CPN Certified Pediatric Nurse Practice Questions
Prepare for CPN with more than an answer.
- Exam fee
- $399 USD
- Level
- Professional
- Valid for
- 5 years
Domains covered on the exam 4
- Requirements and Systems Engineering20%
- Python Programming Fundamentals40%
- Network Device Management25%
- Network Monitoring and Analysis15%
- 1
A 6-year-old child with a history of poorly controlled persistent asthma is brought to the emergency department in acute respiratory distress following a viral upper respiratory infection. On initial assessment, the child is sitting upright in a tripod position, speaking in single words, and exhibiting suprasternal and intercostal retractions. Vital signs are: temperature 37.4°C (99.3°F), heart rate 148/min, respiratory rate 48/min, blood pressure 106/68 mmHg, pulse oximetry (SpO2) 90% on room air, and end-tidal carbon dioxide (ETCO2) 29 mmHg. High-pitched expiratory and inspiratory wheezes are audible throughout all lung fields.
The emergency department team initiates continuous nebulized albuterol (ProAir), ipratropium bromide (Atrovent), supplemental oxygen via non-rebreather mask, and intravenous methylprednisolone (Solu-Medrol) 2 mg/kg. A peripheral intravenous line is secured and continuous cardiopulmonary and capnography monitoring are maintained.
Forty-five minutes later, the pediatric nurse reassesses the child and notes that the child is now lying slumped in bed, appears drowsy and slow to arouse to voice, and has shallow chest wall movement. Repeat vital signs show: heart rate 166/min, respiratory rate 20/min, SpO2 93% on supplemental oxygen, and ETCO2 rising from 29 mmHg to 56 mmHg. Auscultation of the chest reveals an absence of audible wheezing with severely diminished air entry bilaterally. How should the pediatric nurse interpret these serial physiologic trends?
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Correct answer: B
In early status asthmaticus, tachypnea causes hyperventilation and hypocapnia (low ETCO2 of 29 mmHg). As bronchospasm, mucosal edema, and mucus plugging worsen, airflow becomes so restricted that wheezing is no longer generated ('silent chest') and the child's respiratory muscles fatigue, causing the respiratory rate to drop. The rapid rise in ETCO2 to 56 mmHg (hypercapnia) alongside lethargy and severe tachycardia signals decompensated respiratory failure and impending arrest, even when supplemental oxygen masks hypoxemia by maintaining an SpO2 of 93%.
- 2
A 10-year-old child is being monitored on the pediatric neurosurgical unit following a closed head injury from a skateboarding collision. Over a 2-hour period, the nurse documents the physiologic progression shown in the diagram below, along with a newly dilated right pupil (5 mm, sluggish) compared to the left pupil (3 mm, brisk). Which pathophysiologic state do these trends represent?
flowchart LR subgraph Baseline["12:00 Assessment"] B1["HR: 98/min BP: 104/66 mmHg (Pulse Pressure 38) RR: 20/min, regular Alert, oriented"] end subgraph OneHr["13:00 Assessment"] O1["HR: 80/min BP: 118/64 mmHg (Pulse Pressure 54) RR: 16/min Headache, irritable"] end subgraph TwoHr["14:00 Assessment"] T1["HR: 54/min BP: 144/52 mmHg (Pulse Pressure 92) RR: 10/min, Cheyne-Stokes Obtunded, right pupil 5 mm sluggish"] end Baseline --> OneHr --> TwoHrShow answer details
Correct answer: D
The progression from irritability and headache (early signs of increased intracranial pressure) to obtundation, ipsilateral pupillary dilation (cranial nerve III compression), and Cushing triad—characterized by widening pulse pressure (systolic hypertension of 144/52 mmHg), reflex bradycardia (54/min), and irregular Cheyne-Stokes respirations—is a late, life-threatening sign of exhausted intracranial compliance and impending brainstem/uncal herniation. In contrast, neurogenic shock presents with hypotension combined with bradycardia.
- 3
An 11-month-old infant is admitted to the emergency department with a 2-day history of profuse watery diarrhea and fever. On physical examination, the infant is lethargic, has a sunken anterior fontanelle, heart rate of 190/min, respiratory rate of 46/min, blood pressure of 84/56 mmHg, cool mottled extremities, a central-to-peripheral capillary refill time of 4 seconds, and weak peripheral pulses. Which interpretation of the infant's physiological status is most accurate?
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Correct answer: D
Pediatric patients have robust vascular tone and cardiac rate reserve, enabling them to maintain a normal blood pressure in the presence of losing up to 25% to 30% of their intravascular blood volume. Marked tachycardia (190/min), delayed capillary refill (4 seconds), cool mottled skin, weak peripheral pulses, and lethargy with a preserved systolic blood pressure (84/56 mmHg) define compensated hypovolemic shock. Hypotension is a late, pre-arrest sign of decompensated shock in infants and children.
- 4
During a routine well-child visit at an outpatient pediatric clinic, the parents of a 9-year-old biological female express concern after noticing unilateral breast bud development and ask when she will experience her maximum height spurt and first menstrual period. Which anticipatory guidance from the certified pediatric nurse is most accurate?
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Correct answer: C
In biological females, normal puberty begins between ages 8 and 13 years, most commonly presenting with thelarche (breast bud development), which can initially be unilateral and slightly tender. Peak height velocity (the maximum linear growth spurt) occurs during Tanner stages II to III, approximately 6 to 12 months prior to menarche. Menarche typically occurs 2 to 2.5 years after the onset of thelarche, after which linear growth slows significantly due to epiphyseal plate closure.
- 5
While receiving anticipatory guidance at a 9-month health supervision visit, a mother reports that her previously easygoing infant now cries intensely whenever she leaves the room or when a familiar relative arrives to babysit. Which strategy should the pediatric nurse recommend to support healthy infant-caregiver bonding and emotional development during this stage?
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Correct answer: D
Stranger anxiety and separation protest peak between 8 and 12 months of age as the infant develops object permanence (understanding that people and objects continue to exist when out of sight) and secure attachment to primary caregivers. Playing peek-a-boo reinforces that the caregiver reliably returns after disappearing, while brief, honest, and predictable goodbye routines build trust. Sneaking away undermines trust and heightens hypervigilance in the infant.
- 6
When providing anticipatory guidance on expected gross motor milestones for an infant with a chronological age of 10 months who was born at 28 weeks' gestation, the certified pediatric nurse evaluates developmental progression and tailors parental expectations using a corrected age of _____.
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Correct answer: A
For preterm infants born prior to 37 weeks' gestation, growth parameters and developmental milestones are evaluated using corrected gestational age until 24 months of chronological age. Corrected age is calculated by subtracting the number of weeks born prematurely from 40 weeks' full-term gestation (40 weeks - 28 weeks = 12 weeks, or 3 months) from the infant's chronological age (10 months - 3 months = 7 months). Therefore, anticipatory guidance should focus on 7-month developmental milestones such as sitting unsupported and transferring objects from hand to hand.
