Emergency Nursing Pediatric Course (ENPC)
Examination – Practice Exam: Verified
Questions and Answers | Instant PDF Study
Guide
1. A 4-year-old child is brought to the emergency department
after being involved in a motor vehicle collision. The child is
awake but anxious and has obvious facial trauma. What is the
priority nursing action?
A. Obtain a complete health history
B. Assess the child's pain level
C. Establish a peripheral IV
D. Assess and maintain the airway while protecting the
cervical spine
Answer: D. Assess and maintain the airway while protecting
the cervical spine
In pediatric trauma, the initial priority follows the ABCDE
approach. Airway assessment and management take
precedence, and cervical spine protection is essential when a
mechanism of injury could have caused spinal trauma. Facial
trauma can rapidly compromise the airway because of bleeding,
edema, secretions, or displaced tissue. Obtaining a history,
assessing pain, and establishing IV access are important but
,should occur after immediate threats to airway and breathing
have been addressed.
2. A 2-year-old child with severe respiratory distress is sitting
upright, drooling, and leaning forward. The child has a muffled
voice and inspiratory stridor. Which action is most
appropriate?
A. Inspect the throat with a tongue blade
B. Place the child supine for examination
C. Keep the child calm and allow the child to remain in a
position of comfort
D. Encourage the child to drink cool fluids
Answer: C. Keep the child calm and allow the child to remain
in a position of comfort
These findings are highly concerning for upper-airway
obstruction, classically associated with epiglottitis. Agitation,
crying, forced positioning, or attempts to visualize the airway
can precipitate complete airway obstruction. The child should be
kept calm, allowed to remain in the position that facilitates
breathing, and managed by personnel prepared for controlled
airway intervention. Routine throat examination with a tongue
blade should be avoided.
,3. A 6-month-old infant presents with respiratory distress.
Which finding is considered an early sign of respiratory
compromise in an infant?
A. Bradycardia
B. Cyanosis
C. Tachycardia
D. Hypotension
Answer: C. Tachycardia
Tachycardia is commonly an early compensatory response to
hypoxia and increased work of breathing in children. Pediatric
patients can maintain blood pressure despite significant
deterioration because of strong compensatory mechanisms.
Bradycardia, hypotension, and cyanosis are generally late and
ominous findings. Therefore, a change in heart rate, respiratory
effort, mental status, and work of breathing should be
recognized early.
4. A child with asthma is receiving nebulized bronchodilator
therapy. Which finding indicates worsening respiratory failure
rather than improvement?
A. Decreased respiratory rate with improved air movement
B. Reduced accessory muscle use
C. Improved ability to speak
, D. Diminishing breath sounds despite continued respiratory
distress
Answer: D. Diminishing breath sounds despite continued
respiratory distress
In a child with severe asthma, a progressively quiet chest can
indicate critically reduced airflow. Although wheezing may
decrease as bronchospasm improves, a marked reduction or
disappearance of breath sounds in a child who remains
distressed can mean that insufficient air is moving through the
airways. This is an ominous sign and may indicate impending
respiratory failure. Improved speech, air movement, and
reduced work of breathing are signs of clinical improvement.
5. A 3-year-old child has a respiratory rate of 48/min, nasal
flaring, intercostal retractions, and grunting. Which
interpretation is most appropriate?
A. The child has mild respiratory distress
B. The child is demonstrating normal respiratory compensation
C. The child has significant respiratory distress and requires
immediate intervention
D. The findings primarily indicate cardiovascular disease
Answer: C. The child has significant respiratory distress and
requires immediate intervention
Examination – Practice Exam: Verified
Questions and Answers | Instant PDF Study
Guide
1. A 4-year-old child is brought to the emergency department
after being involved in a motor vehicle collision. The child is
awake but anxious and has obvious facial trauma. What is the
priority nursing action?
A. Obtain a complete health history
B. Assess the child's pain level
C. Establish a peripheral IV
D. Assess and maintain the airway while protecting the
cervical spine
Answer: D. Assess and maintain the airway while protecting
the cervical spine
In pediatric trauma, the initial priority follows the ABCDE
approach. Airway assessment and management take
precedence, and cervical spine protection is essential when a
mechanism of injury could have caused spinal trauma. Facial
trauma can rapidly compromise the airway because of bleeding,
edema, secretions, or displaced tissue. Obtaining a history,
assessing pain, and establishing IV access are important but
,should occur after immediate threats to airway and breathing
have been addressed.
2. A 2-year-old child with severe respiratory distress is sitting
upright, drooling, and leaning forward. The child has a muffled
voice and inspiratory stridor. Which action is most
appropriate?
A. Inspect the throat with a tongue blade
B. Place the child supine for examination
C. Keep the child calm and allow the child to remain in a
position of comfort
D. Encourage the child to drink cool fluids
Answer: C. Keep the child calm and allow the child to remain
in a position of comfort
These findings are highly concerning for upper-airway
obstruction, classically associated with epiglottitis. Agitation,
crying, forced positioning, or attempts to visualize the airway
can precipitate complete airway obstruction. The child should be
kept calm, allowed to remain in the position that facilitates
breathing, and managed by personnel prepared for controlled
airway intervention. Routine throat examination with a tongue
blade should be avoided.
,3. A 6-month-old infant presents with respiratory distress.
Which finding is considered an early sign of respiratory
compromise in an infant?
A. Bradycardia
B. Cyanosis
C. Tachycardia
D. Hypotension
Answer: C. Tachycardia
Tachycardia is commonly an early compensatory response to
hypoxia and increased work of breathing in children. Pediatric
patients can maintain blood pressure despite significant
deterioration because of strong compensatory mechanisms.
Bradycardia, hypotension, and cyanosis are generally late and
ominous findings. Therefore, a change in heart rate, respiratory
effort, mental status, and work of breathing should be
recognized early.
4. A child with asthma is receiving nebulized bronchodilator
therapy. Which finding indicates worsening respiratory failure
rather than improvement?
A. Decreased respiratory rate with improved air movement
B. Reduced accessory muscle use
C. Improved ability to speak
, D. Diminishing breath sounds despite continued respiratory
distress
Answer: D. Diminishing breath sounds despite continued
respiratory distress
In a child with severe asthma, a progressively quiet chest can
indicate critically reduced airflow. Although wheezing may
decrease as bronchospasm improves, a marked reduction or
disappearance of breath sounds in a child who remains
distressed can mean that insufficient air is moving through the
airways. This is an ominous sign and may indicate impending
respiratory failure. Improved speech, air movement, and
reduced work of breathing are signs of clinical improvement.
5. A 3-year-old child has a respiratory rate of 48/min, nasal
flaring, intercostal retractions, and grunting. Which
interpretation is most appropriate?
A. The child has mild respiratory distress
B. The child is demonstrating normal respiratory compensation
C. The child has significant respiratory distress and requires
immediate intervention
D. The findings primarily indicate cardiovascular disease
Answer: C. The child has significant respiratory distress and
requires immediate intervention
