ENPC 6th Edition Course Exam
Questions with Correct Answers 2025
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? -
CORRECT 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, ab
dominal pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia, and weight loss. Ex
pected laboratory values would reveal an acidotic state with a pH level below 7.3, an elevated serum b
Icarbonate level, and an elevated blood glucose level > 200 mg.dL.
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 tim
e of the event, the patient was started on antibiotics with subsequent increasing manifestations instead
of improvement. Which of the following would be considered to be definitive treatment for the suspect
ed diagnosis? - CORRECT ANSWERV-Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with subsequent failure to im
prove on antibiotics. Wheezing or decreased lung sounds in one area of the pulmonary system is a hig
h indicator for a foreign body along with signs of hypoxia such as cyanosis, tachypnea, tachycardia, in
creased respiratory effort, agitation or lethargy, and elevated white blood cell counts indicating an infec
tious process. The definitive treatment would be a bronchoscopy in order to retrieve the suspected forei
gn body instead of diagnostic tests to locate the foreign body itself.
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 woul
d be the priority intervention? - CORRECT ANSWER-Establishing a secure airway
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? - CORRECT ANSWERV-Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population. Initial medication interventi
on includes an inhaled short-acting beta agonist.
A 6-week-
old is brought to the emergency department by the caregivers for poor feeding, listlessness, and fever.
Assessment reveals a crying infant, HRV160 beats/minute, RRV52 breaths/minute, rectal temperature of
, 96.0 F (35.5 C), 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? - CORRECT ANSWER-
Lumbar puncture
A 12-year-
old is being prepped for surgical intervention of acute appendicitis. Which of the following intravenous
medication orders should the nurse question? - CORRECT ANSWER-Hydromorphone (wrong)
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.
A 17-year-
old female arrives in the ED with her boyfriend who states she is pregnant and having vaginal bleedin
g. The patient is unsure of the gestational age and has not had any prenatal treatment. The patient is qu
iet 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? - CORRECT ANSWER-
Have the boyfriend leave the room during the pelvic exam.
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 opt
ion for establishing access quickly? - CORRECT ANSWER-Intraosseous in the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of specimen s
amples would provide visual information regarding a potential complication of this injury? -
CORRECT ANSWER-Sputum (wrong)
Remediation feedback:
Electrical injuries, though they may appear to be small, can produce large amounts of damage internall
y, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-
tinged urine.
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 sens
e of comfort and control for these parents? - CORRECT ANSWERV-
Providing frequent updates and re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
CORRECT ANSWER-Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations for topica
l anesthesia would be the best choice for this procedure? - CORRECT ANSWER-
LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-
acetylcysteine (NAC) for an acetaminophen overdose? - CORRECT ANSWERV-
A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-
old arrives at the ED post motor vehicle crash. The following assessment is noted: hypotension, tachyc
Questions with Correct Answers 2025
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? -
CORRECT 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, ab
dominal pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia, and weight loss. Ex
pected laboratory values would reveal an acidotic state with a pH level below 7.3, an elevated serum b
Icarbonate level, and an elevated blood glucose level > 200 mg.dL.
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 tim
e of the event, the patient was started on antibiotics with subsequent increasing manifestations instead
of improvement. Which of the following would be considered to be definitive treatment for the suspect
ed diagnosis? - CORRECT ANSWERV-Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with subsequent failure to im
prove on antibiotics. Wheezing or decreased lung sounds in one area of the pulmonary system is a hig
h indicator for a foreign body along with signs of hypoxia such as cyanosis, tachypnea, tachycardia, in
creased respiratory effort, agitation or lethargy, and elevated white blood cell counts indicating an infec
tious process. The definitive treatment would be a bronchoscopy in order to retrieve the suspected forei
gn body instead of diagnostic tests to locate the foreign body itself.
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 woul
d be the priority intervention? - CORRECT ANSWER-Establishing a secure airway
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? - CORRECT ANSWERV-Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population. Initial medication interventi
on includes an inhaled short-acting beta agonist.
A 6-week-
old is brought to the emergency department by the caregivers for poor feeding, listlessness, and fever.
Assessment reveals a crying infant, HRV160 beats/minute, RRV52 breaths/minute, rectal temperature of
, 96.0 F (35.5 C), 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? - CORRECT ANSWER-
Lumbar puncture
A 12-year-
old is being prepped for surgical intervention of acute appendicitis. Which of the following intravenous
medication orders should the nurse question? - CORRECT ANSWER-Hydromorphone (wrong)
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.
A 17-year-
old female arrives in the ED with her boyfriend who states she is pregnant and having vaginal bleedin
g. The patient is unsure of the gestational age and has not had any prenatal treatment. The patient is qu
iet 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? - CORRECT ANSWER-
Have the boyfriend leave the room during the pelvic exam.
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 opt
ion for establishing access quickly? - CORRECT ANSWER-Intraosseous in the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of specimen s
amples would provide visual information regarding a potential complication of this injury? -
CORRECT ANSWER-Sputum (wrong)
Remediation feedback:
Electrical injuries, though they may appear to be small, can produce large amounts of damage internall
y, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-
tinged urine.
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 sens
e of comfort and control for these parents? - CORRECT ANSWERV-
Providing frequent updates and re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
CORRECT ANSWER-Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations for topica
l anesthesia would be the best choice for this procedure? - CORRECT ANSWER-
LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-
acetylcysteine (NAC) for an acetaminophen overdose? - CORRECT ANSWERV-
A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-
old arrives at the ED post motor vehicle crash. The following assessment is noted: hypotension, tachyc
