Free CPEN Basic Exam Question and Answers — Questions and Answers
Question 1: An abdominal mass that can be felt in the right lower quadrant is present in a 17-year-old cystic fibrosis patient who frequently experiences constipation and complains of weight loss, abdominal cramps, pain, and distension. The patient is vulnerable to:
- irritable bowel syndrome
- distal intestinal obstruction syndrome (Correct answer)
- volvulus
- short bowel syndrome
Correct answer: distal intestinal obstruction syndrome
A 17-year-old cystic fibrosis patient with a history of constipation, weight loss, abdominal cramps, pain, distension, and a palpable abdominal mass in the right lower quadrant is highly susceptible to distal intestinal obstruction syndrome (DIOS). DIOS is a common complication in cystic fibrosis, caused by thick, inspissated (dried and hardened) fecal material obstructing the ileocecum. This can often mimic appendicitis or intussusception.
Question 2: A teen who was inebriated tried to pick up a rattlesnake and got bitten on the wrist. The first course of action ought to be to:
- elevate the limb above the heart
- immobilize the limb and keep it below the heart (Correct answer)
- cleanse the wound with alcohol
- apply a tourniquet above the wound
Correct answer: immobilize the limb and keep it below the heart
For a rattlesnake bite, the limb should be immobilized and kept below the heart to slow the spread of venom through the lymphatic system and bloodstream. Elevating the limb or applying a tourniquet can increase venom absorption or cause tissue damage, respectively. Cleansing with alcohol is not the primary first course of action for venom management.
Question 3: A 20-day-old male child who has poor eating, bile vomiting, and signs of abdominal pain, but whose abdomen is not swollen, has recently passed small amounts of liquid stool. A small abdominal mass is palpable, the stool guaiac tests positive for blood, and the double bubble sign is shown on the radiograph. What diagnosis do these results imply?
- Fecal impaction with overflow diarrhea
- Renal calculus with ileus
- Gastroenteritis
- Malrotation defect with volvulus (Correct answer)
Correct answer: Malrotation defect with volvulus
The combination of bile vomiting, abdominal pain, a palpable mass, positive guaiac stool, and the 'double bubble sign' on a radiograph in a neonate is highly indicative of a malrotation defect with volvulus. This condition involves abnormal intestinal rotation leading to twisting of the bowel, which obstructs the intestine and compromises blood supply, causing the described symptoms and characteristic radiographic finding.
Question 4: An ankle sprain occurs while a 16-year-old is playing basketball (grade II, inversion injury). Which type of therapy is the MOST likely?
- Surgical repair
- Analgesia only
- RICE therapy (rest, ice, compress, and elevate) (Correct answer)
- Cast application
Correct answer: RICE therapy (rest, ice, compress, and elevate)
RICE therapy (Rest, Ice, Compression, and Elevation) is the standard initial treatment for most acute musculoskeletal injuries, including a Grade II ankle sprain. This approach helps to reduce pain, swelling, and inflammation, promoting healing. Surgical repair is typically reserved for severe sprains or chronic instability, while analgesia alone doesn't address the physical injury, and a cast is usually for more severe injuries like fractures or Grade III sprains.
Question 5: A 3-year-old child has several bruises on her arms, legs, and face that range in color from purple to yellow-green to brown, as well as a spiral fracture of the shaft of her right humerus. The toddler reportedly fell off a swing set the day before while playing, according to the mother. The best suitable course of action is:
- ask the child what happened
- contact the local child protective services agency (Correct answer)
- tell the mother that you suspect child abuse
- caution the mother to supervise the child during play
Correct answer: contact the local child protective services agency
The presence of multiple bruises in various stages of healing (purple to yellow-green to brown) and a spiral fracture of the humerus, especially when inconsistent with the reported mechanism of injury (falling off a swing set), are strong indicators of potential child abuse. Healthcare professionals have a legal and ethical obligation to report suspected child abuse to the local child protective services agency to ensure the child's safety.
Question 6: In cases of supratentorial herniation of the brain, in addition to consciousness level, the following three functions are evaluated to determine the progression of the syndrome:
- ocular, motor, and respiratory (Correct answer)
- cardiac, ocular, and motor
- motor, cardiac, and hearing
- ocular, cardiac, and respiratory
Correct answer: ocular, motor, and respiratory
In cases of supratentorial herniation, the progression of the syndrome is primarily monitored by evaluating ocular responses (pupil size, reactivity, and eye movements), motor responses (strength, posturing), and respiratory patterns. These three functions, along with the level of consciousness, provide crucial information about the extent of brainstem compression and neurological deterioration.
Question 7: A 2-cm forehead laceration on a 12-year-old is stitched up. When should the kid come back so the stitches can be taken out?
- 10 days
- 14 days
- 2 days
- 5 days (Correct answer)
Correct answer: 5 days
Sutures on the face, like a forehead laceration, are typically removed relatively early to minimize scarring. A timeframe of 5 days is common for facial sutures, as the skin here heals quickly and prolonged suture presence can lead to 'track marks' or 'railroad tracks' along the incision line.
Free CPEN Basic Exam Question and Answers
An abdominal mass that can be felt in the right lower quadrant is present in a 17-year-old cystic fibrosis patient who frequently experiences constipation and complains of weight loss, abdominal cramps, pain, and distension.
The patient is vulnerable to: