CPN Study Questions 1-100 Exam 100 Questions with Verified Answers
A 6-week-old male infant is brought into the ED by his mother. He has a weeklong
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progressively worsening emesis that is projectile in nature. What is his most likely diagnosis?
A. Intussusception.
B. Appendicitis.
C. Pyloric stenosis.
D. Pancreatitis. - CORRECT ANSWER C: Projectile vomiting in a 6 week-old male is the classic presentation for pyloric stenosis,
obstruction of the pyloric sphincter between the gastric pylorus and the small intestine, caused by
hypertrophy and hyperplasia of the circular muscle of the pylorus, which obstructs the sphincter.
An 8-year-old male has contracted chicken pox (varicella virus). With which of the following
family members can the child have contact?
A. 20-year-old aunt on chemotherapy.
B. 35-year-old uncle with HIV.
C. 95-year-old grandfather on long-term steroid therapy.
D. 2-year-old brother who has never had varicella but has had the vaccine - CORRECT ANSWER D: The 2-year-old brother, who has had the vaccine, is likely immune to varicella, so contact
is safe. All of the other relatives have some form of immunosuppression from infection (HIV) or
medications (chemotherapy and steroids) and should avoid contact with the patient
A 5-year-old girl has a fever, headache, and complaints of a stiff neck. The physician suspects
bacterial meningitis. What is the best test culture site to detect the bacteria?
A. Lumbar puncture.
B. Clean catch urine.
C. Blood culture.
D. Nasal swab. - CORRECT ANSWER A: Lumbar puncture is the method of choice for detecting the bacteria causing bacterial
meningitis and sending a sample for culture, as meningitis infects the meninges and bacteria is
present in the cerebrospinal fluid.
A 2-year-old child has severe dental caries in the upper and lower front teeth, posterior aspects.
What is the most likely cause for this type of caries?
A. Lack of fluoridation in the water.
B. Sleeping with water in a nighttime bottle.
C. Low carbohydrate diet.
D. Sleeping with sugared liquid in nighttime bottle - CORRECT ANSWER D: Caries in the posterior front teeth is a sign of sleeping with sugared drinks in the
nighttime bottle (such as juice) because fluid pools in the mouth when the child falls to sleep.
***Which of the following patients will likely need surgical correction of his/her fracture?***
A. 10-year-old with humeral head fracture.
B. 5-year-old with tuft fracture of the distal phalanx.
C. 4-year-old with tuft fracture of the toe.
D. 16-year-old with radial head fracture. - CORRECT ANSWER A: Humeral head fractures usually need open reduction and internal fixation to maintain
proper future functioning. Distal phalanx and toe fractures are treated with splints and fracture of
the radial head with a sling.
An infant with a chronic respiratory condition should be offered all of the following vaccines
EXCEPT:
A. Hepatitis A.
B. Hepatitis B.
C. Hepatitis C.
D. Influenza. - CORRECT ANSWER C: A vaccine for Hepatitis C does not currently exist. Hepatitis A, hepatitis B and influenza
vaccines are all recommended for the infant
A 14-year-old boy with leukemia is receiving an IV infusion of packed red blood cells. The client
reports that he is feeling anxious and short of breath even though his respiratory rate is 24.
What should the nurse do in this situation?
A. Give a dose of ibuprofen (Motrin).
B. Give a dose of acetaminophen (Tylenol).
C. Give a dose of diphenhydramine (Benadryl).
D. Stop infusion and notify physician. - CORRECT ANSWER D: Anxiety and the sensation of breathlessness are signs of possible anaphylactic shock, a
reaction to the packed red blood cells, so the nurse should stop the infusion immediately and notify
the physician.
As part of counseling for a 7-year-old child with mild persistent asthma, the nurse tells the
client's family that the most reliable indicator of worsening asthma is:
A. Coughing.
B. Fever.
C. Decreased peak flow.
D. Fatigue. - CORRECT ANSWER C: A decreased peak flow is the most reliable indicator that asthma may be worsening. It is
therefore vital that the client's family know what the baseline is so that any deviation can be quickly
addressed. Coughing and fever may trigger asthma, so peak flows should be monitored. Fatigue
may result from poor oxygenation but alone it is not a reliable indicator of worsening asthma.
***A patient is experiencing dizziness, shortness of breath, lightheadedness, and nausea caused by
encephalitis. Which of the following descriptions most accurately describes the patient's
condition?***
A. metabolic acidosis
B. respiratory alkalosis
C. metabolic alkalosis
D. respiratory acidosis - CORRECT ANSWER B: Respiratory alkalosis results from hyperventilation, during which extra CO2 is excreted,
causing a decrease in carbonic acid (H2CO3) concentration in the plasma. Symptoms include
tachycardia, arrhythmias, lightheadedness, nausea, and vomiting.
10-year-old male with sickle cell disease comes into the ED complaining of pain in his legs due
to a vaso-occlusive crisis. In addition to IV fluids, what is the other initial treatment for this
client?
A. Elevate legs.
B. Ace wrap to legs.
C. Nitroglycerine paste.
D. Pain medication. - CORRECT ANSWER D: In addition to IV fluids, the other primary initial treatment for sickle cell crisis resulting
in vascular occlusion is pain medication because pain is often severe. Other treatments include
oxygen, hydroxyurea (anti-sickling medication), blood transfusions if anemia is pronounced, and
antibiotics if the crisis was triggered by an infection.
14-year-old male with renal failure is given an arteriovenous fistula (shunt) for future dialysis.
How does the nurse assess the shunt post-operatively for patency?
A. Assess for bruit and thrill.
B. Monitor blood pressure on that arm.
C. Ease of venipuncture at shunt site.
D. Rate of flow during dialysis. - CORRECT ANSWER A: The patency of an AV shunt is assured by assessing for bruit and thrill. Continuous wave
Doppler ultrasound can also assess patency. Venipuncture and blood pressure measurements
should never be done on the arm with an AV shunt.
nurse is admitting a 16-year-old female to the mental health unit with a diagnosis of bulimia
and anorexia. What OTC medications should the client's belongings be screened for as they may
interfere with treatment?
A. Imodium.
B. Acetaminophen (Tylenol).
C. Laxatives.
D. Ibuprofen (Motrin). - CORRECT ANSWER C: People with eating disorders, such as bulimia and anorexia, often use laxatives as well as
diuretics to control weight. New patients should be checked for these items. Bulimics may purge by
vomiting after eating.
10-year-old is accidentally shot in the forearm by a small caliber firearm. The wound enters the
dorsum of the forearm and exits on the ventral side. The patient is ambulatory and has minor
pain at the site. What test is likely needed for evaluation of the injury?
A. Arteriogram.
B. CT of arm.
C. MRI of arm.
D. Ultrasound of arm - CORRECT ANSWER A: An arteriogram is needed to assess the vascular supply in the arm after a gunshot wound
to ensure that no injury to the ulnar and radial artery has occurred.
A 17-year-old female with severe acne wants treatment for her condition. What form of
treatment requires the patient use 2 forms of contraception and sign a consent form?
A. Benzoyl peroxide cream.
B. Tetracycline (Sumycin) pills.
C. Isotretinoin (Accutane) pills.
D. Ultraviolet light treatment. - CORRECT ANSWER C: Accutane is a vitamin A derivative and can lead to severe birth defects if given to
pregnant females. Two forms of contraception and a lengthy consent form are needed. Benzoyl
peroxide and ultraviolet light treatment pose no risks to the fetus. Tetracycline has a low risk
during the first trimester of pregnancy but can cause discoloration of the child's teeth if taken
during the second trimester.
An 8-year-old with suspected appendicitis is evaluated. The physician asks the child to lie on his
left side and extend the hip, eliciting pain in the RLQ. What is this test called?
A. Rovsing's sign.
B. Psoas sign.
C. Kernig's sign.
D. Brudzinski's sign. - CORRECT ANSWER B: The Psoas sign consists of extension of the thigh while lying on the left side and causes
pain with a posterior pointing appendix. Rovsing's sign also assesses for appendicitis and elicits
referred pain in the right lower quadrant with palpation in the left lower quadrant. Kernig's sign
and Brudzinski's sign are used to assess for meningitis.
In order to collect proper blood culture samples, which of the following actions should the
nurse take?
A. Sterilize the antecubital fossa with iodine.
B. Draw sample from femoral site.
C. Cleanse the site with alcohol.
D. Shave collection site. - CORRECT ANSWER A: In order to minimize contaminants, blood cultures are taken from the antecubital fossa
after sterilizing with iodine and wearing sterile gloves. Alcohol cleansing does not sterilize, and
shaving can break the skin, increasing the chance of contamination. Samples are not routinely
drawn from the femoral site.
The child of a celebrity client is admitted to a nursing floor, and the nurse taking care of this
patient notices a medical assistant not involved in the care of the patient looking at her chart.
What would be the most appropriate course of action?
A. Confront medical assistant and make her apologize.
B. Notify nursing supervisor of HIPAA violation.
C. Place chart in locked cabinet.
D. Place chart at end of client's bed. - CORRECT ANSWER B: An unauthorized person's looking at any patient's chart is a clear HIPAA violation and
must be reported to the supervisor in charge so that appropriate disciplinary action can be taken.
A 7-year-old female is newly diagnosed with celiac disease. What is the best choice for a
carbohydrate food source for this patient?
A. Baked potato.
B. Pasta.
C. Bread.
D. Saltine crackers. - CORRECT ANSWER A: Only the potato is a suitable source of carbohydrate for a person with celiac disease.
Celiac disease is an allergic sensitivity to gluten in wheat products. Pasta, bread, and saltine
crackers are all made with flour, which contains gluten.
The parents of a newborn male ask you about the benefits of circumcision. It is appropriate to
inform them that circumcision seems to decrease the risk of transmission of which of the
following sexually transmitted diseases?
A. Human papillomavirus (HPV).
B. Syphilis.
C. HIV.
D. Hepatitis C. - CORRECT ANSWER C: Circumcision has been shown to decrease the rates of transmission of HIV but does not
affect rates of syphilis, HPV, or hepatitis C.
A 15-year-old female is diagnosed with a newly-acquired infectious disease. Which of the
following is NOT a mandatory reportable disease to the health department?
A. TB.
B. Varicella.
C. Syphilis.
D. Rabies. - CORRECT ANSWER B: Varicella (chickenpox) is not a reportable disease, and most children are vaccinated for
varicella; however, the CDC requires reporting of TB, syphilis, and rabies as these are public health
concerns.
Following an exposure to a TB-infected family member, a twelve-year-old male is screened for
TB with a PPD (Mantoux) test. After administration of the test, when should he be brought back
for reading of the result?
A. 24 to 36 hours.
B. 36 to 48 hours.
C. 48 to 72 hours.
D. 72 to 96 hours. - CORRECT ANSWER C: PPD tests should be read 48 to 72 hours after administration. Any sign of induration is
measured. Induration of 15 mm or blistering is a positive finding for general screening, but if the
person has been exposed to someone with active TB, then 10 mm induration is considered positive.
A newborn is scheduled for a chloride sweat test. For which genetic disorder does this test
screen?
A. Muscular dystrophy.
B. Cystic Fibrosis.
C. Trisomy 18.
D. Fragile X. - CORRECT ANSWER B: A chloride sweat test is used in the diagnosis of cystic fibrosis, which affects excretion of
sodium and chloride in the sweat. A child with cystic fibrosis will have up to 5 times the normal
level of sodium and chloride in his sweat.
A teenage female at a school health clinic asks the nurse what she can do to prevent contracting
the human papilloma virus (HPV). All of the following would be considered suitable means of
prevention EXCEPT:
A. Abstinence.
B. Condom use.
C. Gardasil vaccine.
D. Intrauterine devices. - CORRECT ANSWER D: IUD's offer no protection for HPV and only provide birth control. Abstinence, condom
use, and Gardasil vaccine, recommended for girls/women ages 9 to 26, all provide protection
against HPV.
Which of the following children has a fracture most likely caused by abuse?
A. 6-month-old with a spiral fracture of the femur.
B. 5-year-old with a wrist fracture.
C. 8-year-old with a clavicle fracture.
D. 15-year-old with an avulsion fracture of the ankle. - CORRECT ANSWER A: Spiral fractures in children are considered due to abuse until proven otherwise. These
fractures result from a twisting force that the child would not be able to perform on her own.
Which of the following conditions increases the risk of testicular cancer?
A. Undescended testes.
B. Umbilical hernia.
C. Inguinal hernia.
D. Hiatal hernia. - CORRECT ANSWER A: An undescended testis increases the risk of testicular cancer in adulthood in the affected
testis as well as the contralateral testis. Hernias are unrelated to incidence of testicular cancer.
A 2-year-old client with a corneal abrasion needs to be examined. What is the best
positioning for this client?
A. Restrained on papoose board.
B. Restrained by parent on gurney.
C. Under sedation in an operative room.
D. Held on a parent's lap - CORRECT ANSWER D: Difficult examinations should be initially attempted while the child is sitting on a parent's
lap. This will allow examination while under the calming care of the parent. Restraints are
psychologically traumatic and should be used as a last resort only. Sedation in the operating room is
not necessary
Following a diagnosis of cystic fibrosis in their infant child, the parents should be educated in all
of the following EXCEPT:
A. Genetic counseling.
B. Sign language.
C. Home chest percussions.
D. Dietary modifications. - CORRECT ANSWER B: CF is not directly associated with deafness, so education in sign language is not indicated
although repeated treatment with antibiotics (aminoglycosides) can cause sensorineural hearing
deficit. Cystic fibrosis is an autosomal recessive disease and the parents should receive genetic
counseling about the risk of the disease in future offspring. CF has both pulmonary and pancreatic
manifestations so chest percussions and dietary modifications would be appropriate.
Which of the following medications has been linked to the development of Reye's syndrome
when given to febrile children?
A. Acetaminophen (Tylenol).
B. Naprosyn (Aleve).
C. Aspirin.
D. Ibuprofen (Motrin). - CORRECT ANSWER C: Use of aspirin in febrile children has been linked to the development of Reye's syndrome,
a severe respiratory condition. Therefore, aspirin is not recommended for use in children. Fever in
children is usually treated with acetaminophen or ibuprofen.
A newborn with jaundice is treated with outpatient ultraviolet light therapy. What blood test is
tested to ensure that the jaundice is clearing?
A. Bilirubin.
B. CBC.
C. AST.
D. Amylase. - CORRECT ANSWER A: Jaundice is caused by an elevation of bilirubin, which is monitored to ensure treatment
success. As red blood cells break down, bilirubin forms and is excreted through the liver, but the
infant's liver may be immature and unable to remove bilirubin fast enough, so bilirubin levels in the
blood rise. Ultraviolet light helps to break down bilirubin.
A 2-month-old male is being evaluated for gastroesophageal reflux. What is the best test to
confirm this diagnosis?
A. CT scan.
B. Barium enema.
C. Upper GI barium series
D. Night-time Ph probe - CORRECT ANSWER D: A nighttime Ph probe requires a special monitoring device be inserted through the nose
and down the esophagus to assess for acid reflux into the esophagus, confirming the diagnosis.
A 16-year-old female is undergoing an evaluation for possible juvenile rheumatoid arthritis.
What lab test serves as a marker for general inflammation?
A. Monospot.
B. Erythrocyte sedimentation rate.
C. White blood count (WBC).
D. Mean corpuscular volume (MCV) - CORRECT ANSWER B:The erythrocyte sedimentation rate is a non-specific marker for inflammation and would
be elevated with rheumatoid arthritis. Monospot tests for the Epstein-Barr virus, which causes
mononucleosis. WBC tests for infection, and MCV assesses the average volume of red blood cells.
A 7-year-old female is evaluated for possible leukemia. She is scheduled for a bone marrow
biopsy the next morning. What part of the body should be listed on the consent form for the
biopsy?
A. Radius.
B. Skull.
C. Posterior pelvis.
D. Calcaneus (heel). - CORRECT ANSWER C: The posterior superior pelvic area is the preferred choice for bone marrow biopsy site
because it is a large flat bone. The skull is too thin and the radius and calcaneus too small.
While performing trauma resuscitation on a 5-year-old male, neither peripheral nor central IV
access can be obtained. The physician orders an intraosseous line. What is the best site on the
body for this line?
A. Radius.
B. Proximal anterior tibia.
C. Skull.
D. Medial malleolus. - CORRECT ANSWER B: An intraosseous line is inserted into the proximal anterior tibia in infants and children to
5 years old for rapid infusion of fluids and medications if another IV site is not accessible. The
medial malleolus is used for older children and adults. Other possible sites include the distal femur,
clavicle, humerus, and ileum.
A 5-year-old is diagnosed with probable "Fifth's disease" caused by Parvovirus B19 although
she does not yet have a rash. Which of the following should the child avoid?
A. Contact sports.
B. Tylenol.
C. Pregnant women.
D. Spicy food - CORRECT ANSWER C: Parvovirus B19 can cause birth defects if contracted by a pregnant mother, so the child
should be counseled to avoid anyone pregnant until the disease resolves. Parvovirus B19 is
contagious in the time from onset until the bright red rash occurs on the cheeks and a lacy rash on
the body. Once the rash appears, the child is probably no longer contagious and can resume normal
contacts and activity
A 13-year-old female is diagnosed with Clostridium difficile colitis. What is the most probable
cause of this infection?
A. Recent antibiotic use.
B. Travel to Central America.
C. Drinking from a stream.
D. Eating undercooked pork - CORRECT ANSWER A: The most common cause for C. difficile colitis is recent antibiotic use that disrupts the
normal colonic flora, allowing overgrowth of the offending bacteria. C. difficile produces a lethal
cytotoxin (Toxin B) and an endotoxin with cytotoxic action (Toxin A), which cause fluid to
accumulate in the colon and severe damage to mucous membranes.
A 14-year-old male is suspected of having infectious mononucleosis. What Point of Care Testing
(POCT) device can be used to confirm this diagnosis?
A. Urine dip.
B. Monospot.
C. Rapid strep test.
D. Rapid influenza test - CORRECT ANSWER B: A Monospot test for Epstein-Barr virus is used to confirm infectious mononucleosis. The
test requires one drop of serum mixed with a special solution. The test can confirm mononucleosis
between 2 and 9 weeks after infection. It is not accurate during the incubation period.
A 12-year-old female immigrant from the Philippines has a positive PPD (Mantoux) skin test.
What vaccine given routinely in her native country can cause false positive PPD tests?
A. Varicella.
B. Yellow fever.
C. Influenza.
D. BCG. - CORRECT ANSWER D: BCG (Bacille Calmette-Guérin) is a tuberculosis vaccine routinely administered to
children in countries with high incidences of childhood tuberculous meningitis. PPD can show false
positive although PPD may still be used. QuantiFERON-TB®-TB Gold test is not affected by prior
BCG vaccination
Which of the following congenital hernias is more commonly seen in African-American
children?
A. Umbilical hernia.
B. Inguinal hernia.
C. Hiatal hernia.
D. Femoral hernia. - CORRECT ANSWER A: Umbilical hernias are more common in African-American children. They usually resolve
with growth of the child by age 4 and do not require surgical correction
A 13-year-old female has the development of breast buds and sparse long, downy pubic hair.
What Tanner stage does this development suggest?
A. Tanner 1.
B. Tanner 2.
C. Tanner 3.
D. Tanner 4. - CORRECT ANSWER B: Breast buds and sparse downy pubic hair are characteristics of Tanner stage 2. Tanner's
5 stages assess maturity of both males and females based on direct observation of breasts and
genitals. Females are evaluated on breast development, onset of menses, and pubic hair
distribution. Males are evaluation on penis and testes development and pubic hair distribution
Apocrine sweat glands develop during onset of puberty. In which part of the body are these
glands most commonly located?
A. Scalp.
B. Feet.
C. Hands.
D. Axilla - CORRECT ANSWER D: Apocrine sweat glands develop with the increase in hormones during the onset of
puberty and are located primarily in the axilla and pubic area, opening into hair follicles. These
sweat glands cause body odor.
A 16-year-old male has hearing loss at the 4000-Hertz range on audiogram. What is the most
common cause for such a hearing deficit?
A. Cerumen in the ear canal.
B. Prolonged exposure to noises over 100 decibels.
C. Medulla oblongata tumor.
D. Ruptured tympanic membrane. - CORRECT ANSWER B: Prolonged exposure to loud noises (music, power tools, firearms) can lead to high
frequency hearing loss at the 4000-Hertz level, making it hard for the child to hear high-pitched
voices and certain sounds, such as consonants. Digital hearing aids may be programmed to
compensate for high frequency hearing loss
Which of the following would NOT be considered a pediatric patient at high risk for
dehydration?
A. 4-year-old male with 30% body surface area burn.
B. 7-year-old female with diabetic ketoacidosis
C. 12-year-old male with hyperventilation due to anxiety
D. 8-year-old male with cellulitis in the right arm. - CORRECT ANSWER D: Cellulitis, a bacterial skin infection, is not associated with dehydration. Burns, diabetic
ketoacidosis, and hyperventilation may all contribute to dehydration in children.
A 15-year-old female is evaluated for an intentional overdose of aspirin. The excessive ingestion
of this medication puts the patient at risk for what acid-base disorder?
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis. - CORRECT ANSWER A: The ingestion of aspirin (salicylic acid) puts the patient at risk for a metabolic acidosis
due to the acidic medication. Symptoms include drowsiness, confusion, headache, decreased blood
pressure, flushed skin, nausea, vomiting, diarrhea and tachypnea.
Symptoms consistent with a diagnosis of dehydration in children would include all of the
following EXCEPT:
A. Thirst.
B. Bradycardia.
C. Dry mucous membranes.
D. Depressed fontanelles. - CORRECT ANSWER B: Tachycardia, not bradycardia, is a common sign of dehydration in pediatric patients.
Children with dehydration typically are thirsty and have dry mucous membranes, reduced skin
turgor, and depressed fontanelles (in infants).
A 6-year-old female with dehydration due to vomiting is evaluated with a complete blood count
(CBC). What lab finding is expected?
A. Decreased mean corpuscular (cell) volume (MCV).
B. Increased MCV.
C. Increased hematocrit.
D. Normal red cell distribution width (RDW). - CORRECT ANSWER C: Due to volume loss, the hematocrit will be elevated as red blood cells become more
concentrated in the blood. The MCV test shows the average size of the red blood cells and helps to
determine the type of anemia while RDW shows the variations in cell size, important for some types
of anemia (such as pernicious anemia).
What is the leading cause of death in children in developing countries?
A. Accidental trauma.
B. TB.
C. AIDS.
D. Infectious diarrhea. - CORRECT ANSWER D: Infectious diarrhea remains the leading cause of death in developing countries.
Outbreaks of diarrhea are common in areas with poor sanitation that allows food and water to
become contaminated with bacteria, such as E. coli or Shigella.
What is the most common cause of viral (non-bacterial) diarrhea in pediatric patients?
A. Rotavirus.
B. Parainfluenza.
C. Influenza.
D. Parvovirus B19. - CORRECT ANSWER A: Rotavirus is the most common cause for viral diarrhea in children and may be
accompanied by nausea and vomiting that lead to severe dehydration. Parainfluenza, influenza, and
parvovirus B19 cause mainly upper respiratory illnesses. [Show Less]