A child arrives with suspected measles. Which type of isolation precaution does this call for?MedlinePlus Medical Encyclopedia, "Isolation precautions", Transmission-based Precautions. Outline: CPEN Examination Content Outline (effective August 2023), 1.A.4 Isolation concerns.
A child splashed with a household chemical arrives still in soaked clothes. What comes first?MedlinePlus Medical Encyclopedia, "Chemical burn or reaction", First Aid. Outline: CPEN Examination Content Outline (effective August 2023), 1.B.1 Decontamination.
A mother speaks only Spanish, and her bilingual 10-year-old offers to translate at triage. What should the nurse do?Agency for Healthcare Research and Quality, Health Literacy Universal Precautions Toolkit, Tool 9: Address Language Differences. Outline: CPEN Examination Content Outline (effective August 2023), 1.A.7 Cultural and language considerations.
In the JumpSTART system for pediatric mass casualty triage, a child is still not breathing after the airway is opened but has a pulse. What is done next?Wikipedia, "JumpSTART triage", Step 2: Is the patient breathing?. Outline: CPEN Examination Content Outline (effective August 2023), 1.B.2 Mass casualty.
On a five-level emergency triage scale based on acuity and resources, which level is the most urgent?Wikipedia, "Emergency Severity Index", Algorithm. Outline: CPEN Examination Content Outline (effective August 2023), 1.A.2 Triage priority based on acuity and resources.
Which three things does the Pediatric Assessment Triangle have the nurse judge from across the room?Wikipedia, "Pediatric assessment triangle", Components of the Triangle. Outline: CPEN Examination Content Outline (effective August 2023), 1.A.1 Visual assessment / Pediatric Assessment Triangle.
Show all 46 questions (40 more)
Assessment 8
A 3-week-old newborn has a rectal temperature of 101 F (38.3 C) and looks well. How should the fever be treated at triage?MedlinePlus Medical Encyclopedia, "When your baby or infant has a fever". Outline: CPEN Examination Content Outline (effective August 2023), 2.A.1 Primary and secondary survey.
A feverish, irritable infant has a soft spot that is tense and bulging when the infant is calm and upright. What does this suggest?MedlinePlus Medical Encyclopedia, "Fontanelles - bulging". Outline: CPEN Examination Content Outline (effective August 2023), 2.A.1 Primary and secondary survey.
A mother worries that her 1-year-old walks only when one hand is held and says just two words besides momma and papa. How does this compare with a typical 12-month-old?MedlinePlus Medical Encyclopedia, "Developmental milestones record - 12 months". Outline: CPEN Examination Content Outline (effective August 2023), 2.A.2 Developmental milestones.
At triage a 5-month-old who has taken almost no feeds since yesterday has a soft spot that dips inward. Which cause does this point to?MedlinePlus Medical Encyclopedia, "Fontanelles - sunken", Causes. Outline: CPEN Examination Content Outline (effective August 2023), 2.A.1 Primary and secondary survey.
From what age can the faces pain scale, a row of cartoon faces, generally be used?Wikipedia, "Wong-Baker Faces Pain Rating Scale". Outline: CPEN Examination Content Outline (effective August 2023), 2.B.1 Developmentally appropriate pain assessment.
In the primary survey of an injured child, what is assessed first?Wikipedia, "Advanced trauma life support", Primary survey. Outline: CPEN Examination Content Outline (effective August 2023), 2.A.1 Primary and secondary survey.
What is the normal resting heart rate range for an infant aged 1 to 11 months?MedlinePlus Medical Encyclopedia, "Pulse", Normal Results. Outline: CPEN Examination Content Outline (effective August 2023), 2.A.1 Primary and secondary survey.
Which five behaviors does the FLACC scale score in a child who cannot report pain?Wikipedia, "FLACC scale". Outline: CPEN Examination Content Outline (effective August 2023), 2.B.1 Developmentally appropriate pain assessment.
System-focused emergencies 17
A 2-year-old refuses to use one arm after being swung by the hands. The elbow is held slightly bent, with no swelling. What is the likely injury?MedlinePlus Medical Encyclopedia, "Nursemaid's elbow". Outline: CPEN Examination Content Outline (effective August 2023), 3.G.3 Musculoskeletal trauma.
A 4-month-old has wheezing, fast breathing and nasal flaring after a cold. What most often causes bronchiolitis?MedlinePlus Medical Encyclopedia, "Bronchiolitis", Causes. Outline: CPEN Examination Content Outline (effective August 2023), 3.A.4.a Lower airway infections.
A 4-year-old with high fever sits leaning forward, drooling, with noisy breathing. The parent says the child has had no vaccines. Which vaccine has made this illness very uncommon?MedlinePlus Medical Encyclopedia, "Epiglottitis", Causes; Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 3.A.3.a Upper airway infections.
A 5-week-old vomits forcefully after every feeding and is hungry again right away. What is the likely cause?MedlinePlus Medical Encyclopedia, "Pyloric stenosis in infants", Symptoms; Treatment. Outline: CPEN Examination Content Outline (effective August 2023), 3.D.3 Obstructions.
A 9-year-old has been drinking and urinating a great deal and now has vomiting, deep fast breathing and breath that smells fruity. What is the likely problem?MedlinePlus Medical Encyclopedia, "Diabetic ketoacidosis", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 3.J.2 Acquired endocrine disorders.
A 10-year-old arrives with a permanent front tooth knocked out fifteen minutes ago. How should the tooth be kept if it cannot be put back in the socket?MedlinePlus Medical Encyclopedia, "Broken or knocked out tooth", First Aid. Outline: CPEN Examination Content Outline (effective August 2023), 3.F.4 Maxillofacial trauma.
A 13-year-old boy has sudden, severe pain and swelling on one side of the scrotum, with nausea. Why is speed important?MedlinePlus Medical Encyclopedia, "Testicular torsion", Treatment. Outline: CPEN Examination Content Outline (effective August 2023), 3.E.2 Genitourinary emergencies.
A 16-year-old with a missed period has lower abdominal pain on one side and vaginal spotting. Which condition must be ruled out first?MedlinePlus Medical Encyclopedia, "Ectopic pregnancy", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 3.E.3 OB emergencies.
A child has had fever for six days with red eyes, cracked red lips, a rash and swollen hands. Which complication makes early treatment of Kawasaki disease important?MedlinePlus Medical Encyclopedia, "Kawasaki disease", Treatment; Possible Complications. Outline: CPEN Examination Content Outline (effective August 2023), 3.B.1 Cardiovascular infections.
A child with a ventriculoperitoneal shunt has a headache, vomiting and unusual sleepiness. What should be suspected?MedlinePlus Medical Encyclopedia, "Ventriculoperitoneal shunt - discharge", When to Call the Doctor. Outline: CPEN Examination Content Outline (effective August 2023), 3.C.4 Shunt dysfunction.
A child with sickle cell disease arrives with severe pain in the legs and back. What is the usual treatment for a pain crisis?MedlinePlus Medical Encyclopedia, "Sickle cell disease", Treatment. Outline: CPEN Examination Content Outline (effective August 2023), 3.I.1 Hematology.
A feverish, irritable child has a new rash of very small red and purple spots on the legs. Why is this treated as an emergency?MedlinePlus Medical Encyclopedia, "Meningococcemia". Outline: CPEN Examination Content Outline (effective August 2023), 3.H.2 Rash.
A toddler has a barking cough and a harsh sound on breathing in that is worse at night. Which condition is most likely?MedlinePlus Medical Encyclopedia, "Croup", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 3.A.3.a Upper airway infections.
A toddler may have swallowed a button battery. Why is this an emergency?MedlinePlus Medical Encyclopedia, "Dry cell battery poisoning", What to Expect at the Emergency Room. Outline: CPEN Examination Content Outline (effective August 2023), 3.D.1 Gastrointestinal foreign body.
An 8-month-old has bouts of sudden loud crying with the knees pulled up, then passes stool mixed with blood and mucus. Which condition fits?MedlinePlus Medical Encyclopedia, "Intussusception – children", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 3.D.3 Obstructions.
An infant with tetralogy of Fallot turns deep blue while crying. Which position helps?MedlinePlus Medical Encyclopedia, "Tetralogy of Fallot". Outline: CPEN Examination Content Outline (effective August 2023), 3.B.2 Congenital heart defects.
Which statement about a simple febrile seizure is correct?MedlinePlus Medical Encyclopedia, "Febrile seizures". Outline: CPEN Examination Content Outline (effective August 2023), 3.C.5 Seizure.
Special considerations 7
A 4-day-old newborn has a very high bilirubin level. Which treatment should the nurse expect?MedlinePlus Medical Encyclopedia, "Newborn jaundice", Treatment. Outline: CPEN Examination Content Outline (effective August 2023), 4.A.2 Jaundice.
A 15-year-old tells the triage nurse about wanting to die. Which response is correct?MedlinePlus Medical Encyclopedia, "Suicide and suicidal behavior". Outline: CPEN Examination Content Outline (effective August 2023), 4.B.3 Suicidal and homicidal ideations.
A child found in a hot parked car is confused, with a temperature of 105 F (40.6 C). What is the priority?MedlinePlus Medical Encyclopedia, "Heat emergencies", Symptoms; First Aid. Outline: CPEN Examination Content Outline (effective August 2023), 4.D.1 Temperature-related emergencies.
A nurse suspects, but cannot prove, that a child's injuries come from abuse. What do state mandatory reporting laws require?Child Welfare Information Gateway (US Children's Bureau), Mandated Reporting. Outline: CPEN Examination Content Outline (effective August 2023), 4.C Maltreatment Emergencies.
A teenager swallowed a large amount of acetaminophen four hours ago. Which organ is at greatest risk?MedlinePlus Medical Encyclopedia, "Acetaminophen overdose", Outlook (Prognosis). Outline: CPEN Examination Content Outline (effective August 2023), 4.E.1 Ingestion and poisoning.
An infant is lethargic and vomiting, with no bruises. The eye exam shows bleeding behind both eyes. Which cause must be considered?MedlinePlus Medical Encyclopedia, "Shaken baby syndrome", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 4.C.2 Physical neglect/abuse.
An unvaccinated child has fever, cough, runny nose, red eyes and tiny white spots inside the cheeks. Which disease do the spots point to?MedlinePlus Medical Encyclopedia, "Measles", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 4.F.1 Childhood diseases.
Multi-system considerations 4
A child has hives, lip swelling, wheezing and vomiting minutes after eating peanuts. Which medicine is given first?MedlinePlus Medical Encyclopedia, "Anaphylaxis", Treatment. Outline: CPEN Examination Content Outline (effective August 2023), 5.C Anaphylaxis.
A child pulled from a pool is now awake and breathing normally. Why is observation still needed?MedlinePlus Medical Encyclopedia, "Non-fatal drowning". Outline: CPEN Examination Content Outline (effective August 2023), 5.A Submersion injuries.
A child receives conscious sedation for a fracture reduction. Which statement about safe care is correct?MedlinePlus Medical Encyclopedia, "Conscious sedation for surgical procedures". Outline: CPEN Examination Content Outline (effective August 2023), 5.E Procedural sedation.
Which set of findings in a child with an infection suggests septic shock?MedlinePlus Medical Encyclopedia, "Septic shock", Symptoms. Outline: CPEN Examination Content Outline (effective August 2023), 5.B Sepsis.
Professional issues 4
At discharge a parent asks how an infant should ride in the car. Which teaching is correct?MedlinePlus Medical Encyclopedia, "Child safety seats", Rear-facing seats. Outline: CPEN Examination Content Outline (effective August 2023), 6.C.3 Patient safety and injury prevention.
May a hospital give protected health information to the child protection agency when reporting suspected abuse, without the parent's authorization?Code of Federal Regulations, 45 CFR 164.512, Uses and disclosures for which an authorization or opportunity to agree or object is not required, (b)(1)(ii). Outline: CPEN Examination Content Outline (effective August 2023), 6.A.3 Government regulations.
Under EMTALA, what must a Medicare-participating hospital with an emergency department give anyone who asks for emergency care?Centers for Medicare & Medicaid Services, Emergency Medical Treatment & Labor Act (EMTALA). Outline: CPEN Examination Content Outline (effective August 2023), 6.A.3 Government regulations.
Which feature marks a culture of safety in an emergency department?Agency for Healthcare Research and Quality, PSNet, Culture of Safety primer. Outline: CPEN Examination Content Outline (effective August 2023), 6.B.3 Culture of safety.
How this list was compiled: Our own questions, written to the Certified Pediatric Emergency Nurse (CPEN) Examination Content Outline of the Board of Certification for Emergency Nursing, effective August 2023 (https://bcen.org/wp-content/uploads/2026/02/BCEN-CPEN-ECO-2022_FINAL-effective-August-2023_Public.pdf, linked from https://bcen.org/cpen/study-and-prepare/, read 2026-10-14). The bank holds 6, 8, 17, 7, 4 and 4 questions in the outline's six sections, close to the shares of its 20, 25, 56, 25, 12 and 12 scored items. Every fact was read on 2026-10-14 in the public page the question names: the MedlinePlus Medical Encyclopedia of the US National Library of Medicine for 35 questions, six named Wikipedia articles for the triage and pain scales and the trauma survey, AHRQ, CMS, the Code of Federal Regulations and the Child Welfare Information Gateway. Licence: Questions, choices and explanations are original work of this site.
How it works
These free CPEN practice questions follow the content outline for the Certified Pediatric Emergency Nurse exam. They are unofficial, written for this site, and not affiliated with the Board of Certification for Emergency Nursing (BCEN).
Read the full guide
What the CPEN exam covers
The outline effective August 2023, read October 14, 2026, gives 150 scored items: triage 20, assessment 25, system-focused emergencies 56, special considerations 25, multi-system 12 and professional issues 12. The 46 questions here are split 6, 8, 17, 7, 4 and 4.
A CPEN study guide by section
Each explanation names the public page behind the answer: MedlinePlus for clinical facts, federal pages for EMTALA and privacy rules, and Wikipedia for the triage and pain scales.
A timed practice CPEN test
The timed test asks 45 questions in 46 minutes and passes at 33 right, the same share as the real pass mark.
System-focused emergencies are over a third of the CPEN exam: ten body systems, from respiratory to endocrine.
Questions and answers
How many questions are on the CPEN exam?
175 items in 3 hours, by the CPEN pages on bcen.org read October 14, 2026. 150 are scored and 25 are unscored pretest items.
What is a passing score on the CPEN exam?
BCEN says a candidate must answer 110 of the 150 scored items correctly. The score is not curved, and BCEN notes that the passing score can change after each role delineation study.
Is there a CPEN free practice test from BCEN?
BCEN publishes sample questions and has its own practice exam on its learning site. This page is separate and free, and none of its questions comes from BCEN.
What happens if I fail the CPEN exam?
BCEN says a candidate may apply to retake the exam after a 90-day waiting period, with a discounted retest fee for up to one year after the first exam.