CPEN Pediatric Assessment 2 — Questions and Answers
Question 1: When assessing a 2-year-old using the Pediatric Assessment Triangle (PAT), which component evaluates the child's skin color and circulation?
- Appearance
- Work of breathing
- Circulation to skin (Correct answer)
- Mental status
Correct answer: Circulation to skin
The PAT's Circulation to Skin component evaluates skin color, mottling, pallor, and cyanosis to indicate perfusion status.
Question 2: A 6-year-old presents with a heart rate of 140 bpm, respiratory rate of 28, capillary refill of 3 seconds, and altered mental status. This constellation BEST describes which pediatric emergency state?
- Compensated shock
- Decompensated shock (Correct answer)
- Respiratory failure
- Hypertensive crisis
Correct answer: Decompensated shock
Decompensated shock is present when altered mental status accompanies tachycardia, tachypnea, and prolonged capillary refill, indicating failing compensatory mechanisms.
Question 3: Which pain assessment tool is MOST appropriate for a 4-year-old child who can understand simple instructions but cannot verbalize a numeric score?
- Numeric Rating Scale (NRS)
- FLACC scale
- Wong-Baker FACES scale (Correct answer)
- CPOT scale
Correct answer: Wong-Baker FACES scale
The Wong-Baker FACES scale is validated for children ages 3 and older who can point to a face representing their pain but cannot use numeric scales.
Question 4: In a 9-month-old infant, the anterior fontanelle is bulging and tense at rest. This finding is MOST consistent with which condition?
- Dehydration
- Increased intracranial pressure (Correct answer)
- Normal variant for age
- Hypothyroidism
Correct answer: Increased intracranial pressure
A bulging, tense anterior fontanelle at rest in an infant suggests elevated intracranial pressure requiring urgent evaluation.
Question 5: When measuring blood pressure in a pediatric patient, which cuff size principle is MOST important for accuracy?
- Cuff bladder should cover 50% of arm circumference
- Cuff bladder width should be 40% of mid-arm circumference (Correct answer)
- Cuff bladder should cover the entire upper arm
- Use the largest cuff that fits on the arm
Correct answer: Cuff bladder width should be 40% of mid-arm circumference
The cuff bladder width should be approximately 40% of mid-arm circumference to ensure accurate blood pressure readings in children.
Question 6: A 3-year-old is brought in after a seizure. During assessment, you note horizontal nystagmus and ataxia. Which ingestion should be HIGHEST on your differential?
- Acetaminophen
- Iron tablets
- Ethanol or benzodiazepines (Correct answer)
- Aspirin
Correct answer: Ethanol or benzodiazepines
Nystagmus and ataxia are classic signs of CNS depressant ingestion such as ethanol or benzodiazepines in the pediatric patient.
Question 7: Which assessment finding in a neonate (0–28 days) requires the MOST immediate intervention?
- Respiratory rate of 45 breaths/min
- Central cyanosis with respiratory rate of 70 breaths/min (Correct answer)
- Heart rate of 140 bpm
- Mild acrocyanosis of the hands
Correct answer: Central cyanosis with respiratory rate of 70 breaths/min
Central cyanosis with tachypnea (RR >60) in a neonate indicates significant cardiorespiratory compromise requiring immediate intervention.
CPEN Pediatric Assessment 2
When assessing a 2-year-old using the Pediatric Assessment Triangle (PAT), which component evaluates the child's skin color and circulation?