ENPC 5TH EDITION EXAM QUESTIONS WITH
CORRECT ANSWERS 2025
/.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? -
Answer-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.
/.You are discharging a patient to home with a history of depression. Discharge teaching
should include which of the following? - Answer-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.
/.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? - Answer-Obtain vascular
access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions.
/.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? - Answer-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.
/.What is the priority intervention for symptomatic bradycardia in a four-year-old child? -
Answer-ventilation to address hypoxia is the priority intervention.
, /.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? - Answer-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."
/.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? - Answer-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
/.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? - Answer-Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate
by increasing heart rate
/.Which of the following patient presentations should increase suspicion of potential
child maltreatment? - Answer-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
Pg 11Any bruising in a child younger than 4 months.
/.All of the vaccine administrations listed are appropriate EXCEPT for which of the
following? - Answer-Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease.
/.Which of the following statements indicates the caregiver understands your discharge
teaching on influenza? - Answer-My child can go to daycare since they have been off of
Tylenol and fever free for 24 hours.
CORRECT ANSWERS 2025
/.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? -
Answer-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.
/.You are discharging a patient to home with a history of depression. Discharge teaching
should include which of the following? - Answer-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.
/.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? - Answer-Obtain vascular
access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions.
/.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? - Answer-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.
/.What is the priority intervention for symptomatic bradycardia in a four-year-old child? -
Answer-ventilation to address hypoxia is the priority intervention.
, /.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? - Answer-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."
/.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? - Answer-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
/.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? - Answer-Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate
by increasing heart rate
/.Which of the following patient presentations should increase suspicion of potential
child maltreatment? - Answer-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
Pg 11Any bruising in a child younger than 4 months.
/.All of the vaccine administrations listed are appropriate EXCEPT for which of the
following? - Answer-Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease.
/.Which of the following statements indicates the caregiver understands your discharge
teaching on influenza? - Answer-My child can go to daycare since they have been off of
Tylenol and fever free for 24 hours.
