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ULTIMATE ENPC Questions with
Detailed Verified Answers
Question: A 4-year-old presents with vomiting, lethargy, frequent urination,
weight loss, and dry mucous membranes. Vital signs reveal deep respirations
at 44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute.
Which of the following laboratory values would be most expected in this child?
✓ Answer: Hypoglycemia (wrong)
✓
✓ Remediation feedback:
✓ Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence (polyuria), vomiting,
abdominal pain, Kussmaul respirations (to counter the acidosis),
polydipsia, anorexia, and weight loss. Expected laboratory values would
reveal an acidotic state with a pH level below 7.3, an elevated serum
bIcarbonate level, and an elevated blood glucose level > 200 mg.dL.
Question:
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing
noted on auscultation in the right upper lobe of the lung field after a choking
event 4 days ago. The white blood cell count is elevated and the patient noted
to be tachypneic, tachycardic, agitated, and has an increased respiratory
effort. At the time of the event, the patient was started on antibiotics with
, Page | 2
subsequent increasing manifestations instead of improvement. Which of the
following would be considered to be definitive treatment for the suspected
diagnosis?
✓ Answer: The definitive treatment would be a bronchoscopy in order to
retrieve the suspected foreign body instead of diagnostic tests to locate
the foreign body itself.
Question:
A child in cardiopulmonary arrest is receiving chest compressions and manual
ventilations with a bag-mask device. Once return of spontaneous circulation
has been confirmed, which of the following would be the priority intervention?
✓ Answer: Establishing a secure airway
Question:
Parents report their 3-year-old child has developed noisy breathing. On
assessment, high-pitched wheezes are audible and auscultated on inspiration
and expiration. What medication would be appropriate to administer first?
✓ Answer: initial medication intervention includes an inhaled short-
acting beta agonist.
Question:
A 6-week-old is brought to the emergency department by the caregivers for
poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR
160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C),
, Page | 3
and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these
findings what is the most likely diagnostic test the nurse should anticipate?
✓ Answer: Lumbar puncture
Question:
A 12-year-old is being prepped for surgical intervention of acute appendicitis.
Which of the following intravenous medication orders should the nurse
question?
✓ Answer: Ketorolac
✓
✓ Remediation feedback:
✓ Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
Question:
A 17-year-old female arrives in the ED with her boyfriend who states she is
pregnant and having vaginal bleeding. The patient is unsure of the gestational
age and has not had any prenatal treatment. The patient is quiet and lets her
boyfriend answer most of the questions. Which of the following is the most
appropriate action for the nurse to take at this point?
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✓ Answer: Have the boyfriend leave the room during the pelvic exam.
Question:
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids
immediately. After several attempts, your team has been unsuccessful at
establishing vascular access. Of the following, which is the next best option for
establishing access quickly?
✓ Answer: Intraosseous in the patient's medial tibia.
Question:
A child with an electrical injury is seen 1 hour post event. Which of the
following types of specimen samples would provide visual information
regarding a potential complication of this injury?
✓ Answer: Myoglobin is excreted in the urine and is evidenced by dark,
red-tinged urine.
Question:
Parents with an infant requiring multiple laboratory tests, radiographic
studies, and invasive procedures appear to be distressed and withdrawn.
Which of the following interventions would best ensure a sense of comfort and
control for these parents?
✓ Answer: Providing frequent updates and re-educating them on the care
that is being provided
ULTIMATE ENPC Questions with
Detailed Verified Answers
Question: A 4-year-old presents with vomiting, lethargy, frequent urination,
weight loss, and dry mucous membranes. Vital signs reveal deep respirations
at 44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute.
Which of the following laboratory values would be most expected in this child?
✓ Answer: Hypoglycemia (wrong)
✓
✓ Remediation feedback:
✓ Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence (polyuria), vomiting,
abdominal pain, Kussmaul respirations (to counter the acidosis),
polydipsia, anorexia, and weight loss. Expected laboratory values would
reveal an acidotic state with a pH level below 7.3, an elevated serum
bIcarbonate level, and an elevated blood glucose level > 200 mg.dL.
Question:
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing
noted on auscultation in the right upper lobe of the lung field after a choking
event 4 days ago. The white blood cell count is elevated and the patient noted
to be tachypneic, tachycardic, agitated, and has an increased respiratory
effort. At the time of the event, the patient was started on antibiotics with
, Page | 2
subsequent increasing manifestations instead of improvement. Which of the
following would be considered to be definitive treatment for the suspected
diagnosis?
✓ Answer: The definitive treatment would be a bronchoscopy in order to
retrieve the suspected foreign body instead of diagnostic tests to locate
the foreign body itself.
Question:
A child in cardiopulmonary arrest is receiving chest compressions and manual
ventilations with a bag-mask device. Once return of spontaneous circulation
has been confirmed, which of the following would be the priority intervention?
✓ Answer: Establishing a secure airway
Question:
Parents report their 3-year-old child has developed noisy breathing. On
assessment, high-pitched wheezes are audible and auscultated on inspiration
and expiration. What medication would be appropriate to administer first?
✓ Answer: initial medication intervention includes an inhaled short-
acting beta agonist.
Question:
A 6-week-old is brought to the emergency department by the caregivers for
poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR
160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C),
, Page | 3
and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these
findings what is the most likely diagnostic test the nurse should anticipate?
✓ Answer: Lumbar puncture
Question:
A 12-year-old is being prepped for surgical intervention of acute appendicitis.
Which of the following intravenous medication orders should the nurse
question?
✓ Answer: Ketorolac
✓
✓ Remediation feedback:
✓ Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
Question:
A 17-year-old female arrives in the ED with her boyfriend who states she is
pregnant and having vaginal bleeding. The patient is unsure of the gestational
age and has not had any prenatal treatment. The patient is quiet and lets her
boyfriend answer most of the questions. Which of the following is the most
appropriate action for the nurse to take at this point?
, Page | 4
✓ Answer: Have the boyfriend leave the room during the pelvic exam.
Question:
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids
immediately. After several attempts, your team has been unsuccessful at
establishing vascular access. Of the following, which is the next best option for
establishing access quickly?
✓ Answer: Intraosseous in the patient's medial tibia.
Question:
A child with an electrical injury is seen 1 hour post event. Which of the
following types of specimen samples would provide visual information
regarding a potential complication of this injury?
✓ Answer: Myoglobin is excreted in the urine and is evidenced by dark,
red-tinged urine.
Question:
Parents with an infant requiring multiple laboratory tests, radiographic
studies, and invasive procedures appear to be distressed and withdrawn.
Which of the following interventions would best ensure a sense of comfort and
control for these parents?
✓ Answer: Providing frequent updates and re-educating them on the care
that is being provided
