ENPC 6TH EDITION COURSE EXAM
Questions and Answers
1. 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?
Answer Initial medication intervention includes an inhaled short-acting beta agonist.
2. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and
dry mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute,
BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of the following
laboratory values would be most expected in this child?
Answer Expected laboratory values would reveal an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate
level, and an elevated blood glucose level > 200 mg.dL.
3. 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 in- creasing manifestations
instead of improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis?
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.
4. 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?-
Answer Establishing a secure airway
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, 5. 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?
Answer Lumbar puncture
6. A 12-year-old is being prepped for surgical intervention of acute appendici- tis.
Which of the following intravenous medication orders should the nurse question?
Answer 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.
7. 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?
Answer Have the boyfriend leave the room during the pelvic exam.
8. A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immedi- ately.
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?
Answer Intraosseous in the patient's medial tibia.
9. A child with an electrical injury is seen 1 hour post event. Which of the follow- ing
types of specimen samples would provide visual information regarding a potential
complication of this injury?
Answer Electrical injuries, though they may appear to be small, can produce large amounts of damage internally,
including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine.
10. Parents with an infant requiring multiple laboratory tests, radiographic studies,
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Questions and Answers
1. 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?
Answer Initial medication intervention includes an inhaled short-acting beta agonist.
2. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and
dry mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute,
BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of the following
laboratory values would be most expected in this child?
Answer Expected laboratory values would reveal an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate
level, and an elevated blood glucose level > 200 mg.dL.
3. 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 in- creasing manifestations
instead of improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis?
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.
4. 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?-
Answer Establishing a secure airway
1/
11
, 5. 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?
Answer Lumbar puncture
6. A 12-year-old is being prepped for surgical intervention of acute appendici- tis.
Which of the following intravenous medication orders should the nurse question?
Answer 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.
7. 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?
Answer Have the boyfriend leave the room during the pelvic exam.
8. A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immedi- ately.
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?
Answer Intraosseous in the patient's medial tibia.
9. A child with an electrical injury is seen 1 hour post event. Which of the follow- ing
types of specimen samples would provide visual information regarding a potential
complication of this injury?
Answer Electrical injuries, though they may appear to be small, can produce large amounts of damage internally,
including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine.
10. Parents with an infant requiring multiple laboratory tests, radiographic studies,
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11
