TheoryCPEN Emergency Nurse Prep
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30 free CPEN Emergency Nurse Prep questions
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CPEN Emergency Nurse Prep
A nurse is caring for a child with acute asthma exacerbation. Which assessment finding would prompt the nurse to contact the physician immediately?
Correct — D. Answer: Diminished breath sounds Acute asthma exacerbation can cause symptoms such as wheezing, coughing, and an increased respiratory rate. However, diminished breath sounds may indicate severe airway obstruction or imminent respiratory failure, which is a serious complication and necessitates immediate contact with the physician. Wheezing and coughing are common symptoms of asthma exacerbation but are not immediately life-threatening. -
CPEN Emergency Nurse Prep
Which of the following conditions is NOT commonly associated with an increased risk of developing Reye's syndrome?
Correct — D. Answer: Asthma Reye's syndrome is a rare but serious condition that causes swelling in the liver and brain. It most commonly affects children and teenagers recovering from a viral infection. Although the exact cause is unclear, the relationship between taking aspirin during a viral illness and the development of Reye's syndrome has been well documented. Conditions most associated with an increased risk of Reye's syndrome include the use of aspirin for viral infections such as influenza, chickenpox, or measles. Asthma, however, is not typically linked to an increased risk of Reye's syndrome. -
CPEN Emergency Nurse Prep
Which of the following conditions frequently results in chronic hypoxemia due to airway obstruction and pulmonary hypertension?
Correct — C. Answer: Cystic fibrosis (CF) CF is a genetic disorder that affects the respiratory, digestive, and reproductive systems and is characterized by the production of abnormal mucus. This mucus can obstruct the airways, leading to infections, inflammation, and chronic hypoxemia. Patients with CF often develop pulmonary hypertension due to the increased resistance in the pulmonary vasculature, secondary to chronic airway obstruction and hypoxemia. -
CPEN Emergency Nurse Prep
Which of the following is the MOST likely cause of respiratory failure in a pediatric patient with severe asthma?
Correct — B. Answer: Status asthmaticus Status asthmaticus is a severe, life-threatening asthma attack that is unresponsive to standard treatments like bronchodilators and steroids. This condition can lead to respiratory failure due to severe airway narrowing and increased work of breathing. Bacterial pneumonia can cause respiratory distress but is typically associated with fever and localized lung findings. Viral bronchiolitis often affects infants and usually presents with wheezing and mild to moderate respiratory distress. Foreign body aspiration typically presents with sudden onset of coughing, choking, and possible localized wheezing or stridor. -
CPEN Emergency Nurse Prep
A 5-year-old child with a history of Kawasaki disease is being evaluated for possible complications. Which of the following is a common cardiovascular complication associated with Kawasaki disease?
Correct — A. Answer: Coronary artery aneurysm Kawasaki disease is an inflammatory condition that primarily affects children. A significant cardiovascular complication is coronary artery aneurysm, which can lead to myocardial infarction or ischemia. Early diagnosis and treatment with intravenous immunoglobulin (IVIG) can reduce the risk of coronary artery abnormalities. Kawasaki disease does not typically cause congestive heart failure, pulmonary embolism, or mitral valve prolapse. -
CPEN Emergency Nurse Prep
Which essential medication should be administered to a pediatric patient experiencing an acute asthma exacerbation?
Correct — D. Answer: Albuterol Albuterol, a short-acting beta-agonist, is a critical medication for relieving bronchospasm during an acute asthma exacerbation. It works rapidly to dilate the airways, improving airflow and oxygenation. Oxygen may be necessary if hypoxia is present, but it is not the primary treatment for relieving bronchospasm. Ipratropium can be used as an adjunct to albuterol in severe cases. Epinephrine is generally reserved for severe anaphylaxis and is not first-line therapy for asthma exacerbations. -
CPEN Emergency Nurse Prep
In the context of pediatric patients with cystic fibrosis, surfactant plays several important roles in the respiratory system. All of the following are functions of surfactant, except:
Correct — C. Answer: Vasodilating the pulmonary vasculature Surfactant, while aiding in respiratory functions like reducing surface tension to prevent alveolar collapse and contributing to defense against infections, does not have a vasodilating effect on the pulmonary vasculature. Patients with cystic fibrosis may benefit from surfactant's ability to support lung function, but not in expanding blood vessels. In cystic fibrosis, the thick mucus obstructs the airways, so surfactant can aid in mucociliary clearance but it is not involved in vasodilation. -
CPEN Emergency Nurse Prep
Which of the following diagnostic steps is LEAST appropriate for confirming a diagnosis of respiratory distress in a pediatric patient?
Correct — B. Answer: Blood glucose measurement Respiratory distress in a pediatric patient is characterized by difficulty in breathing, often requiring prompt diagnosis and intervention. The most appropriate diagnostic tests include a chest x-ray to assess the lungs, arterial blood gas (ABG) analysis to evaluate oxygenation and carbon dioxide levels, and pulse oximetry for continuous monitoring of oxygen saturation. Blood glucose measurement is not directly helpful in diagnosing respiratory distress. It may be part of a broader evaluation but does not provide specific information about respiratory function. -
CPEN Emergency Nurse Prep
A pediatric nurse is caring for an infant presenting with bronchiolitis. Which pathogen is the most common cause of this condition?
Correct — A. Answer: Respiratory syncytial virus (RSV) Bronchiolitis is a common respiratory infection in infants, characterized by inflammation of the bronchioles. The primary pathogen responsible for bronchiolitis is the Respiratory syncytial virus (RSV). This virus can cause severe illness, particularly in young infants and those with underlying health conditions. Preventative measures include good hand hygiene and avoiding contact with infected individuals. Vaccination for RSV is typically administered in high-risk infants. Other pathogens like Rhinovirus, Human metapneumovirus, and Parainfluenza virus can also cause bronchiolitis but are less common than RSV. -
CPEN Emergency Nurse Prep
A nurse is caring for a 10-year-old child who has been administered an IV antibiotic for a bacterial infection. The nurse should instruct the child to report which sign(s) and/or symptom(s) immediately?
Correct — D. Answer: Itching, swelling at the injection site Prior to administering an antibiotic, the patient should be instructed to report itching or swelling immediately as these could be indicative of an allergic reaction. Other signs and symptoms of an allergic reaction may include rashes, difficulty breathing, and hives. Sore throat and cough are common signs of a respiratory infection but not specifically related to an allergic reaction. Drowsiness and headache can be side effects of many medications but are not specifically indicative of an allergic reaction to antibiotics. -
CPEN Emergency Nurse Prep
A 7-year-old female presents to the emergency department with a severe headache, photophobia, neck stiffness, and a high fever. The nurse suspects bacterial meningitis and anticipates the doctor will order which of the following tests to diagnose this condition?
Correct — C. Answer: Lumbar puncture A lumbar puncture is recommended as the initial diagnostic test for suspected bacterial meningitis. It allows analysis of the cerebrospinal fluid (CSF), which can confirm the infection and identify the causative organism. A head CT scan is sometimes performed before a lumbar puncture to rule out increased intracranial pressure or to identify contraindications. However, it is not a diagnostic test for meningitis. EEG is used to assess electrical activity in the brain and is generally not indicated for diagnosing meningitis. A chest X-ray is irrelevant in diagnosing meningitis but might be used to identify other concurrent infections or complications. -
CPEN Emergency Nurse Prep
Identify the primary treatment for a chemical burn that minimizes further tissue damage.
Correct — B. Answer: Immediate irrigation with water. Immediate irrigation with water helps to dilute and remove the chemical agent, minimizing further tissue damage. It is the most effective immediate treatment for chemical burns. Applying ice or rubbing alcohol may worsen the injury, and topical antibiotics do not address the initial need to remove the chemical agent. -
CPEN Emergency Nurse Prep
Which cardiovascular medication has a direct effect by slowing the conduction through the atrioventricular (AV) node, allowing greater time for ventricular filling?
Correct — A. Answer: Digoxin Digoxin is a medication that slows conduction through the AV node, increasing the duration for ventricular filling. It is used in various cardiac conditions, including atrial fibrillation and heart failure. Epinephrine increases heart rate and contractility. Atropine blocks parasympathetic pathways, increasing heart rate. Amiodarone is an antiarrhythmic medication with different actions. -
CPEN Emergency Nurse Prep
A 10-year-old boy is brought to the emergency department after a near-drowning incident in cold water. Based on this diagnosis, the nurse prepares to administer which of the following treatments?
Correct — D. Answer: Rewarming with heated oxygen and IV fluids Hypothermia is a common complication of near-drowning in cold water. Rapid rewarming is essential to prevent further physiological complications. Heated, humidified oxygen helps rewarm the respiratory system, and warmed intravenous (IV) fluids help rewarm the core body temperature. Symptoms of hypothermia include shivering, lethargy, and hypotension. Without appropriate rewarming, patients may suffer from arrhythmias and other severe cardiovascular issues. -
CPEN Emergency Nurse Prep
Which phase of an asthma exacerbation is characterized by severe, unmanageable symptoms that do not respond to treatment?
Correct — C. Answer: Status asthmaticus Status asthmaticus is a severe and life-threatening form of asthma characterized by prolonged respiratory distress that does not respond to standard treatments. This condition requires immediate medical intervention to prevent respiratory failure and death. -
CPEN Emergency Nurse Prep
Which of the following electrolyte imbalances is likely to occur in a child with severe dehydration?
Correct — D. Answer: Hypernatremia Hypernatremia occurs in severe dehydration due to the loss of water relative to sodium. Dehydration decreases the volume of extracellular fluid, which in turn increases the sodium concentration. Clinical manifestations include irritability, lethargy, seizures, and decreased level of consciousness. In severe cases, it can lead to brain cell shrinkage and neurological impairment. The treatment involves gradual rehydration over 48-72 hours to avoid the risk of cerebral edema. -
CPEN Emergency Nurse Prep
The amount of airflow into and out of the lungs per minute, called minute ventilation, is crucial for maintaining proper respiratory function. Which of the following factors affect minute ventilation?
Correct — C. Answer: Tidal volume, respiratory rate Minute ventilation is the total volume of air entering or leaving the lungs per minute and is calculated by multiplying the tidal volume (the amount of air moved into or out of the lungs per breath) and the respiratory rate (number of breaths per minute). A proper balance of these two factors is essential for effective gas exchange. -
CPEN Emergency Nurse Prep
Which of the following types of pediatric burn injuries are often treated with skin grafts?
Correct — A. Answer: Types 2 and 3 Pediatric burn injuries are classified into four types: Type Description Treatment Type I Superficial burns with minimal tissue damage Topical treatments; no skin grafting needed Type II Partial-thickness burns with blistering and damage to the epidermis and dermis May require skin grafts if extensive Type III Full-thickness burns with damage to all skin layers and possibly underlying tissues Requires skin grafts Type IV Burns that extend through the skin and into muscle, fat, or bone Extensive surgical interventions including grafts Type II and III injuries may be treated with skin grafts to facilitate healing and restore function. -
CPEN Emergency Nurse Prep
A 6-month-old infant with a severe bacterial infection is receiving antibiotic therapy. During the assessment, the nurse notes that the infant has significantly decreased urine output and alerts the physician. What is the most likely cause of this patient's oliguria?
Correct — B. Answer: Decreased renal perfusion Oliguria in the context of a severe bacterial infection is often caused by decreased renal perfusion due to systemic hypotension or sepsis-related hemodynamic changes. Decreased renal blood flow can impair kidney function, leading to reduced urine output. Increased renal perfusion typically leads to increased urine output. Hyperkalemia and hyponatremia are electrolyte imbalances that can present with different symptoms but are not directly related to decreased urine output in this context. -
CPEN Emergency Nurse Prep
A 7-year-old child presents to the emergency department with a significant fever and a new onset of a heart murmur, heard best at the left sternal border. Upon auscultation, a grade IV diastolic murmur is identified. What characteristic finding would most likely accompany this type of murmur?
Correct — D. Answer: A palpable thrill Diastolic murmurs are heard between S2 and S1 (early, mid, or late) and are caused by blood flowing through narrowed or leaky valves. A grade IV murmur, heard well in all positions using a stethoscope, is accompanied by a palpable thrill. Murmurs are graded from barely audible grade I to grade VI, which can be heard without a stethoscope. A grade V murmur can be heard with the stethoscope partly off the chest. -
CPEN Emergency Nurse Prep
All the following are associated with an increased risk of catheter-associated urinary tract infections (CAUTIs), EXCEPT:
Correct — C. Answer: Early catheter removal CAUTIs are a significant concern in pediatric emergency settings. CAUTI is defined as a urinary tract infection that develops in a patient who had a catheter placed within the last 2 days. The infection cannot be attributable to another source. Consistent and early removal of urinary catheters significantly reduces the risk of CAUTIs. Proper catheter care and early removal when no longer needed is essential to prevent infections. Longer catheter dwell times increase the risk of CAUTIs. Utilizing the bladder for catheter placement without proper sterile technique increases the risk and should be avoided. Catheter insertion sites and tubing need regular monitoring and maintenance to ensure they remain clean and dry. -
CPEN Emergency Nurse Prep
Which of the following medications are primarily used in the initial treatment of status epilepticus in pediatric patients?
Correct — C. Answer: Intravenous benzodiazepines and antiepileptic drugs (AEDs) Status epilepticus is a prolonged seizure or series of seizures without full recovery between them. In children, it is a medical emergency that requires immediate treatment to prevent long-term neurological damage. The first-line treatment for status epilepticus typically includes intravenous benzodiazepines, such as lorazepam or diazepam. These medications act quickly to stop seizures. If seizures persist, intravenous antiepileptic drugs (AEDs) like fosphenytoin or levetiracetam may be used. These treatments aim to stabilize neural activity and prevent further seizures. -
CPEN Emergency Nurse Prep
A pediatric patient is brought to the emergency department after being in a severe motor vehicle accident, exhibiting signs of multiple fractures and internal injuries. What should be the nurse's first priority of care?
Correct — B. Answer: Airway management In trauma cases, the primary assessment follows the "ABCDE" methodology: A: Airway B: Breathing C: Circulation D: Disability E: Expose/Examine Airway and breathing should be assessed and managed first. Basic life-support measures, including providing 100% supplemental oxygen via facemask, should be instituted if necessary. Assessing and ensuring adequate respirations is crucial, with symmetrical and bilateral chest movement and auscultation for breath sounds. After airway, breathing, and circulation have been addressed, other issues such as pain management, neurological status, and stabilizing fractures can be attended to. -
CPEN Emergency Nurse Prep
You are triaging a 5-year-old child who was found unresponsive at home. Initial assessment reveals that the child has pinpoint pupils and is experiencing respiratory depression. Which statement, if made by the parent, demonstrates they understood your explanation about the possible cause of the child’s condition?
Correct — A. Answer: "My child may have ingested opioids, which can cause pinpoint pupils and respiratory depression." Opioid ingestion in children can lead to life-threatening conditions such as respiratory depression and pinpoint pupils. This scenario necessitates immediate medical attention and the administration of an opioid antagonist, such as naloxone, to counteract the effects. Other conditions such as hypoglycemia, seizure disorders, or infections can cause unresponsiveness but do not typically present with pinpoint pupils and respiratory depression. -
CPEN Emergency Nurse Prep
A pediatric nurse would NOT expect to observe bradycardia in which emergent situation?
Correct — B. Answer: Acute dehydration Bradycardia, defined as a slower than normal heart rate, is typically observed in situations that affect the autonomic regulation of the heart. This includes instances like increased intracranial pressure, severe hypothermia, and complete heart block. In the context of acute dehydration, compensatory mechanisms usually result in tachycardia rather than bradycardia. -
CPEN Emergency Nurse Prep
What is the Platelet Antibody Test (PAT) used to detect?
Correct — A. Answer: Immune thrombocytopenic purpura (ITP) The Platelet Antibody Test (PAT) is used to detect antibodies that act against the platelets. This condition, known as immune thrombocytopenic purpura (ITP), occurs when the immune system mistakenly targets and destroys platelets. Platelets are small cell fragments that play a crucial role in blood clotting, and their destruction can lead to excessive bleeding and bruising. The PAT is essential for diagnosing ITP and differentiating it from other causes of thrombocytopenia. Any acute inflammatory response is typically identified using markers such as the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), which are nonspecific indicators of inflammation. IgM-positive antibodies in maternal and newborn blood are often investigated using other specific tests aimed at identifying maternal-fetal blood incompatibility. Histocompatibility testing identifies HLA antigens, which are crucial for organ transplantation compatibility, rather than platelet antibodies. -
CPEN Emergency Nurse Prep
How should the progression of physical recovery following a pediatric injury be described?
Correct — B. Answer: Variable and individualized Physical recovery in children following an injury is highly variable and depends on multiple factors including the severity of the injury, the child's overall health, and the availability of supportive care. Just like the process of grief, recovery is subjective and unique to each child. Stages of healing can overlap and one child's progress may differ greatly from another's. -
CPEN Emergency Nurse Prep
Which patient is the FLACC Pain Scale most appropriate for in a pediatric emergency setting?
Correct — D. The FLACC (face, legs, activity, cry, and consolability) Pain Scale is most appropriate for preverbal or nonverbal patients who cannot self-report their pain intensity. This includes infants and toddlers with developmental delays or cognitive impairments. It is not suitable for children who can communicate their pain or newborns who require different pain assessment scales like N-PASS or CRIES. -
CPEN Emergency Nurse Prep
Bradycardia is indicative of which type of pediatric shock?
Correct — A. Answer: Hypovolemic shock Bradycardia is a symptom of hypovolemic shock in pediatric patients. Other symptoms include hypotension, altered mental status, tachypnea, delayed capillary refill, and cool, clammy skin. Septic shock often presents with tachycardia and fever. Cardiogenic shock can present with hypotension, poor perfusion, and pulmonary edema. Anaphylactic shock is characterized by hypotension, tachycardia, and multiple organ dysfunction due to severe allergic reactions. -
CPEN Emergency Nurse Prep
Which of the following interventions BEST enhances rapid assessment skills for a nursing team in a pediatric emergency department?
Correct — C. Regular simulation scenarios with debriefing sessions allow the nursing team to practice rapid assessment and decision-making in a controlled environment. This method enhances learning through immersive experiences and reflective practices. Debriefing sessions help identify strengths and areas for improvement, leading to enhanced competence and confidence.
CPEN Emergency Nurse Prep sample questions
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CPEN Emergency Nurse Prep A pediatric patient is brought to the emergency department after being in a severe motor vehicle accident, exhibiting signs of multiple fractures and internal injuries. What should be the nurse's first priority of care?
A. Stabilizing fractures
B. Airway management ✓
C. Pain management
D. Assessing neurological status
Correct — B. Answer: Airway management In trauma cases, the primary assessment follows the "ABCDE" methodology: A: Airway B: Breathing C: Circulation D: Disability E: Expose/Examine Airway and breathing should be assessed and managed first. Basic life-support measures, including providing 100% supplemental oxygen via facemask, should be instituted if necessary. Assessing and ensuring adequate respirations is crucial, with symmetrical and bilateral chest movement and auscultation for breath sounds. After airway, breathing, and circulation have been addressed, other issues such as pain management, neurological status, and stabilizing fractures can be attended to.
CPEN Emergency Nurse Prep You are triaging a 5-year-old child who was found unresponsive at home. Initial assessment reveals that the child has pinpoint pupils and is experiencing respiratory depression. Which statement, if made by the parent, demonstrates they understood your explanation about the possible cause of the child’s condition?
A. "My child may have ingested opioids, which can cause pinpoint pupils and respiratory depression." ✓
B. "My child has a low blood sugar level, which is causing the unresponsiveness and pinpoint pupils."
C. "The unresponsiveness and pinpoint pupils are signs of a seizures disorder."
D. "My child may have an infection leading to these symptoms."
Correct — A. Answer: "My child may have ingested opioids, which can cause pinpoint pupils and respiratory depression." Opioid ingestion in children can lead to life-threatening conditions such as respiratory depression and pinpoint pupils. This scenario necessitates immediate medical attention and the administration of an opioid antagonist, such as naloxone, to counteract the effects. Other conditions such as hypoglycemia, seizure disorders, or infections can cause unresponsiveness but do not typically present with pinpoint pupils and respiratory depression.
CPEN Emergency Nurse Prep A pediatric nurse would NOT expect to observe bradycardia in which emergent situation?
A. Complete heart block
B. Acute dehydration ✓
C. Increased intracranial pressure
D. Severe hypothermia
Correct — B. Answer: Acute dehydration Bradycardia, defined as a slower than normal heart rate, is typically observed in situations that affect the autonomic regulation of the heart. This includes instances like increased intracranial pressure, severe hypothermia, and complete heart block. In the context of acute dehydration, compensatory mechanisms usually result in tachycardia rather than bradycardia.
CPEN Emergency Nurse Prep What is the Platelet Antibody Test (PAT) used to detect?
A. Immune thrombocytopenic purpura (ITP) ✓
B. Any acute inflammatory response
C. IgM-positive antibodies in maternal and newborn blood
D. Human leukocyte (HLA) antigens
Correct — A. Answer: Immune thrombocytopenic purpura (ITP) The Platelet Antibody Test (PAT) is used to detect antibodies that act against the platelets. This condition, known as immune thrombocytopenic purpura (ITP), occurs when the immune system mistakenly targets and destroys platelets. Platelets are small cell fragments that play a crucial role in blood clotting, and their destruction can lead to excessive bleeding and bruising. The PAT is essential for diagnosing ITP and differentiating it from other causes of thrombocytopenia. Any acute inflammatory response is typically identified using markers such as the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), which are nonspecific indicators of inflammation. IgM-positive antibodies in maternal and newborn blood are often investigated using other specific tests aimed at identifying maternal-fetal blood incompatibility. Histocompatibility testing identifies HLA antigens, which are crucial for organ transplantation compatibility, rather than platelet antibodies.
CPEN Emergency Nurse Prep How should the progression of physical recovery following a pediatric injury be described?
A. Linear and fixed
B. Variable and individualized ✓
C. Predictable and uniform
D. Consistent and rapid
Correct — B. Answer: Variable and individualized Physical recovery in children following an injury is highly variable and depends on multiple factors including the severity of the injury, the child's overall health, and the availability of supportive care. Just like the process of grief, recovery is subjective and unique to each child. Stages of healing can overlap and one child's progress may differ greatly from another's.
CPEN Emergency Nurse Prep Which patient is the FLACC Pain Scale most appropriate for in a pediatric emergency setting?
A. A preschool-aged child who is interactive
B. A 7-year-old child who can self-report pain
C. A 2-day-old neonate
D. A toddler with a developmental delay ✓
Correct — D. The FLACC (face, legs, activity, cry, and consolability) Pain Scale is most appropriate for preverbal or nonverbal patients who cannot self-report their pain intensity. This includes infants and toddlers with developmental delays or cognitive impairments. It is not suitable for children who can communicate their pain or newborns who require different pain assessment scales like N-PASS or CRIES.
CPEN Emergency Nurse Prep Bradycardia is indicative of which type of pediatric shock?
A. Hypovolemic shock ✓
B. Septic shock
C. Cardiogenic shock
D. Anaphylactic shock
Correct — A. Answer: Hypovolemic shock Bradycardia is a symptom of hypovolemic shock in pediatric patients. Other symptoms include hypotension, altered mental status, tachypnea, delayed capillary refill, and cool, clammy skin. Septic shock often presents with tachycardia and fever. Cardiogenic shock can present with hypotension, poor perfusion, and pulmonary edema. Anaphylactic shock is characterized by hypotension, tachycardia, and multiple organ dysfunction due to severe allergic reactions.
CPEN Emergency Nurse Prep Which of the following interventions BEST enhances rapid assessment skills for a nursing team in a pediatric emergency department?
A. Offer optional lunchtime educational lectures
B. Create a list of online assessment training resources
C. Implement regular simulation scenarios with debriefing sessions ✓
D. Distribute quick-reference flashcards
Correct — C. Regular simulation scenarios with debriefing sessions allow the nursing team to practice rapid assessment and decision-making in a controlled environment. This method enhances learning through immersive experiences and reflective practices. Debriefing sessions help identify strengths and areas for improvement, leading to enhanced competence and confidence.
About the CPEN Emergency Nurse Prep test
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You will be tested on
- Safe and effective care environment
- Health promotion and maintenance
- Psychosocial and physiological integrity
- Pharmacology, infection control and patient safety
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Topics in this question bank
Safe and effective care environment
Health promotion and maintenance
Psychosocial and physiological integrity
Pharmacology, infection control and patient safety
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