ENPC 5th edition Questions and Answers Graded A
A 5 year-old with no health problems presents to The patient has no seizure history. Upon
the Emergency Department with a sudden onset examination, the patient is post-ictal with a heart
of chest pain and shortness of breath. Parents rate of 142 beats per minute, respiratory rate of
state that the family was involved in a bad car 36 breaths per minute, and blood pressure of
crash one week ago. A thorough assessment 86/72 mm Hg. Significant burns are noted to the
and workup has not revealed any abnormalities. patient's back and lower extremities. The mother
Which of the following steps is the best next step states the burns accidentally occurred 3 days
to take? - ANSWER -Ask about any new ago, but she was afraid to bring patient in due to
bed-wetting or sleep disturbances an ongoing child welfare investigation. Which of
the following are the MOST appropriate
Pediatric patients with anxiety and PTSD may immediate interventions? - ANSWER -Draw
present with physical complaints. Assess for and send a metabolic panel and venous blood
other behavioral symptoms to facilitate gas, administer a fluid bolus, and obtain a point
appropriate care and follow-up. of care glucose
Electrolyte imbalances need to be identified and
You are discharging a patient to home with a treated to prevent another seizure.
history of depression. Discharge teaching should
include which of the following? -
ANSWER -Ensuring all firearms in the What is the priority intervention for symptomatic
home are locked in a safe place with no access bradycardia in a four-year-old child? -
by the patient. ANSWER -ventilation to address hypoxia is
the priority intervention.
Promoting injury prevention with caregivers of
patients with a history of depression or suicidal
ideation by encouraging that all firearms and A 14-year-old high school student who was
medications are under lock to prevent overdoses pitching for his baseball team was hit in the chest
or suicide attempt. by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of
the cardiac arrest? - ANSWER -Commotio
A 2-year old has uniformly demarcated burns to cordis
bilateral lower extremities, approximately 30% of
the childs total body surface area. The father Comotio Cordis "occurs when chest is struck
states he briefly left the room while the child was during the refractory period of the cardiac
in the bath and the child apparently played with conduction cycle. This type of injury usually
the faucet. Which of the following interventions occurs in recreational sports such as baseball or
has the highest priority? - ANSWER - ice hockey."
Obtain vascular access for rapid fluid
administration
A 5-year-old child presents to the emergency
Rapid vascular access and fluid administration department after being hit by a car. She
are the priority interventions. complains of left upper quadrant pain and the
focused assessment with sonography for trauma
(FAST) exam shows fluid around her spleen.
A 7-year-old arrives via ambulance. The patient's Which of the following findings would be an early
mother reports witnessing a seizure at home. indication of ongoing blood loss? -
1/7
, ENPC 5th edition Questions and Answers Graded A
ANSWER -Focused Assessment: Vital
Signs: "As the patient compensates for altered Which of the following statements indicates the
tissue perfusion, the pulse pressure narrows and caregiver understands your discharge teaching
the heart rate increases" - (need to rewrite either on influenza? - ANSWER -My child can go
the question or the answers) to daycare since they have been off of Tylenol
and fever free for 24 hours.
Widening Pulse pressure - not correct (suppose
to be narrow pulse pressure) Yes, the patient needs to be afebrile WITHOUT
Bradycardia - not correct the use of antipyretics to be able to go back to
Decreasing diastolic blood pressure - late sign daycare or school.
Weak peripheral pulses - late sign
The neurosurgeon has decided to perform an
A 5-year-old patient presents to the emergency invasive procedure in the emergency department
department with severe dehydration due to viral to monitor the intracranial pressure on a 5-year-
gastroenteritis. He has signs of shock due to his old patient. The family does not speak English
hypovolemia. Which of the following physiologic and has identified their religion as Muslim. Which
responses to shock has the greatest impact on of the following interventions is most supportive
improving cardiac output in the pediatric patient? of the family? - ANSWER -Dedicate a
- ANSWER -Increasing heart rate healthcare team member with a qualified
interpreter to be with the family during the
Pathophysiology: Cardiac Output. In pediatric procedure.
patients, cardiac out is primarily regulate by
increasing heart rate Providing the option for family presence with an
assigned team member to facilitate
communication is most supportive of the family in
Which of the following patient presentations this situation.
should increase suspicion of potential child
maltreatment? - ANSWER -Bruising to the
left ear of a newborn from sleeping on his side A 6 year-old child presents to the emergency
department with caregivers who report a cough
Pg 10- Any bruises in a non exploratory location with nasal congestion and pink-eye that started 2
(especially torso ears, neck) in children younger days ago. They have been treating with an over-
than 4 the-counter medicine without relief. Today they
noticed a raised red rash on the face and papules
Pg 11Any bruising in a child younger than 4 in the mouth. You suspect which of the following?
months. - ANSWER -Rubeola On presentation the
child starts with cough, nasal inflammation
(coryza) and a non-purulent conjunctivitis.
All of the vaccine administrations listed are
appropriate EXCEPT for which of the following? - After 2-4 days a rash begins as erythematous
ANSWER -Fifth Disease at 6 months macules and papules on the face that spreads to
the torso and extremities.
There is an animal vaccine, but not a human
vaccine for Fifth Disease.
A fertilizer silo exploded during a school tour of a
2/7
A 5 year-old with no health problems presents to The patient has no seizure history. Upon
the Emergency Department with a sudden onset examination, the patient is post-ictal with a heart
of chest pain and shortness of breath. Parents rate of 142 beats per minute, respiratory rate of
state that the family was involved in a bad car 36 breaths per minute, and blood pressure of
crash one week ago. A thorough assessment 86/72 mm Hg. Significant burns are noted to the
and workup has not revealed any abnormalities. patient's back and lower extremities. The mother
Which of the following steps is the best next step states the burns accidentally occurred 3 days
to take? - ANSWER -Ask about any new ago, but she was afraid to bring patient in due to
bed-wetting or sleep disturbances an ongoing child welfare investigation. Which of
the following are the MOST appropriate
Pediatric patients with anxiety and PTSD may immediate interventions? - ANSWER -Draw
present with physical complaints. Assess for and send a metabolic panel and venous blood
other behavioral symptoms to facilitate gas, administer a fluid bolus, and obtain a point
appropriate care and follow-up. of care glucose
Electrolyte imbalances need to be identified and
You are discharging a patient to home with a treated to prevent another seizure.
history of depression. Discharge teaching should
include which of the following? -
ANSWER -Ensuring all firearms in the What is the priority intervention for symptomatic
home are locked in a safe place with no access bradycardia in a four-year-old child? -
by the patient. ANSWER -ventilation to address hypoxia is
the priority intervention.
Promoting injury prevention with caregivers of
patients with a history of depression or suicidal
ideation by encouraging that all firearms and A 14-year-old high school student who was
medications are under lock to prevent overdoses pitching for his baseball team was hit in the chest
or suicide attempt. by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of
the cardiac arrest? - ANSWER -Commotio
A 2-year old has uniformly demarcated burns to cordis
bilateral lower extremities, approximately 30% of
the childs total body surface area. The father Comotio Cordis "occurs when chest is struck
states he briefly left the room while the child was during the refractory period of the cardiac
in the bath and the child apparently played with conduction cycle. This type of injury usually
the faucet. Which of the following interventions occurs in recreational sports such as baseball or
has the highest priority? - ANSWER - ice hockey."
Obtain vascular access for rapid fluid
administration
A 5-year-old child presents to the emergency
Rapid vascular access and fluid administration department after being hit by a car. She
are the priority interventions. complains of left upper quadrant pain and the
focused assessment with sonography for trauma
(FAST) exam shows fluid around her spleen.
A 7-year-old arrives via ambulance. The patient's Which of the following findings would be an early
mother reports witnessing a seizure at home. indication of ongoing blood loss? -
1/7
, ENPC 5th edition Questions and Answers Graded A
ANSWER -Focused Assessment: Vital
Signs: "As the patient compensates for altered Which of the following statements indicates the
tissue perfusion, the pulse pressure narrows and caregiver understands your discharge teaching
the heart rate increases" - (need to rewrite either on influenza? - ANSWER -My child can go
the question or the answers) to daycare since they have been off of Tylenol
and fever free for 24 hours.
Widening Pulse pressure - not correct (suppose
to be narrow pulse pressure) Yes, the patient needs to be afebrile WITHOUT
Bradycardia - not correct the use of antipyretics to be able to go back to
Decreasing diastolic blood pressure - late sign daycare or school.
Weak peripheral pulses - late sign
The neurosurgeon has decided to perform an
A 5-year-old patient presents to the emergency invasive procedure in the emergency department
department with severe dehydration due to viral to monitor the intracranial pressure on a 5-year-
gastroenteritis. He has signs of shock due to his old patient. The family does not speak English
hypovolemia. Which of the following physiologic and has identified their religion as Muslim. Which
responses to shock has the greatest impact on of the following interventions is most supportive
improving cardiac output in the pediatric patient? of the family? - ANSWER -Dedicate a
- ANSWER -Increasing heart rate healthcare team member with a qualified
interpreter to be with the family during the
Pathophysiology: Cardiac Output. In pediatric procedure.
patients, cardiac out is primarily regulate by
increasing heart rate Providing the option for family presence with an
assigned team member to facilitate
communication is most supportive of the family in
Which of the following patient presentations this situation.
should increase suspicion of potential child
maltreatment? - ANSWER -Bruising to the
left ear of a newborn from sleeping on his side A 6 year-old child presents to the emergency
department with caregivers who report a cough
Pg 10- Any bruises in a non exploratory location with nasal congestion and pink-eye that started 2
(especially torso ears, neck) in children younger days ago. They have been treating with an over-
than 4 the-counter medicine without relief. Today they
noticed a raised red rash on the face and papules
Pg 11Any bruising in a child younger than 4 in the mouth. You suspect which of the following?
months. - ANSWER -Rubeola On presentation the
child starts with cough, nasal inflammation
(coryza) and a non-purulent conjunctivitis.
All of the vaccine administrations listed are
appropriate EXCEPT for which of the following? - After 2-4 days a rash begins as erythematous
ANSWER -Fifth Disease at 6 months macules and papules on the face that spreads to
the torso and extremities.
There is an animal vaccine, but not a human
vaccine for Fifth Disease.
A fertilizer silo exploded during a school tour of a
2/7
