ENPC 6th EDITION COURSE EXAM NEWEST VERSION
2026-2027 ACTUAL QUESTION AND CORRECT
DETAILED VERIFIED ANSWERS WITH RATIONALES
FROM VERIFIED SOURCES BY EXPERT RATED A+.
QUESTION
A 10-year-old arrives at the emergency department (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 the
left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left
upper leg, and a Glasgow Coma Scale score of 7. Which of the following orders will
prompt the nurse to have a discussion with the provider before initiating?
a) Assist with chest tube insertion.
b) Insert a urinary catheter.
c) Administer a fluid bolus.
d) Apply a cervical collar.
CORRECT ANS: b) Insert a urinary catheter.
Expert Rationale
The order to insert a urinary catheter should prompt the nurse to have a discussion with
the provider before initiating (option b). The presence of blood at the urinary meatus
and pelvic pain are classic signs of a potential urethral or pelvic injury. Inserting a urinary
catheter in the presence of these signs can exacerbate the injury, potentially converting
a partial urethral tear into a complete transection or causing further pelvic hemorrhage.
A retrograde urethrogram should be performed first to assess urethral integrity before
any attempt at catheterization.
Option a is incorrect; a chest tube is indicated for a suspected hemothorax or
pneumothorax (absent breath sounds). Option c is incorrect; a fluid bolus is indicated
,for hypotension and tachycardia. Option d is incorrect; a cervical collar is indicated for a
trauma patient with a mechanism of injury consistent with spinal injury (GCS of 7).
DIF: Cognitive Level: Analyze (Application/Analysis)
TOP: Pediatric Trauma
MSC: Pediatric Emergency Nursing: Trauma
QUESTION
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?
a) Clean catch urine sample.
b) Urinary catheterization.
c) Suprapubic aspiration.
d) Urine bag collection.
CORRECT ANS: b) Urinary catheterization.
Expert Rationale
The most appropriate method for obtaining a urine sample in this scenario is urinary
catheterization (option b). The child is hypotensive and tachycardic, indicating potential
sepsis or severe dehydration. A clean catch or bag specimen would be unreliable and
time-consuming. A catheterized specimen provides a sterile, uncontaminated sample
that is essential for accurate diagnosis and guiding antibiotic therapy in a critically ill
child. The presence of foul-smelling urine suggests a urinary tract infection, which can
cause sepsis in young children.
Option a is incorrect; a clean catch sample is difficult to obtain in a 2-year-old and is not
appropriate in an unstable patient. Option c is incorrect; suprapubic aspiration is a more
invasive procedure typically reserved for infants or when catheterization is not possible.
Option d is incorrect; a urine bag specimen is prone to contamination and is not
appropriate for a critically ill child.
,DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Genitourinary
MSC: Pediatric Emergency Nursing: Genitourinary
QUESTION
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?
a) Administering a sedative immediately.
b) Performing a suicide risk assessment.
c) Placing the child in seclusion.
d) Discharging the child with a referral.
CORRECT ANS: b) Performing a suicide risk assessment.
Expert Rationale
The plan of care for a child with bipolar disorder presenting with signs of mania
(irritability, agitation, pressured speech, decreased need for sleep) should include
performing a suicide risk assessment (option b). Children with bipolar disorder are at an
increased risk for suicidal ideation and behaviors, especially during manic or mixed
episodes. A comprehensive suicide risk assessment is essential for ensuring patient
safety and determining the appropriate level of care.
Option a is incorrect; while sedation may be needed, it is not the first step. Option c is
incorrect; seclusion should be used as a last resort. Option d is incorrect; discharge
should not occur without a thorough safety assessment.
DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Behavioral Health
MSC: Pediatric Emergency Nursing: Behavioral Health
, QUESTION
You are discharging a patient home who has a history of depression. Discharge teaching
should include which of the following?
a) Encouraging the patient to exercise regularly.
b) Ensuring all firearms in the home are locked up with no access available by the
patient.
c) Scheduling a follow-up appointment with a therapist.
d) Providing a list of crisis hotlines.
CORRECT ANS: b) Ensuring all firearms in the home are locked up with no access
available by the patient.
Expert Rationale
Discharge teaching for a patient with a history of depression should include ensuring all
firearms in the home are locked up with no access available by the patient (option b).
Firearms are the most lethal method of suicide, and restricting access is a critical safety
intervention for a patient at risk for self-harm. This is a standard component of suicide
prevention education.
Option a, c, and d are important but are not the most critical safety intervention. While
exercise, follow-up, and crisis hotlines are helpful, ensuring firearm safety directly
addresses the highest risk of lethality.
DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Behavioral Health
MSC: Pediatric Emergency Nursing: Behavioral Health
QUESTION
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?
2026-2027 ACTUAL QUESTION AND CORRECT
DETAILED VERIFIED ANSWERS WITH RATIONALES
FROM VERIFIED SOURCES BY EXPERT RATED A+.
QUESTION
A 10-year-old arrives at the emergency department (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 the
left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left
upper leg, and a Glasgow Coma Scale score of 7. Which of the following orders will
prompt the nurse to have a discussion with the provider before initiating?
a) Assist with chest tube insertion.
b) Insert a urinary catheter.
c) Administer a fluid bolus.
d) Apply a cervical collar.
CORRECT ANS: b) Insert a urinary catheter.
Expert Rationale
The order to insert a urinary catheter should prompt the nurse to have a discussion with
the provider before initiating (option b). The presence of blood at the urinary meatus
and pelvic pain are classic signs of a potential urethral or pelvic injury. Inserting a urinary
catheter in the presence of these signs can exacerbate the injury, potentially converting
a partial urethral tear into a complete transection or causing further pelvic hemorrhage.
A retrograde urethrogram should be performed first to assess urethral integrity before
any attempt at catheterization.
Option a is incorrect; a chest tube is indicated for a suspected hemothorax or
pneumothorax (absent breath sounds). Option c is incorrect; a fluid bolus is indicated
,for hypotension and tachycardia. Option d is incorrect; a cervical collar is indicated for a
trauma patient with a mechanism of injury consistent with spinal injury (GCS of 7).
DIF: Cognitive Level: Analyze (Application/Analysis)
TOP: Pediatric Trauma
MSC: Pediatric Emergency Nursing: Trauma
QUESTION
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?
a) Clean catch urine sample.
b) Urinary catheterization.
c) Suprapubic aspiration.
d) Urine bag collection.
CORRECT ANS: b) Urinary catheterization.
Expert Rationale
The most appropriate method for obtaining a urine sample in this scenario is urinary
catheterization (option b). The child is hypotensive and tachycardic, indicating potential
sepsis or severe dehydration. A clean catch or bag specimen would be unreliable and
time-consuming. A catheterized specimen provides a sterile, uncontaminated sample
that is essential for accurate diagnosis and guiding antibiotic therapy in a critically ill
child. The presence of foul-smelling urine suggests a urinary tract infection, which can
cause sepsis in young children.
Option a is incorrect; a clean catch sample is difficult to obtain in a 2-year-old and is not
appropriate in an unstable patient. Option c is incorrect; suprapubic aspiration is a more
invasive procedure typically reserved for infants or when catheterization is not possible.
Option d is incorrect; a urine bag specimen is prone to contamination and is not
appropriate for a critically ill child.
,DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Genitourinary
MSC: Pediatric Emergency Nursing: Genitourinary
QUESTION
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?
a) Administering a sedative immediately.
b) Performing a suicide risk assessment.
c) Placing the child in seclusion.
d) Discharging the child with a referral.
CORRECT ANS: b) Performing a suicide risk assessment.
Expert Rationale
The plan of care for a child with bipolar disorder presenting with signs of mania
(irritability, agitation, pressured speech, decreased need for sleep) should include
performing a suicide risk assessment (option b). Children with bipolar disorder are at an
increased risk for suicidal ideation and behaviors, especially during manic or mixed
episodes. A comprehensive suicide risk assessment is essential for ensuring patient
safety and determining the appropriate level of care.
Option a is incorrect; while sedation may be needed, it is not the first step. Option c is
incorrect; seclusion should be used as a last resort. Option d is incorrect; discharge
should not occur without a thorough safety assessment.
DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Behavioral Health
MSC: Pediatric Emergency Nursing: Behavioral Health
, QUESTION
You are discharging a patient home who has a history of depression. Discharge teaching
should include which of the following?
a) Encouraging the patient to exercise regularly.
b) Ensuring all firearms in the home are locked up with no access available by the
patient.
c) Scheduling a follow-up appointment with a therapist.
d) Providing a list of crisis hotlines.
CORRECT ANS: b) Ensuring all firearms in the home are locked up with no access
available by the patient.
Expert Rationale
Discharge teaching for a patient with a history of depression should include ensuring all
firearms in the home are locked up with no access available by the patient (option b).
Firearms are the most lethal method of suicide, and restricting access is a critical safety
intervention for a patient at risk for self-harm. This is a standard component of suicide
prevention education.
Option a, c, and d are important but are not the most critical safety intervention. While
exercise, follow-up, and crisis hotlines are helpful, ensuring firearm safety directly
addresses the highest risk of lethality.
DIF: Cognitive Level: Apply (Application)
TOP: Pediatric Behavioral Health
MSC: Pediatric Emergency Nursing: Behavioral Health
QUESTION
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?
