ENPC EXAM PREP QUESTIONS AND
ANSWERS FULL TEST PAPER ACCURACY
CHECKED
◉ A 9 month pregnant woman presents to the emergency
department and delivers a term neonate vaginally. The neonate is
dried and stimulated and the mouth and nose are suctioned using
a bulb syringe. After repositioning the head, the neonate remains
limp and apneic and the HR is 80 beats/minute. What is the
priority intervention?
A. Begin chest compressions
B. Suction the oropharynx with a catheter
C. Obtain vascular access
D. Initiate positive pressure ventilation
Answer: D
Immediately after delivery all neonates should be warmed,
stimulated, and have their mouth then nose suctioned using a
bulb syringe. Following this, if the neonate is not breathing or is
gasping and/or has a heart rate of less than 100 beats per minute
positive pressure ventilation at 21% FiO2 at a rate of 40-60
breaths per minute should be immediately initiated. The heart
rate should be assessed after 15 seconds of PPV and if not
improving additional measures should be taken (MRSOPA).
Vascular access is not always needed but can be worked on by
,another team member while airway and breathing interventions
are being completed.
◉ A 5-year-old with no health problems presents to the
emergency department with a sudden onset of chest pain and
shortness of breath. Parents state that the family was involved in a
bad car crash one week ago. A thorough assessment and workup
has not revealed any abnormalities. Which of the following the
best next step to take?
A.Ask about any new bed-wetting or sleep disturbances
B.Discharge to home and follow-up with their primary care
physician
C.Repeat a head-to-toe exam to identify any missed traumatic
injuries
D.Consult cardiology for appropriate follow-up
Answer: A
Physical complaints are not uncommon in children following a
traumatic event. Once any physical injuries or illnesses have been
ruled out, assessment for any other behavioral symptoms to
facilitate appropriate care and follow-up would be indicated. The
incident occurred a week ago so the likelihood any an severe
medical issues is pretty low.
◉ Which of the following patient presentations should increase
suspicion of potential child maltreatment?
, A.Closed greenstick wrist fracture in a 4-year-old child who fell off
his bicycle
B.Bruises in various stages of healing to the lower extremities of a
2-year-old child
C.Right radial spiral fracture in a 10 year old practicing martial
arts
D.Bruising to the left ear of a newborn from sleeping on his side
Answer: D
Any bruises in a non-exploratory location (especially torso, ears,
and neck) in children younger than 4 years old and ANY bruising
in a child younger than 4 months old is suspicious for child
maltreatment. Bruises to the lower extremities of a 2-year-old
who is learning to walk on their own is not uncommon. Greenstick
fractures are a more common fracture is children due to the
immaturity of their bone structure. Martial arts includes many
moves that could produce a spiral fracture.
◉ The caregiver of a 2-month-old infant states the patient has had
trouble breathing for the past two days. Pediatric assessment
triangle (PAT) reveals an age-appropriate general appearance,
rapid breathing with mild distress, and pink skin. Mucous is noted
in both nares. Which of the following is the best next step?
A.Obtain a history including immunization status
B.Suction nasal passages using a bulb syringe
C.Administer oxygen by nasal cannula with patient in caregiver's
arms
ANSWERS FULL TEST PAPER ACCURACY
CHECKED
◉ A 9 month pregnant woman presents to the emergency
department and delivers a term neonate vaginally. The neonate is
dried and stimulated and the mouth and nose are suctioned using
a bulb syringe. After repositioning the head, the neonate remains
limp and apneic and the HR is 80 beats/minute. What is the
priority intervention?
A. Begin chest compressions
B. Suction the oropharynx with a catheter
C. Obtain vascular access
D. Initiate positive pressure ventilation
Answer: D
Immediately after delivery all neonates should be warmed,
stimulated, and have their mouth then nose suctioned using a
bulb syringe. Following this, if the neonate is not breathing or is
gasping and/or has a heart rate of less than 100 beats per minute
positive pressure ventilation at 21% FiO2 at a rate of 40-60
breaths per minute should be immediately initiated. The heart
rate should be assessed after 15 seconds of PPV and if not
improving additional measures should be taken (MRSOPA).
Vascular access is not always needed but can be worked on by
,another team member while airway and breathing interventions
are being completed.
◉ A 5-year-old with no health problems presents to the
emergency department with a sudden onset of chest pain and
shortness of breath. Parents state that the family was involved in a
bad car crash one week ago. A thorough assessment and workup
has not revealed any abnormalities. Which of the following the
best next step to take?
A.Ask about any new bed-wetting or sleep disturbances
B.Discharge to home and follow-up with their primary care
physician
C.Repeat a head-to-toe exam to identify any missed traumatic
injuries
D.Consult cardiology for appropriate follow-up
Answer: A
Physical complaints are not uncommon in children following a
traumatic event. Once any physical injuries or illnesses have been
ruled out, assessment for any other behavioral symptoms to
facilitate appropriate care and follow-up would be indicated. The
incident occurred a week ago so the likelihood any an severe
medical issues is pretty low.
◉ Which of the following patient presentations should increase
suspicion of potential child maltreatment?
, A.Closed greenstick wrist fracture in a 4-year-old child who fell off
his bicycle
B.Bruises in various stages of healing to the lower extremities of a
2-year-old child
C.Right radial spiral fracture in a 10 year old practicing martial
arts
D.Bruising to the left ear of a newborn from sleeping on his side
Answer: D
Any bruises in a non-exploratory location (especially torso, ears,
and neck) in children younger than 4 years old and ANY bruising
in a child younger than 4 months old is suspicious for child
maltreatment. Bruises to the lower extremities of a 2-year-old
who is learning to walk on their own is not uncommon. Greenstick
fractures are a more common fracture is children due to the
immaturity of their bone structure. Martial arts includes many
moves that could produce a spiral fracture.
◉ The caregiver of a 2-month-old infant states the patient has had
trouble breathing for the past two days. Pediatric assessment
triangle (PAT) reveals an age-appropriate general appearance,
rapid breathing with mild distress, and pink skin. Mucous is noted
in both nares. Which of the following is the best next step?
A.Obtain a history including immunization status
B.Suction nasal passages using a bulb syringe
C.Administer oxygen by nasal cannula with patient in caregiver's
arms
