ENPC 5th Edition Exam with verified
Solutions
Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other
behavioral symptoms to facilitate appropriate care and follow-up. - Answer -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 steps is the best
next step to take?
Ensuring all firearms in the home are locked in a safe place with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of depression or suicidal ideation
by encouraging that all firearms and medications are under lock to prevent overdoses or suicide attempt.
- Answer -You are discharging a patient to home with a history of depression. Discharge teaching should
include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions. - Answer -A 2-year old has
uniformly demarcated burns to bilateral lower extremities, approximately 30% of the childs total body
surface area. The father states he briefly left the room while the child was in the bath and the child
apparently played with the faucet. Which of the following interventions has the highest priority?
Draw and send a metabolic panel and venous blood gas, administer a fluid bolus, and obtain a point of
care glucose
Electrolyte imbalances need to be identified and treated to prevent another seizure. - Answer -A 7-year-
old arrives via ambulance. The patient's mother reports witnessing a seizure at home. The patient has no
seizure history. Upon examination, 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 mother states the burns accidentally occurred 3
, days ago, but she was afraid to bring patient in due to an ongoing child welfare investigation. Which of
the following are the MOST appropriate immediate interventions?
ventilation to address hypoxia is the priority intervention. - Answer -What is the priority intervention for
symptomatic bradycardia in a four-year-old child?
Commotio cordis
Comotio Cordis "occurs when chest is struck during the refractory period of the cardiac conduction cycle.
This type of injury usually occurs in recreational sports such as baseball or ice hockey." - Answer -A 14-
year-old high school student who was pitching for his baseball team was hit in the chest by the ball and
had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest?
Focused Assessment: Vital Signs: "As the patient compensates for altered tissue perfusion, the pulse
pressure narrows and the heart rate increases" - (need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign - Answer -A 5-year-old child presents to the emergency department
after being hit by a car. She 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate by increasing
heart rate - Answer -A 5-year-old patient presents to the emergency department with severe
dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the
following physiologic responses to shock has the greatest impact on improving cardiac output in the
pediatric patient?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children younger than 4
Solutions
Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other
behavioral symptoms to facilitate appropriate care and follow-up. - Answer -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 steps is the best
next step to take?
Ensuring all firearms in the home are locked in a safe place with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of depression or suicidal ideation
by encouraging that all firearms and medications are under lock to prevent overdoses or suicide attempt.
- Answer -You are discharging a patient to home with a history of depression. Discharge teaching should
include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions. - Answer -A 2-year old has
uniformly demarcated burns to bilateral lower extremities, approximately 30% of the childs total body
surface area. The father states he briefly left the room while the child was in the bath and the child
apparently played with the faucet. Which of the following interventions has the highest priority?
Draw and send a metabolic panel and venous blood gas, administer a fluid bolus, and obtain a point of
care glucose
Electrolyte imbalances need to be identified and treated to prevent another seizure. - Answer -A 7-year-
old arrives via ambulance. The patient's mother reports witnessing a seizure at home. The patient has no
seizure history. Upon examination, 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 mother states the burns accidentally occurred 3
, days ago, but she was afraid to bring patient in due to an ongoing child welfare investigation. Which of
the following are the MOST appropriate immediate interventions?
ventilation to address hypoxia is the priority intervention. - Answer -What is the priority intervention for
symptomatic bradycardia in a four-year-old child?
Commotio cordis
Comotio Cordis "occurs when chest is struck during the refractory period of the cardiac conduction cycle.
This type of injury usually occurs in recreational sports such as baseball or ice hockey." - Answer -A 14-
year-old high school student who was pitching for his baseball team was hit in the chest by the ball and
had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest?
Focused Assessment: Vital Signs: "As the patient compensates for altered tissue perfusion, the pulse
pressure narrows and the heart rate increases" - (need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign - Answer -A 5-year-old child presents to the emergency department
after being hit by a car. She 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate by increasing
heart rate - Answer -A 5-year-old patient presents to the emergency department with severe
dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the
following physiologic responses to shock has the greatest impact on improving cardiac output in the
pediatric patient?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children younger than 4
