CPEN Exam 5

Question 1

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?

Accepted Answer

Notify the provider for urgent surgical consultation

Answer

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.

Question 2

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?

Accepted Answer

Cold water submersion may be protective; do not declare death until normothermic

Answer

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.

Question 3

A nurse is performing a pain assessment on a 2-year-old after a laceration repair. Which validated pain scale is most appropriate?

Accepted Answer

FLACC Scale

Answer

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.

Question 4

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?

Accepted Answer

1:1:1 PRBCs to FFP to platelets

Answer

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.

Question 5

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?

Accepted Answer

Ensure adequate fluid resuscitation is initiated

Answer

Fluid resuscitation must begin before insulin in DKA because insulin shifts potassium into cells and fluids help correct hypovolemia and dilute glucose.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Exam 5