CPEN Emergency Nurse Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q1A nurse is caring for a child with acute asthma exacerbation. Which assessment finding would prompt the nurse to contact the physician immediately?
✓ Correct answer: D. Diminished breath sounds
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.
Q2Which of the following conditions is NOT commonly associated with an increased risk of developing Reye's syndrome?
✓ Correct answer: D. Asthma
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.
Q3Which of the following conditions frequently results in chronic hypoxemia due to airway obstruction and pulmonary hypertension?
✓ Correct answer: C. Cystic fibrosis (CF)
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.
Q4Which of the following is the MOST likely cause of respiratory failure in a pediatric patient with severe asthma?
✓ Correct answer: B. Status asthmaticus
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.
Q5A 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 answer: A. Coronary artery aneurysm
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.
Q6Which essential medication should be administered to a pediatric patient experiencing an acute asthma exacerbation?
✓ Correct answer: D. Albuterol
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.
Q7In 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 answer: C. Vasodilating the pulmonary vasculature
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.
Q8Which of the following diagnostic steps is LEAST appropriate for confirming a diagnosis of respiratory distress in a pediatric patient?
✓ Correct answer: B. Blood glucose measurement
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.
Q9A pediatric nurse is caring for an infant presenting with bronchiolitis. Which pathogen is the most common cause of this condition?
✓ Correct answer: A. Respiratory syncytial virus (RSV)
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.
Q10A 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 answer: D. Itching, swelling at the injection site
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.
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