Practice · 90 free items
Free CPEN Practice Questions: a 90-Question Practice Test on BCEN's Blueprint
Ninety free CPEN practice questions, four options each, weighted to BCEN's six domains, with the reasoning under every card and no sign-up. Read the four answers first, rule out with the ✕, narrow to two, then pick.
90items
in the browser, no sign-up
9sets
of ten
6domains
BCEN's outline
30each
Recognize · Reason · Discriminate
This is a practice test, not the exam: 90 items written to BCEN's published CPEN content outline, cut into 9 sets of ten, with 34 of the 90 in System-Focused Emergencies because that domain carries 56 of the 150 scored items on the real form. Every option has a second control. The ✕ strikes an option out without committing you to an answer; a click on the option text commits. Use them in that order.
When two options survive your rule-outs, the worksheet under the card names both survivors and frames the reasoning as the difference between them, which is the only comparison left that matters. Filters sit in the bar above the sheet: one domain, one level, or the whole bank. The method is spelled out under the sheet; the numbers on the real exam are on the home page.
Set 1 of 9 · questions 1–10 of 90 · 0 of 10 answered · read the four answers first, then the stem.
- Q1System-Focused EmergenciesRecognize
A child with a forearm fracture returns 4 hours after casting with increased pain, swelling, and dusky fingers. What is the most likely cause?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q2System-Focused EmergenciesRecognize
A child is diagnosed with acute ischemic stroke at a community hospital. What is the appropriate disposition?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q3System-Focused EmergenciesRecognize
Following the unsuccessful resuscitation of a preschooler, the family is escorted to a private room. Which nursing intervention best supports the family's immediate grieving process?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q4System-Focused EmergenciesRecognize
A child arrives actively seizing with audible secretions and cyanosis. What is the first priority intervention?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q5System-Focused EmergenciesRecognize
A 14-year-old hospitalized for a vaso-occlusive crisis has chest pain but normal oxygen saturation. Which intervention best reduces the risk of acute chest syndrome?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q6System-Focused EmergenciesRecognize
A 4-week-old presents with projectile nonbilious vomiting immediately after feeding and appears hungry. A firm, mobile mass is palpable in the epigastrium. These findings suggest:
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q7System-Focused EmergenciesRecognize
An 8-kg infant requires synchronized cardioversion for supraventricular tachycardia. The available defibrillator pads overlap when placed on the anterior chest. Which placement is appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q8System-Focused EmergenciesRecognize
Why are central venous catheters or large-bore cannulas preferred over small peripheral lines for the administration of 50% dextrose or calcium chloride?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q9System-Focused EmergenciesRecognize
An infant presents with generalized seizures and altered mental status. Which concurrent assessment is essential to identify a reversible cause?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q10System-Focused EmergenciesRecognize
A child is being discharged after stabilization of an anterior nosebleed. Which instruction should be included in the discharge education to prevent recurrence?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q11System-Focused EmergenciesRecognize
A child struck by a car presents with severe respiratory distress, hypotension, and absent breath sounds on the right. Which intervention should be performed immediately, prior to any diagnostic imaging?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q12System-Focused EmergenciesRecognize
A child presents with acute hemiparesis. Which diagnostic study should be performed first to guide immediate management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q13System-Focused EmergenciesReason
A 9-year-old arrives 20 minutes after avulsing a permanent central incisor. If immediate reimplantation is not possible, which storage medium preserves periodontal ligament viability best?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q14System-Focused EmergenciesReason
A 3-year-old swallowed a "shiny coin" 2 hours ago. Which radiographic series is required to rule out high-risk button battery ingestion?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q15System-Focused EmergenciesReason
A 5-year-old sustained facial trauma resulting in a fractured incisor. The tooth fragment cannot be located in the mouth or at the scene. Which diagnostic study is indicated?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q16System-Focused EmergenciesReason
A 6-year-old child requires incision and drainage of a large, painful abscess on the buttock. Which approach provides the most appropriate pain management for this procedure?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q17System-Focused EmergenciesReason
A child presents following direct blunt trauma to the eye. Which assessment finding mandates immediate cessation of the ocular examination and placement of a rigid shield?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q18System-Focused EmergenciesReason
A team is preparing for synchronized cardioversion of an unstable pediatric patient. After ensuring airway patency and vascular access, which action is the immediate priority?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q19System-Focused EmergenciesReason
An adolescent presents with epistaxis that has not resolved with anterior packing. Blood is visualized pooling in the posterior oropharynx. What is the indicated management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q20System-Focused EmergenciesReason
A pediatric trauma patient presents with tachycardia, hypotension, and absent breath sounds on the left side. The trachea is midline. Based on these findings, the nurse should suspect:
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q21System-Focused EmergenciesReason
A child with acute renal failure presents with a potassium level of 8.2 mEq/L and peaked T-waves on the ECG. Which medication should be administered immediately to protect the myocardium?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q22System-Focused EmergenciesReason
A 6-year-old with status asthmaticus remains in severe distress despite continuous albuterol, ipratropium, and IV steroids. Which medication is the appropriate next step?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q23System-Focused EmergenciesReason
A child with tumor lysis syndrome has a calcium level of 6.8 mg/dL but no seizures, tetany, or arrhythmias. Which management strategy is appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q24System-Focused EmergenciesDiscriminate
A 2-year-old presents with new-onset lethargy. The parents report the child had episodes of crying earlier in the day but is now quiet and sleepy. Vital signs are stable. Which diagnostic test is most appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q25System-Focused EmergenciesDiscriminate
A patient with a forearm fracture exhibits severe pain with passive stretch and paresthesias. A compartment pressure reading is 28 mmHg. Which action is most appropriate based on these findings?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q26System-Focused EmergenciesDiscriminate
A 5-year-old ingested a small magnet and a metal washer 30 minutes ago. Radiographs show both objects in the stomach appearing to touch. What is the indicated management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q27System-Focused EmergenciesDiscriminate
A toddler swallowed a button battery 5 hours ago. The object is lodged in the esophagus. Following endoscopic removal, which diagnostic study is indicated due to the delayed presentation?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q28System-Focused EmergenciesDiscriminate
A child taking a new anticonvulsant develops fever, a targetoid rash, and erosions on the lips and conjunctiva. Which disposition is most appropriate for this patient?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q29System-Focused EmergenciesDiscriminate
A hypotensive child with severe traumatic brain injury requires intracranial pressure management. Which agent is most appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q30System-Focused EmergenciesDiscriminate
A 5-year-old oncology patient with fever and neutropenia has poor perfusion. Peripheral access attempts are unsuccessful. Which intervention is the priority within the first 60 minutes?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q31System-Focused EmergenciesDiscriminate
A 3 kg neonate presents with symptomatic hypoglycemia. Using a dose of 0.25 g/kg, what volume of D10W (10% dextrose) should be administered?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q32System-Focused EmergenciesDiscriminate
An adolescent female presents with severe, intermittent pelvic pain. Ultrasound shows an enlarged ovary with peripheral follicles but preserved Doppler flow. What is the indicated management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q33System-Focused EmergenciesDiscriminate
To effectively treat status epilepticus while minimizing respiratory depression risk, how should benzodiazepines be administered?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q34System-Focused EmergenciesDiscriminate
Which febrile neutropenic patient is considered the safest candidate for discharge and outpatient antibiotic management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q35AssessmentRecognize
A 2-week-old infant is brought in for poor feeding. Vital signs show a rectal temperature of 35.8°C (96.4°F), heart rate 180, and respiratory rate 65. Which condition must be ruled out immediately?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q36AssessmentRecognize
A 2-year-old is discharged after evaluation for a minor injury. The nurse notes the child does not use words but physical exam is otherwise normal. What is the most appropriate discharge plan?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q37AssessmentRecognize
A 15-year-old female presents with abdominal pain. Her parents are at the bedside and answering all questions. How should the nurse obtain the psychosocial history?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q38AssessmentRecognize
Which patient finding indicates a respiratory rate that requires immediate further assessment for pathology?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q39AssessmentRecognize
A crying 2-year-old has a heart rate of 140 beats/min, respiratory rate of 30 breaths/min, and warm skin. No work of breathing is noted. How should these findings be interpreted?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q40AssessmentReason
To achieve optimal anesthesia depth for a lumbar puncture, what is the minimum recommended application time for EMLA cream?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q41AssessmentReason
A mother brings her 3-year-old with cerebral palsy to triage. Vitals appear stable, but she insists, "This is not my child's baseline behavior." What is the priority nursing action?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q42AssessmentReason
The nurse considers applying EMLA cream to a large, fresh abrasion. Why is this application generally contraindicated?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q43AssessmentReason
A child dependent on a home ventilator arrives via EMS for evaluation of fever. The child is alert with stable vital signs and oxygen saturation of 98%. What is the safest initial action regarding the ventilator?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q44AssessmentReason
A 6-year-old with sickle cell pain rated pain as 8/10 on the FACES scale. At reassessment, the nurse uses the Numeric Rating Scale. What is the primary error in this approach?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q45AssessmentDiscriminate
A 2-year-old presents with fever. The child is sitting quietly, makes no eye contact, and does not reach for the caregiver's phone. How should the nurse interpret this appearance finding?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q46AssessmentDiscriminate
A 7-year-old patient can count and rank objects by size but struggles with abstract spatial concepts. Which pain scale is most appropriate for this cognitive level?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q47AssessmentDiscriminate
A ventilator-dependent child is being transferred to a tertiary center. In addition to the transfer summary, which documentation is essential to ensure patient safety during transport?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q48AssessmentDiscriminate
A 10-year-old opioid-naive child presents with a femur fracture and requires IV morphine. Which prescribing principle is most appropriate to ensure safety and prevent respiratory depression?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q49AssessmentDiscriminate
A 6-year-old presents with a respiratory rate of 50 breaths/minute but no retractions or stridor. The lungs are clear. Which underlying pathology is the most likely cause of this physiologic compensation?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q50Special ConsiderationsRecognize
A 7-year-old child discloses abuse during triage. Which method of documentation is legally required to preserve the integrity of the child's statement?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q51Special ConsiderationsRecognize
A family presents with headache and nausea. Carboxyhemoglobin levels are 15% and symptoms resolve with oxygen. Prior to discharge, which action is required to ensure patient safety?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q52Special ConsiderationsRecognize
A nurse audits restraint documentation. Which reason for continued restraint is legally insufficient?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q53Special ConsiderationsRecognize
A football player collapses during summer practice. He is confused and hot to the touch. Which finding most specifically differentiates heat stroke from heat exhaustion?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q54Special ConsiderationsRecognize
A low-risk patient is being discharged after a suicide attempt. Which discharge plan component best ensures safety continuity?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q55Special ConsiderationsReason
A 10-day-old infant presents to triage. Which subtle clinical finding is most specific for neonatal sepsis compared to localized infections or benign conditions?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q56Special ConsiderationsReason
A newborn treated for suspected sepsis has negative blood cultures at 48 hours and remains clinically asymptomatic. What is the appropriate next step in management?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q57Special ConsiderationsReason
An adolescent treated with naloxone for heroin overdose is alert and requesting discharge after 45 minutes. Why is discharge contraindicated?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q58Special ConsiderationsReason
During the resuscitation of a pediatric gunshot victim, clothing is removed for exposure. Which action is essential to maintain the chain of custody for this evidence?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q59Special ConsiderationsReason
A toddler is brought to the ED 45 minutes after ingesting a large quantity of liquid acetaminophen. He is asymptomatic. When is the earliest the serum acetaminophen level should be drawn?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q60Special ConsiderationsDiscriminate
An agitated 17-year-old with acute psychosis refuses blood work. The patient lacks decision-making capacity and has a potentially reversible medical cause. Which action is correct?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q61Special ConsiderationsDiscriminate
A 4-year-old stung by a scorpion presents with thrashing, drooling, roving eye movements, and tachycardia. Oxygen saturation is 98%. Which pharmacologic intervention addresses the underlying pathology?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q62Special ConsiderationsDiscriminate
A child presents with agitation, tachycardia, and hypertension. Which physical finding distinguishes a sympathomimetic toxidrome from an anticholinergic toxidrome?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q63Special ConsiderationsDiscriminate
A term newborn is apneic with heart rate 85 bpm after drying and stimulation. Maternal fever and prolonged rupture of membranes are reported. Which immediate sequence of actions is most appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q64Special ConsiderationsDiscriminate
An adolescent has a paroxysmal cough confirmed as pertussis. A newborn sibling lives at home. Which intervention is indicated for the sibling?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q65Triage ProcessRecognize
An unidentified toddler is brought to the emergency department during a chaotic surge. Which documentation element is most critical to record immediately upon arrival?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q66Triage ProcessRecognize
An agitated adolescent presents to triage brandishing a knife and shouting. What is the immediate priority for the triage nurse?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q67Triage ProcessRecognize
To reduce medication dosing errors during a high-stress pediatric surge event, which tool should be immediately available in the treatment zone?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q68Triage ProcessRecognize
A toddler presents with blue lips and audible gasping. The nurse begins asking the caregiver about allergies. This action represents which error in the assessment process?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q69Triage ProcessReason
A 10-day-old infant presents with poor muscle tone and weak cry. Vital signs are within normal limits. What is the most appropriate triage disposition?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q70Triage ProcessReason
A child presents with a bat bite. Wound care is complete. Which medication administration is the priority?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q71Triage ProcessReason
A child arrives with dry chemical powder on the torso and complaints of severe eye burning. Which intervention is the immediate priority for preventing permanent disability?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q72Triage ProcessReason
During a pediatric mass casualty incident, the nurse triages four victims using the JumpSTART algorithm. Which assessment finding necessitates the highest priority for immediate transport?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q73Triage ProcessDiscriminate
An infant undergoes decontamination for chemical exposure. To prevent rapid physiological deterioration from cold stress, which action should the nurse prioritize immediately after rinsing?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q74Triage ProcessDiscriminate
A 6-year-old with a deformed forearm sits quietly looking at the floor. The heart rate is 130 bpm. Which triage assessment is most appropriate regarding pain?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q75Triage ProcessDiscriminate
An adolescent screens positive for suicidal ideation but attempts to leave the emergency department before medical evaluation. Which action fulfills the nurse's legal and safety obligations?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q76Triage ProcessDiscriminate
A child with lesions consistent with varicella is identified in a crowded waiting room and moved to an airborne infection isolation room. What is the next priority action?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q77Multi-System ConsiderationsRecognize
A child in decompensated septic shock has just had intraosseous access established. Which intervention is the immediate next priority in the first hour of care?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q78Multi-System ConsiderationsRecognize
A child presents with isolated urticaria on the trunk after antibiotic ingestion. Vital signs are normal, and no other organ systems are involved. Which management is appropriate?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q79Multi-System ConsiderationsReason
A 6-year-old is receiving deep sedation with ketamine for a forearm fracture reduction. To meet safety standards, at what interval must the nurse document vital signs and respiratory status on the time-based record?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q80Multi-System ConsiderationsReason
A febrile child with suspected peritonitis and signs of shock is awaiting an abdominal CT scan. Which action prioritizes patient safety?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q81Multi-System ConsiderationsDiscriminate
A nurse prepares to discharge a child after a nonfatal submersion. Which documented finding legally validates the safety of this decision and minimizes liability risk?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q82Multi-System ConsiderationsDiscriminate
A 10 kg infant with septic shock receives 40 mL/kg of fluid. Reassessment reveals a new hepatomegaly and audible rales. Which intervention is indicated immediately?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q83Multi-System ConsiderationsDiscriminate
A child in septic shock presents with cool extremities, weak pulses, and delayed capillary refill despite fluid resuscitation. Which vasoactive agent is appropriate for this hemodynamic profile?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q84Professional IssuesRecognize
A technology-dependent child is being discharged. The caregiver states they are comfortable utilizing the home ventilator. Which action is the most reliable method to verify the caregiver's competency prior to discharge?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q85Professional IssuesRecognize
A 3-year-old has multiple bruises in various healing stages. The skeletal survey is pending. When does the legal duty to report suspected abuse to authorities begin?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q86Professional IssuesReason
A nurse collects clothing from a pediatric assault victim. Law enforcement is delayed. Where must the evidence be stored to maintain chain of custody?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q87Professional IssuesReason
After counseling a caregiver on scald prevention for a toddler, the nurse validates learning. Which caregiver statement indicates effective teaching regarding home safety?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q88Professional IssuesReason
A child with complex congenital heart disease is discharged after a fever workup. Which nursing action best ensures effective care coordination with the medical home?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q89Professional IssuesDiscriminate
A nurse is preparing to discharge a child requiring a home nebulizer. Which social determinant of health identified during the assessment represents the most immediate safety risk for this discharge?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
- Q90Professional IssuesDiscriminate
A nurse identifies a suspicious pattern of bruising on a 3-year-old during triage. The family is cooperative and denies trauma. Which immediate action fulfills the nurse’s primary legal and professional obligation?
Worksheet · 4 in play
Rule out with ✕ (or X on the keyboard) until two survive, then pick — click the option or press 1–4. The reasoning lands here.
End of set 1.
How to work the sheet
The sheet is built around one habit: options first, stem second, strike before you pick. Run all 9 sets that way once and the habit is yours for the 175-item form.
Read the four answers before the stem
The options tell you what an item is testing before the vignette does. Four interventions means a what-do-you-do-first item; four findings means a which-sign-matters item; four sentences to a parent means a communication item. Then read the stem once, already knowing what you are looking for, instead of reading it twice.
Rule out with the ✕, do not answer yet
Strike anything that fails on its own terms: the option that treats before the airway is handled, the one that waits for imaging a hypotensive child does not have time for, the one that has a sibling interpret for the parent. The worksheet counts down from 4 in play. Nothing is graded until you click an option or press a number.
Narrow to two, then name the differentiator
On a well-built item the two survivors are both reasonable and differ on one axis: earlier versus later, patient versus equipment, verify versus act, the sign that appears first versus the sign that appears last. Say the axis to yourself before you pick. If you cannot name it you are guessing between two, which still beats guessing between four.
Pick, read the worksheet, move on
Click the option or press 1–4 (A–D also works). The worksheet grades the item, lists the options you had ruled out and explains why the survivor holds. It keeps a fixed size, so the sheet never jumps under your hand. Ten cards, then Next set.
Filter, then go again
Start over clears every card. The Domain filter drills one column of the outline; the Level filter splits the bank three ways: Recognize (30 items) asks whether you know the fact, Reason (30) whether you can apply it in a vignette, Discriminate (30) whether you can tell two right-sounding options apart. The third pile is where CPEN candidates lose items they knew.
How to read the reasoning
Every reasoning paragraph does the same two jobs: it says why the keyed option holds, and it says what the closest distractor got wrong. Read it in that order even when you were right. A correct pick made for the wrong reason is an item you will miss when the vignette changes.
When you ruled two options out before answering, the worksheet names the pair you left standing. Compare that pair against the reasoning. If the reasoning separates the same two you did, the method worked and the miss, if there was one, was knowledge. If it separates a different pair, you struck the right answer early, and that is the more useful thing to know about yourself before test day.
A correct answer picked for the wrong reason is a miss you have not had yet.
How this bank is weighted
BCEN publishes the CPEN outline as item counts, 150 scored items across six domains, not as percentages. The 90 items here follow those counts scaled down, by largest remainder: System-Focused Emergencies is 56 of 150 on the form, about 37% by our arithmetic, so it gets 34 of the 90 here; the two lightest domains carry 12 each on the form and 7 each here. The weighting follows BCEN's published counts; the items do not come from BCEN's form, and nothing on this page did.
| Domain | Scored items of 150 | In this bank |
|---|---|---|
| System-Focused Emergencies | 56 | 34 |
| Assessment | 25 | 15 |
| Special Considerations | 25 | 15 |
| Triage Process | 20 | 12 |
| Multi-System Considerations | 12 | 7 |
| Professional Issues | 12 | 7 |
The domain filter follows the same order the sheet does, heaviest domain first, so Set 1 opens on System-Focused Emergencies rather than on triage. If you would rather start where the exam starts, filter to Triage Process and work the 12 items there, then read the triage guide for the outline behind them.
What this practice test is not
Free CPEN practice questions attract claims that do not survive a reading of BCEN's own pages. Five things this page is not, in the order candidates most often assume otherwise:
- Not BCEN's practice exam. BCEN sells its own practice exam and a review course, and gives away a ten-question sample set as a PDF on bcen.org under Study and Prepare. If you want to see BCEN's own item style, that PDF is the place, and it is free.
- Not retired or leaked items. Nobody outside BCEN and PSI has those. These ninety were written to the public outline and its subtopics.
- Not a scaled copy of the form. The domain counts follow BCEN's published numbers; the difficulty mix, the subtopic mix and the wording are ours.
- Not a predictor. A score on this sheet is a score on this sheet. The exam is pass/fail by raw score with a cut BCEN sets and revises; no practice tally converts to it.
- Not affiliated. This site and the app are independent study tools. BCEN endorses no third-party preparation, ours included.
The real exam, in three lines
Three numbers to hold before you treat a set as a rehearsal, all BCEN's as published in September 2026: 175 items, 150 of them scored, in 180 minutes; pass/fail by raw score, with 110 of 150 the passing score BCEN currently publishes and says can change; delivery by PSI inside a 90-day testing window. The full format is on the home page, the 2025 pass counts on the pass-rate page, and the application steps in how to get CPEN certified.
Turning a set into a 180-minute rehearsal
The real form is 175 items in 180 minutes, taken in one sitting, and the sheet is 90 items in sets of ten. The bridge is not a stopwatch; it is the three-round pass. Run three sets back to back, unfiltered, in rounds:
Round one: the items you know
Take a set with no filter. Answer only the cards where the survivor is obvious after the rule-out round. Leave the rest at two in play. On the form, this round clears most of the items and shows you how much clock is left for the rest.
Round two: the items you narrowed to two
Go back to every card sitting at two in play. Name the axis between the survivors and pick. This is where the score is decided, and it is the round the Level filter's Discriminate items were written for. If the axis will not come, pick and move; a coin flip between two costs less than a stall.
Round three: the items you could not touch
Whatever is left at three or four in play gets an answer, not a blank; the score is the number correct, so a wrong pick costs exactly what a blank costs. On the form this pile should be small. On the sheet, it is a list of subtopics to read up on in the study guide.
Practice by domain
Missed a column? The two heaviest live pages walk the outline behind it. The System-Focused Emergencies guide covers the ten systems that make up 56 of 150 scored items; the Triage guide covers the 20 that open the outline. The remaining four domains are in preparation and sit in the study guide as a plan until they publish.
Questions candidates ask about CPEN practice tests
Does a score on this practice test predict a pass?
No. A set here is graded by raw count, the way the exam is, but there is no cut score on the sheet and nothing converts to BCEN's. The exam is pass/fail on 150 scored items against a line BCEN currently publishes as 110 of 150 and says can change; the pass-rate page reads that line and BCEN's 2025 counts properly. Use the sheet for the per-domain miss pattern, not for a prediction.
How are the 90 questions split across the six domains?
34 in System-Focused Emergencies, 15 in Assessment, 15 in Special Considerations, 12 in Triage Process, 7 in Multi-System Considerations and 7 in Professional Issues: BCEN's item counts of 150, scaled to 90 by largest remainder. The Domain filter above the sheet shows one column at a time.
Is 90 questions enough to prepare?
Ninety items are enough to install the method and to show you which domains leak items. They are not a syllabus. Use the per-domain miss pattern to pick what to read in the CPEN study guide, then come back and run the sheet again with the Level filter on Discriminate. The web version and the app carry a larger bank with the same reasoning format.
How should I study for the CPEN exam?
Start from BCEN's outline, not from a textbook index: the six domains and their item counts tell you where the scored items are. Work the heaviest domain first, drill items with the rule-out method, and read reasoning for the items you got right as well as the ones you missed. The study guide is organized in outline order for that reason.
Where can I find free CPEN practice questions?
Here, ninety of them with reasoning, no sign-up. BCEN itself publishes a free ten-question sample PDF on bcen.org under Study and Prepare, written in its own item style; work both. BCEN's full practice exam and review course are paid products.
Is there a PDF of these practice questions?
No. The value of the sheet is the rule-out control and the reasoning that appears against the options you left standing, and a PDF cannot do either. The page works on a phone, needs no account and keeps your progress while the tab is open.
Ninety items is the habit; the full bank is the rehearsal
The web version and the app carry the larger question set with the same rule-out reasoning under every card.