST priority intervention?
- Administer diphenhydramine IV
- Administer intramuscular epinephrine (0.01 mg/kg) (Correct answer)
- Establish IV access and give normal saline bolus
- Apply oxygen via non-rebreather mask
Correct answer: Administer intramuscular epinephrine (0.01 mg/kg)
Epinephrine IM is the first and most critical intervention in anaphylaxis, as it reverses bronchospasm, vasodilation, and urticaria.
Question 6: During triage, a 9-month-old presents with a bulging anterior fontanelle, high-pitched cry, and petechial rash. What is the nurse's most urgent concern?
- Benign intracranial hypertension
- Bacterial meningitis with possible septicemia (Correct answer)
- Roseola infantum
- Vitamin K deficiency bleeding
Correct answer: Bacterial meningitis with possible septicemia
A bulging fontanelle, high-pitched cry, and petechial rash are classic signs of bacterial meningitis and meningococcemia, which require immediate antibiotics.
Question 7: A 4-year-old is brought in after a witnessed seizure lasting 8 minutes that stopped spontaneously. The child is now post-ictal. Which diagnostic test is the highest priority?
- Urgent EEG
- Blood glucose measurement (Correct answer)
- CT scan of the head
- Lumbar puncture
Correct answer: Blood glucose measurement
Hypoglycemia is a rapidly reversible and life-threatening cause of seizures that must be identified and corrected immediately with a bedside glucose check.
CPEN Exam 4
A 5-year-old is found unresponsive.
The nurse confirms no pulse and begins CPR.
What is the correct compression-to-ventilation ratio for a single rescuer?