Free CPEN Procedures Practice Questions with Answers

Length-based resuscitation tapes (e.g., Broselow) are the preferred method in emergencies when an actual weight cannot be obtained. While parental estimation is often accurate, length-based tapes provide standardized dosing and equipment sizing. BCEN Tip: If a scale is available, actual weight is ALWAYS the gold standard. Distractor: Do not use age-based formulas if a length-based tape is available, as age-based formulas are statistically less accurate than length-based methods.

Displacement (D) or Equipment (E) (Disconnection). A sudden drop to near-zero EtCO2 with a pulse indicates a total loss of ventilation. Check for circuit disconnection first (E), then tube dislodgement (D). If the tube is in and the circuit is attached, suspect a total Obstruction (O). BCEN emphasizes EtCO2 as the fastest objective tool to differentiate DOPE components.

The Dundee technique involves making multiple small-gauge needle punctures (e.g., with a 21G or 26G needle) into the edematous foreskin to allow the serous fluid to escape under manual compression. This reduces the volume of the edematous tissue, facilitating reduction. Clinical Pearl: This is typically reserved for cases where simple manual compression and osmotic agents have failed but before moving to a surgical dorsal slit.

For dirty wounds in a patient with unknown or incomplete history (<3 doses of tetanus toxoid), both Tetanus Toxoid (DTaP/Tdap) and Tetanus Immune Globulin (TIG) are required. If the child had ≥3 doses, only the vaccine is needed if the last dose was >5 years ago. BCEN Strategy: Memorize the CDC Tetanus table; unknown or uncertain history is always treated as an unprotected status for dirty/puncture wounds.

The chain of custody must document: 1) Date/time of transfer, 2) Full name/signature of the person releasing the evidence, 3) Full name/signature of the person receiving it, and 4) Purpose of the transfer. Each item must be individually bagged in paper (not plastic) to prevent DNA degradation. Exam Tip: BCEN often tests the paper vs. plastic distinction and the fact that any break in the signature chain renders the evidence inadmissible in court. Never leave evidence unattended in an unlocked area.