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ENPC Exam Questions with
Correct and Verified Answers
117 Out of 122 with Remediation Feedback to the remaining
5. Graded A+
"An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The white blood cell count is elevated and the patient noted to be tachypneic, tachycardic, agitated, and has an increased respiratory effort. At the time of the event, the patient was started on antibiotics with subsequent increasing manifestations instead of improvement. Which of the following would be considered to be definitive treatment for the suspected diagnosis? - Correct answer The definitive treatment would be a bronchoscopy in order to retrieve the suspected foreign body instead of diagnostic tests to locate the foreign body itself." "A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a bag-mask device. Once return of spontaneous circulation has been confirmed, which of the following would be the priority intervention? - Correct answer Establishing a secure airway" "Parents report their 3-year-old child has developed noisy breathing. On assessment, high-pitched wheezes are audible and auscultated on inspiration and expiration. What medication would be appropriate to administer first? - Correct answer initial medication intervention includes an inhaled short-acting beta agonist." "A 6-week-old is brought to the emergency department by the caregivers for poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test the nurse should anticipate? - Correct answer Lumbar puncture" "A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and having vaginal bleeding. The patient is unsure of the gestational age and has not had any prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions. Which of the following is the most appropriate action for the nurse to take at this point? - Correct answer Have the boyfriend leave the room during the pelvic exam." "A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After several attempts, your team has been unsuccessful at establishing vascular access. Of the following, which is the next best option for establishing access quickly? - Correct answer Intraosseous in the patient's medial tibia." "A child with an electrical injury is seen 1 hour post event. Which of the following types of specimen samples would provide visual information regarding a potential complication of this injury? - Correct answer Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine." "Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures appear to be distressed and withdrawn. Which of the following interventions would best ensure a sense of comfort and control for these parents? - Correct answer Providing frequent updates and re-educating them on the care that is being provided" "When taking vital signs on a stable infant, which of the following should be done first? - Correct answer Respiratory rate"
"A laceration on a toddler's arm is prepared for suturing. Which of the following preparations for topical anesthesia would be the best choice for this procedure? - Correct answer LET (lidocaine/epinephrine/tetracaine)" "Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acetaminophen overdose? - Correct answer A bolus infusion of 150 mg/kg NAC should be administered." "A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-smelling urine. The child is hypotensive and tachycardic. Which of the following methods for obtaining a urine sample is most appropriate in this circumstance? - Correct answer Urinary catherization" "You are discharging a patient home who has a history of depression. Discharge teaching should include which of the following? - Correct answer Ensuring all firearms in the home are locked up with no access available by the patient." "A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5 seconds. Which of the following would be most indicative of the need for intravenous rehydration therapy for this patient? - Correct answer Capillary refill" "An 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-bilious vomiting, and a low grade fever. On assessment the child is intermittently inconsolable followed by periods of normal activity. A sausage-shaped mass is noted during palpation of the abdomen. The nurse should prepare for which of the following? - Correct answer Enema with air" "A 13-year -old male presents to the triage desk complaining of nausea and vomiting. The patient looks distressed and pale. He complains of spasming pain in his right scrotum which has now become constant and more severe. Which of the following assessment findings would the nurse expect with this patient? - Correct answer Elevated right testicle" "An 8-year-old trauma patient suddenly develops increased respiratory distress with a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt hypotensive event. Distention of the jugular veins is noted. Which of the following emergent interventions should be anticipated first? - Correct answer Needle decompression is emergently necessary to release the air and allow expansion of the lung again." "An 8-year-old pedestrian is thrown onto the hood of a moving vehicle striking the windshield. On arrival to the ED. the patient is minimally responsive with active bleeding from the nose and mouth. The patient is vomiting. Which of the following interventions would most likely be considered? - Correct answer Endotracheal intubation" "The nurse is reevaluating the effectiveness of interventions for a 4-year-old child with a suspected tension pneumothorax. Which assessment finding indicates the interventions were effective? - Correct answer Bilateral chest wall rise with assisted ventilations." "A 3-year-old is brought by caregivers with generalized tonic-clonic activity, unresponsiveness, and drooling that began 6 minutes prior to arrival. Which of the following interventions would be most appropriate for this event? - Correct answer Administer intranasal midazolam" "A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic event. Assessment findings include a patient who is active and alert, in the 10th percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture of the left femur. Which of the following is the most likely cause? - Correct answer Osteogenesis imperfecta"
"A child presents with a history of poor oral intake. The patient is pale, lethargic, and has shallow, rapid respirations. Central pulses are weak and capillary refill time is four seconds. Which of the following interventions has the highest priority? - Correct answer Initiate an intravenous fluid bolus" "A 5-year-old arrives in the ED with a 4 day history of vomiting. Vital signs: HR 136 beats/minute, RR 36 breaths/minute, BP 92/56 mm Hg, T 38oC (100.4oF), and pulse oximetry 93% on room air. The child is pale with warm, dry skin and a capillary refill of 3 seconds. A fluid bolus is completed. Which of the following reassessment findings indicate that a second fluid bolus is necessary? - Correct answer Blood pressure of 92/ mm Hg" "A 3-week old is brought to the emergency department with a history of fussiness, spitting up, crying, and watery stools. Assessment reveals an alert child with moist mucous membranes. Which of the following should be the priority? - Correct answer Identify the type of formula the caregiver uses" "A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the following intravenous medication orders should the nurse question? - Correct answer Ketorolac Remediation feedback: Ketorolac is an appropriate medication for moderate to severe pain, however, it should not be used pre- operatively due to its potential to increase the bleeding risk." "Which of the following is considered a "red flag" when triaging a pediatric patient? - Correct answer 100.4°F" "A neonate presents to the emergency department with irritability, weak cry, and hypotonia. Which of the following is a priority intervention? - Correct answer Serum blood glucose" "A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of consciousness with no pulses. Which of the following is the priority intervention? - Correct answer Utilize AED/defibrillator" "A 12-year-old female patient arrives awake and alert with an acute onset of abdominal pain on the right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right side and there is tenderness to the breasts. Which of the following laboratory tests is the priority for this patient? - Correct answer Human chorionic gonadotropin" "A 7-year-old is being seen for new onset of headaches. Which of the following manifestations would most likely rule out the potential of a primary etiology? - Correct answer Pulsating, unilateral pain (wrong) Remediation feedback: Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the areas is also a contraindication for this adjunct." "Which of the following is a first-line treatment for atopic dermatitis? - Correct answer Skin hydration therapy" "After a seizure at home, a 9-month-old infant is awake and interacting appropriately. Vital signs on arrival are HR 150 beats/minutes, RR 36 breaths/minute (unlabored), BP 80/52 mm Hg, SaO2 97% without supplemental oxygen, and T 102.7°F (39.3°C) rectally. During re-evaluation 2 hours after arrival, which of the following assessments would indicate appropriate measures were taken in treating this child? - Correct answer Temperature 37.7°C (99.9°F)"
"During a diaper change on a 4-month-old infant, the nurse measures the infant's urinary output. After subtracting the weight of a dry diaper, the wet diaper weighs 22 grams. What is the infant's estimated urinary output? - Correct answer 22 mL" "A 3 year-old patient presents following frequent emesis and diarrhea over the past 12 hours. Which of the following assessment findings indicate that the patient' body is compensating for the fluid loss? - Correct answer Diastolic pressure will increase "A six-week-old infant presents to the emergency department with seizures. The infant is afebrile with a normal glucose level ,and caregivers report no signs of illness other than formula intolerance, which they treated by adding extra water to the formula. The nurse would expect to find which of the following laboratory abnormalities? - Correct answer Hyponatremia" "A 12-year-old complains of a severe headache for the past 8 hours. Which of the following past history disease processes would be considered a "red flag" and warrant immediate evaluation for this patient? - Correct answer Sickle cell disease" "A 6-year-old child weighing 20 kg (44.1 lb) arrives in full arrest following an electrocution event. CPR is in progress after defibrillation for ventricular fibrillation. What is the intravenous dose of epinephrine for this patient? - Correct answer The pediatric dose of intravenous epinephrine during a cardiac arrest is 0.01 mg/kg." "The triage nurse is assessing a 14 year old male who was brought in by ambulance. The patient reports he was playing his video games at home when he had a sudden onset of groin pain that was so severe he became nauseated and vomited. Further assessment reveals a swollen scrotum. What is the priority intervention for this patient? - Correct answer Preparing the patient for ultrasound" "Which of the following is the recommended method of insulin administration for a pediatric patient with diabetic ketoacidosis? - Correct answer Insulin infusion" "A child was found unresponsive under the monkey bars during recess and arrives with the following assessment: eyes open only with supraorbital pressure stimulus, no verbal response is elicited, and withdraws arms and legs when a swab is inserted in the nose. Which of the following is the priority intervention for this child? - Correct answer Prepare for immediate intubation" "A term infant is delivered in the emergency department. Which assessment finding is most concerning? - Correct answer Acrocyanosis (wrong) Remediation feedback: Normal findings for a newborn include a heart rate between 90-180 bpm, respiratory rate of 30- breaths/minute, and systolic blood pressure of 67-84 mm Hg. They may also exhibit acrocyanosis, particularly when in cool environments." "A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child? - Correct answer Administration of nebulized epinephrine" "A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made? - Correct answer Provide simple, straightforward information" "During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of 70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of 89%. What is the priority intervention for this patient? - Correct answer Prepare for intubation"
"A 4-week-old infant born prematurely is brought to the emergency department due to the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on these findings, what condition should the nurse suspect? - Correct answer Necrotizing enterocolitis" "An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing? - Correct answer Extreme lethargy" "An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms? - Correct answer Anaphylaxis" "Which of the following is the highest priority intervention for a well-appearing 2-month-old with a fever? - Correct answer Urine culture" "A fertilizer silo exploded during a school tour of a working farm. The children are able to manage their own secretions but all are incontinent and salivating, with excess tearing. Which of the following is the priority intervention? - Correct answer Removal of clothing and decontamination" "Which of the following is the priority intervention for the nurse caring for an immunocompromised pediatric patient with a fever? - Correct answer Placement in a negative pressure room" "A 2-year-old arrives with parents stating the child may have ingested a button battery. The patient initially choked and coughed and is now drooling with bloody sputum. Which of the following is the priority intervention? - Correct answer Prepare the patient for hospitalization" "During the assessment of a 16-year-old patient, the ED nurse identifies them as a potential sex trafficking victim. Which of the following trauma-informed care principles has the highest priority for this patient? - Correct answer Physical and psychological safety" "A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and hypotension after eating lunch. Which of the following is the priority intervention? - Correct answer Intramuscular epinephrine" "A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is noted: hypotension, tachycardia, absent breath sounds from the left chest with an increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow Coma Score of 7. Which of the following orders will prompt the nurse to have a discussion with the provider before initiating? - Correct answer Assist with chest tube insertion (wrong) Remediation feedback: Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the areas is also a contraindication for this adjunct." "A child with bipolar disorder is brought to the emergency department for increasing irritability, agitation, pressured speech, and a decreased need for sleep. What should be included in the plan of care for this child? - Correct answer Performing a suicide risk assessment" "A 5-year-old child presents with hives, swelling of the lips and face, and stridor that developed about an hour after eating lunch. The child has no known allergies. Which of the following is the priority intervention? - Correct answer Administer intramuscular epinephrine" "Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis? - Correct answer Constipation"
"Which of the following is a family-centered care concept? - Correct answer Cultural backgrounds are assessed and incorporated into the plan of care." "A caregiver presents to the emergency department with an 18-month-old and reports the child is not using their left arm after playing a game with an older sibling. The child is alert and curious, with regular, even respirations, and skin color is appropriate. Using the Pediatric Assessment Triangle (PAT), how would you categorize this patient? - Correct answer Sick" "Components in the prioritization of pediatric emergency care (4) - Correct answer PAT, Focused Assessment (objective information), Focused pediatric Hx(subjective information), assignment of an acuity rating decision" "Pediatric Assessment Triangle : (3) components - Correct answer Appearance. Work of Breathing. Circulation to the skin. This forms the "general impression". If there is an acute disruption in 1 component, child is "sicker". If there is an acute disruption in 2+ components the child is "sickest"" "PQRST for Pain - Correct answer (pg86) Precipitating and palliating factors Quality Radiation Severity, symptoms, and site Time or triggering factors" "What age is the respiratory system considered fully developed? - Correct answer 8 years old" "6P's Assessment for Musculoskeletal Trauma - Correct answer (pg 283) Pallor : color different from uninjured Pain Pulselessness Parasthesia Paralysis Poikilothermia" "Burn Transfer Criteria - Correct answer 1. Partial thickness >10% of BSA
- Face, hands, feet, genetalia, perineum or major joints
- Third degree burns in any age group.
- Electrical burns, including lightning injury, and chemical burns.
- Inhalation injury.
- Burn injury in pt with preexisting medical disorders that could complicate tx.
- Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or mortality.
- Burned children in hospital wo qualified equipment or personnel to care for them
- Pt who will require special social, emotional, or rehabilitative intervention." "Infants are obligate nose breathers. If nose is obstructed ___________ - Correct answer mouth then suction nose" "Neutropenic pt with a temperature - Correct answer Don't take rectal temp. No invasive procedures if not necessary." "Nonblanchable Rashes of concern - Correct answer Meningocoxcemia Petiachia/Purpura"
"Caregivers bring in their 3-week-old neonate and describe nonbilious vomiting after every feeding that is becoming more forceful over the past 24 hours. The last time he vomited the vomitus hit a chair 2 feet away. They say he cries, roots, and sucks vigorously on his pacifier right after vomiting as though still hungry. He is not experiencing any diarrhea. What condition is the most likely cause of these signs and symptoms? A. Intussusception B. Volvulus C. Gastroenteritis D. Pyloric stenosis - Correct answer D. Pyloric Stenosis" "Which of the following screening statements/questions is most appropriate in assessing an adolescent for dating violence? A. "What triggers violence you've experienced from your partner?" B. "Does your partner feel entitled to sex even if you say 'no'?" C. "Tell me about a time when you've felt unsafe in your relationship." D. "Do you feel if you tried harder to please, your partner will not become violent?" - Correct answer C. "Tell me about a time when you've felt unsafe in your relationship."" "Which sign distinguishes compensated shock from decompensated shock in the pediatric patient? A. Peripheral pulses B. Blood pressure C. Capillary refill D. Level of consciousness - Correct answer B. Blood Pressure" "A 15-year-old with a history of schizophrenia is taking risperidone (Risperdal) and lithium (Eskalith). She presents with dystonia, akinesia, a shuffling gait, muscle rigidity, and tremors. What does the nurse suspect is the cause of these signs and symptoms? A. Extrapyramidal symptoms B. Tardive dyskinesia C. Neuroleptic malignant syndrome D. Serotonin syndrome - Correct answer A. Extrapyramidal symptoms" "Two ambulances collide in front of the hospital. The victims include three pediatric victims. Using the JumpSTART triage system, which category assignment will the nurse give to a 2-year-old who is lying on the ground, alert and crying with spontaneous respirations of 36 breaths/minute and present peripheral pulses? A. Green B. Yellow C. Red D. Black - Correct answer B. Yellow" "A nurse providing crisis intervention to the family of a seriously ill child can best keep the family informed of the child's condition by: A. Placing them in a secluded room. B. Referring to their child as "the patient". C. Telling the family how they should feel. D. Appointing one staff member to communicate with them. - Correct answer D. Appointing one staff member to communicate with them." "A 16-month-old child was an unrestrained front seat passenger in a motor vehicle crash. The chest x-ray reveals multiple rib fractures. These findings suggest what type of injury? A. Minor surface injury. B. Significant underlying injury. C. Significant surface injury. D. Minor underlying injury. - Correct answer B. Significant underlying injury."
"Which piece of information is most important to know prior to transferring a patient to another facility? A. Documentation of the family's health insurance coverage. B. Pertinent family health history. C. Confirmation of acceptance from the receiving hospital. D. Confirmation of a medical diagnosis. - Correct answer C. Confirmation of acceptance from the receiving hospital." "A 10-year-old child who was struck by a car has a distended, tense abdomen. The child's heart rate is 144 beats/minute, respirations 24 breaths/minute, and blood pressure 120/80 mm Hg. Capillary refill is more than 3 seconds, and skin is pale and cool. The patient's signs and symptoms suggest: A. Obstructive shock. B. Distributive shock. C. Hypovolemic shock. D. Cardiogenic shock. - Correct answer C. Hypovolemic shock." "What is the preferred sit for intraosseous access in the infant? A. Lateral malleolus B. Iliac crest C. Proximal femur D. Proximal tibia - Correct answer D. Proximal tibia" "An 8-month-old infant with pneumonia has severe intercostal and substernal retractions, weak muscle tone, lethargy, and gray skin color. The infant's condition does not improve after bag-mask ventilation. The next step in treatment is most likely to be: A. Administration of epinephrine. B. Supplemental warming measures. C. Rapid sequence intubation. D. Administration of albuterol. - Correct answer C. Rapid sequence intubation." "Which combination of medications is best to have prepared for a pediatric resuscitation? A. Dopamine and sodium bicarbonate. B. Epinephrine and glucose. C. Naloxone and lidocaine. D. Pentothal and vecuronium. - Correct answer B. Epinephrine and glucose." "Which intervention should be performed next if tactile stimulation, positioning, drying, and blow-by oxygen administration do not increase a newborn's heart rate? A. Chest compressions. B. Umbilical vein cannulation. C. Endotracheal intubation. D. Bag-mask ventilation. - Correct answer D. Bag-mask ventilation." "A 10-kg child has deep partial-thickness burns over 35% of the total body surface area. Which evaluation parameter indicates that fluid resuscitation is adequate? A. Heart rate of 160 beats/minute. B. Respiratory rate of 34 breaths/minute. C. Blood pressure of 80/60 mm Hg. D. Urine output of 11 ml/hour. - Correct answer D. Urine output of 11 ml/hour." "A 7-year-old female sustains a minor head injury and did not lose consciousness. She does not respond to commands and groans in response to questions. Which action will quickly determine if her behavior indicates a serious head injury?
