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.
Q11A 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 answer: C. Lumbar puncture
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.
Q12Identify the primary treatment for a chemical burn that minimizes further tissue damage.
✓ Correct answer: B. Immediate irrigation with water
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.
Q13Which cardiovascular medication has a direct effect by slowing the conduction through the atrioventricular (AV) node, allowing greater time for ventricular filling?
✓ Correct answer: A. Digoxin
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.
Q14A 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 answer: D. Rewarming with heated oxygen and IV fluids
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.
Q15Which phase of an asthma exacerbation is characterized by severe, unmanageable symptoms that do not respond to treatment?
✓ Correct answer: C. Status asthmaticus
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.
Q16Which of the following electrolyte imbalances is likely to occur in a child with severe dehydration?
✓ Correct answer: D. Hypernatremia
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.
Q17The 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 answer: C. Tidal volume, respiratory rate
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.
Q18Which of the following types of pediatric burn injuries are often treated with skin grafts?
✓ Correct answer: A. Types 2 and 3
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.
Q19A 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 answer: B. Decreased renal perfusion
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.
Q20A 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 answer: D. A palpable thrill
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.
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