ENPC 6TH EDITION PRE EXAM
Questions and Answers
1. A 14-year-old patient sustained a displaced fracture of the radius
and ulna after falling from a bicycle. Which of the following pain
control interventions is most likely to result in improvement in
symptoms related to pain?
Answer Applying a splint to the affected extremity
Rationale
Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures. This will
also help to minimize complications. Topical creams and elevation of the extremity will not help with pain
control. The application of ice in an appropriate manner can help, but not warmth which would be
contraindicated in the early stages of the injury.
2. Assessment of the fontanelle provides the most useful information
for which
two components of the primary survey?
Answer Circulation and disability
Rationale
A sunken fontanelle is a red flag for circulation assessment in pediatric triage and may indicate dehydration
. A bulging fontanel is a red flag for disability assessment in pediatric triage and can indicate increased
intracranial pressure.
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, 3. A 6-month-old is seen for a recurrent respiratory infection. During the
assess
ment, 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?
Answer Cystic fibrosis
Rationale
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. These fats are
excreted in the stools and can present as "fatty" or "greasy". Combined with the recurrent upper
respiratory infections for an infant, cystic fibrosis should be ruled out. The other three disease processes
frequently present with respiratory issues but fatty stools would not normally be seen.
4. A 4-day-old who is brought to the emergency department with the
parental
complaint of "not acting right" is found to be hypoglycemic. What is
the appropriate glucose concentration to administer to this neonate?
Answer Dextrose 10%
Rationale
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect their fragile
vasculature while providing needed glucose. Dextrose 5% is not used to treat hypoglycemia in children.
Dextrose 25% is used for children above the age of 5 years. Dextrose 50% is not recommended for use
2/
12
Questions and Answers
1. A 14-year-old patient sustained a displaced fracture of the radius
and ulna after falling from a bicycle. Which of the following pain
control interventions is most likely to result in improvement in
symptoms related to pain?
Answer Applying a splint to the affected extremity
Rationale
Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures. This will
also help to minimize complications. Topical creams and elevation of the extremity will not help with pain
control. The application of ice in an appropriate manner can help, but not warmth which would be
contraindicated in the early stages of the injury.
2. Assessment of the fontanelle provides the most useful information
for which
two components of the primary survey?
Answer Circulation and disability
Rationale
A sunken fontanelle is a red flag for circulation assessment in pediatric triage and may indicate dehydration
. A bulging fontanel is a red flag for disability assessment in pediatric triage and can indicate increased
intracranial pressure.
1/
12
, 3. A 6-month-old is seen for a recurrent respiratory infection. During the
assess
ment, 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?
Answer Cystic fibrosis
Rationale
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. These fats are
excreted in the stools and can present as "fatty" or "greasy". Combined with the recurrent upper
respiratory infections for an infant, cystic fibrosis should be ruled out. The other three disease processes
frequently present with respiratory issues but fatty stools would not normally be seen.
4. A 4-day-old who is brought to the emergency department with the
parental
complaint of "not acting right" is found to be hypoglycemic. What is
the appropriate glucose concentration to administer to this neonate?
Answer Dextrose 10%
Rationale
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect their fragile
vasculature while providing needed glucose. Dextrose 5% is not used to treat hypoglycemia in children.
Dextrose 25% is used for children above the age of 5 years. Dextrose 50% is not recommended for use
2/
12
