2026 ENPC CORRECT FINAL EXAM QUESTIONS
AND ANSWERS SURE A+
✔✔The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. The patient is post-ictal with a heart rate of 142 beats per minute, respiratory
rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg. Significant burns
are noted to the patient's back and lower extremities. The caregiver states the burns
accidentally occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of interventions are
the priority for this patient?
A.Call police and child welfare authorities and have security detain the caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions - ✔✔C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help
prevent further seizures. Contacting child protective services and other authorities can
wait. The patient is post-ictal so does not require lorazepam medication at this time.
Pain medication can and should be considered with significant burns, but is not a
priority.
✔✔What is the priority intervention for symptomatic bradycardia in a four-year-old child?
, A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - ✔✔C
\
Identifying and treating other causes, chest compressions, and epinephrine are
interventions for pediatric bradycardia with signs of poor perfusion that are not improved
by adequate oxygenation and ventilation. Atropine and pacing may be considered if
there is no response to the other interventions.
✔✔A 5-year-old child presents to the emergency department after being hit by a car.
The patient complains of left upper quadrant pain, and the focused assessment with
sonography for trauma (FAST) exam shows fluid around her spleen. Which of the
following findings would be an early indication of ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - ✔✔D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The
nurse may note a strong central pulse but weaker peripheral pulses, indicating the child
is compensating by shunting blood to their core.
✔✔Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - ✔✔B
The presence of bilious emesis is especially concerning because it may be indicative of
an immediately life-threatening bowel obstruction. A dislodged gastrostomy tube should
be reinserted within 4-6 hours to prevent stoma closure. Vomiting following a handlebar
injury may be indicative of many possible injuries, but does not take precedence unless
other symptoms are present. Infantile colic is described as inconsolable crying in
infants, 2 weeks to 4 months old, for up to 3 hours per day, more than 3 days per week,
and lasting for more than 3 weeks.
✔✔inconsolable crying - ✔✔rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than three
weeks
✔✔A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations, diminished
AND ANSWERS SURE A+
✔✔The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. The patient is post-ictal with a heart rate of 142 beats per minute, respiratory
rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg. Significant burns
are noted to the patient's back and lower extremities. The caregiver states the burns
accidentally occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of interventions are
the priority for this patient?
A.Call police and child welfare authorities and have security detain the caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions - ✔✔C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help
prevent further seizures. Contacting child protective services and other authorities can
wait. The patient is post-ictal so does not require lorazepam medication at this time.
Pain medication can and should be considered with significant burns, but is not a
priority.
✔✔What is the priority intervention for symptomatic bradycardia in a four-year-old child?
, A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - ✔✔C
\
Identifying and treating other causes, chest compressions, and epinephrine are
interventions for pediatric bradycardia with signs of poor perfusion that are not improved
by adequate oxygenation and ventilation. Atropine and pacing may be considered if
there is no response to the other interventions.
✔✔A 5-year-old child presents to the emergency department after being hit by a car.
The patient complains of left upper quadrant pain, and the focused assessment with
sonography for trauma (FAST) exam shows fluid around her spleen. Which of the
following findings would be an early indication of ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - ✔✔D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The
nurse may note a strong central pulse but weaker peripheral pulses, indicating the child
is compensating by shunting blood to their core.
✔✔Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - ✔✔B
The presence of bilious emesis is especially concerning because it may be indicative of
an immediately life-threatening bowel obstruction. A dislodged gastrostomy tube should
be reinserted within 4-6 hours to prevent stoma closure. Vomiting following a handlebar
injury may be indicative of many possible injuries, but does not take precedence unless
other symptoms are present. Infantile colic is described as inconsolable crying in
infants, 2 weeks to 4 months old, for up to 3 hours per day, more than 3 days per week,
and lasting for more than 3 weeks.
✔✔inconsolable crying - ✔✔rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than three
weeks
✔✔A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations, diminished
