ENPC Exam | 2025/2026 6th Edition Unit-
Based Questions – 50 Verified Correct
Detailed Q&A GRADED A+
1. A neonate presents to the emergency department with irritability, weak cry, and
hypotonic. Which of the following is a priority intervention?
A. Head computerized tomography scan
B. Prostaglandin infusion
C. Toxin Screening
D. Serum blood glucose
Answer: D. Serum blood glucose
Explanation: In a neonate presenting with these symptoms, hypoglycemia is a critical
and common cause that must be rapidly identified and treated to prevent neurological
damage.
2. A 6-week-old is brought to the emergency department by 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?
A. Blood culture
C. Chest X-ray
B. Lumbar puncture
D. Urinalysis
Answer: B. Lumbar puncture
Explanation: The combination of fever, hypothermia, poor feeding, a bulging fontanel,
and signs of shock in a young infant is highly suspicious for meningitis, which requires a
lumbar puncture for a definitive diagnosis.
, 3. A 3-month-old is brought to the emergency department with a new onset of
fever. You note the child to be pale, tachypneic, and tachycardic, with weak distal
pulses. Which intervention is the priority for this patient?
A. Administer an appropriate dose of an antipyretic
B. Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C. Prepare a broad-spectrum antibiotic infusion
D. Administer a vasoactive medication
Answer: B. Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
Explanation: This patient most likely has septic shock. The immediate goal is to reverse
shock and restore tissue perfusion with fluids.
4. 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?
A. Central venous catheter
B. Intraosseous in the patient's medial tibia
C. External jugular vein
D. Femoral vein
Answer: B. Intraosseous in the patient's medial tibia
Explanation: In a pediatric emergency where IV access is unobtainable, intraosseous
(IO) access in the proximal tibia is the recommended and fastest alternative for
delivering fluids and medications.
5. 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?
A. Hypoglycemia
B. Blood pH < 7.3
, C. Normal serum bicarbonate level
D. Blood glucose level < 200 mg/dL
Answer: B. Blood pH < 7.3
Explanation: This presentation is classic for new-onset diabetes mellitus in diabetic
ketoacidosis (DKA), which is characterized by dehydration and metabolic acidosis.
6. A 6-month-old is seen for a recurrent respiratory infection. During the
assessment, the mother adds that the patient's stools seem to be fatty or "greasy."
Which of the following disease processes would be a primary concern for this
child?
A. Cystic fibrosis
B. Bronchopulmonary dysplasia
C. Pneumonitis
D. Down syndrome
Answer: A. Cystic fibrosis
Explanation: In patients with cystic fibrosis, thick mucus inhibits the release of
pancreatic enzymes necessary for digestion. This results in impaired absorption and the
inability to utilize ingested fats, which are then excreted in the stools as "fatty" or
"greasy".
7. Which of the following pathologic processes would most likely be attributed to
a primary diagnosis of cystic fibrosis?
A. Hypernatremia
B. Constipation
C. Obesity
D. Epiglottitis
Answer: B. Constipation
Explanation: Constipation, often severe, is a common gastrointestinal manifestation of
cystic fibrosis due to the thick, sticky mucus that can cause intestinal obstruction.
, 8. 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?
A. Asthma
B. Sickle Cell Disease
C. Diabetes Mellitus
D. Seizure Disorder
Answer: B. Sickle Cell Disease
Explanation: In a patient with sickle cell disease, a severe headache is a "red flag" and
can be a sign of a stroke or other serious neurological complication, requiring
immediate evaluation.
9. A 13-year-old is experiencing a sudden onset of testicular pain, swelling, and
vomiting. The cremasteric reflex is absent. Which of the following dia gnoses is of
highest suspicion in this situation?
A. Testicular Torsion
B. Epididymitis
C. Hydrocele
D. Inguinal Hernia
Answer: A. Testicular Torsion
Explanation: Sudden onset of testicular pain with swelling, vomiting, and an absent
cremasteric reflex is a classic presentation for testicular torsion, a surgical emergency.
10. A 14-year-old patient with Down syndrome presents with an abnormal gait,
head tilted to the left, decreased sensation to the extremities, and urinary
incontinence. The patient has no history of trauma. Which of the following
diagnostics is the priority for this patient?
A. Lumbar Spine MRI
Based Questions – 50 Verified Correct
Detailed Q&A GRADED A+
1. A neonate presents to the emergency department with irritability, weak cry, and
hypotonic. Which of the following is a priority intervention?
A. Head computerized tomography scan
B. Prostaglandin infusion
C. Toxin Screening
D. Serum blood glucose
Answer: D. Serum blood glucose
Explanation: In a neonate presenting with these symptoms, hypoglycemia is a critical
and common cause that must be rapidly identified and treated to prevent neurological
damage.
2. A 6-week-old is brought to the emergency department by 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?
A. Blood culture
C. Chest X-ray
B. Lumbar puncture
D. Urinalysis
Answer: B. Lumbar puncture
Explanation: The combination of fever, hypothermia, poor feeding, a bulging fontanel,
and signs of shock in a young infant is highly suspicious for meningitis, which requires a
lumbar puncture for a definitive diagnosis.
, 3. A 3-month-old is brought to the emergency department with a new onset of
fever. You note the child to be pale, tachypneic, and tachycardic, with weak distal
pulses. Which intervention is the priority for this patient?
A. Administer an appropriate dose of an antipyretic
B. Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C. Prepare a broad-spectrum antibiotic infusion
D. Administer a vasoactive medication
Answer: B. Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
Explanation: This patient most likely has septic shock. The immediate goal is to reverse
shock and restore tissue perfusion with fluids.
4. 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?
A. Central venous catheter
B. Intraosseous in the patient's medial tibia
C. External jugular vein
D. Femoral vein
Answer: B. Intraosseous in the patient's medial tibia
Explanation: In a pediatric emergency where IV access is unobtainable, intraosseous
(IO) access in the proximal tibia is the recommended and fastest alternative for
delivering fluids and medications.
5. 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?
A. Hypoglycemia
B. Blood pH < 7.3
, C. Normal serum bicarbonate level
D. Blood glucose level < 200 mg/dL
Answer: B. Blood pH < 7.3
Explanation: This presentation is classic for new-onset diabetes mellitus in diabetic
ketoacidosis (DKA), which is characterized by dehydration and metabolic acidosis.
6. A 6-month-old is seen for a recurrent respiratory infection. During the
assessment, the mother adds that the patient's stools seem to be fatty or "greasy."
Which of the following disease processes would be a primary concern for this
child?
A. Cystic fibrosis
B. Bronchopulmonary dysplasia
C. Pneumonitis
D. Down syndrome
Answer: A. Cystic fibrosis
Explanation: In patients with cystic fibrosis, thick mucus inhibits the release of
pancreatic enzymes necessary for digestion. This results in impaired absorption and the
inability to utilize ingested fats, which are then excreted in the stools as "fatty" or
"greasy".
7. Which of the following pathologic processes would most likely be attributed to
a primary diagnosis of cystic fibrosis?
A. Hypernatremia
B. Constipation
C. Obesity
D. Epiglottitis
Answer: B. Constipation
Explanation: Constipation, often severe, is a common gastrointestinal manifestation of
cystic fibrosis due to the thick, sticky mucus that can cause intestinal obstruction.
, 8. 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?
A. Asthma
B. Sickle Cell Disease
C. Diabetes Mellitus
D. Seizure Disorder
Answer: B. Sickle Cell Disease
Explanation: In a patient with sickle cell disease, a severe headache is a "red flag" and
can be a sign of a stroke or other serious neurological complication, requiring
immediate evaluation.
9. A 13-year-old is experiencing a sudden onset of testicular pain, swelling, and
vomiting. The cremasteric reflex is absent. Which of the following dia gnoses is of
highest suspicion in this situation?
A. Testicular Torsion
B. Epididymitis
C. Hydrocele
D. Inguinal Hernia
Answer: A. Testicular Torsion
Explanation: Sudden onset of testicular pain with swelling, vomiting, and an absent
cremasteric reflex is a classic presentation for testicular torsion, a surgical emergency.
10. A 14-year-old patient with Down syndrome presents with an abnormal gait,
head tilted to the left, decreased sensation to the extremities, and urinary
incontinence. The patient has no history of trauma. Which of the following
diagnostics is the priority for this patient?
A. Lumbar Spine MRI
