BARKLEY EMERGENCY NURSE
PRACTITIONER (ENP-C)
CERTIFICATION REVIEW EXAM
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute onset of mid-sternal chest pain. The EKG shows ST-
segment depression in leads V1-V3 and tall R waves in V1-V2. Which coronary artery is most
likely occluded?
A. Left anterior descending artery
B. Left main coronary artery
C. Right coronary artery or Left circumflex artery
D. Posterior descending artery only
Answer: C
Conceptual Explanation: Tall R waves and ST depression in V1-V3 are indicative of a
posterior wall myocardial infarction, which is typically supplied by the RCA or the LCx.
,2. A patient presents with a facial injury. On examination, the hard palate and upper teeth
are mobile when grasping the maxillary incisors, but the zygoma remains stable. This is
characteristic of which Le Fort fracture?
A. Le Fort II
B. Le Fort I
C. Le Fort III
D. Le Fort IV
Answer: B
Conceptual Explanation: Le Fort I is a transverse fracture separating the alveolar process
and hard palate from the rest of the maxilla. Le Fort II involves the nasal bones and
infraorbital rim.
3. Which of the following findings is considered the ‘gold standard’ for diagnosing a globe
rupture in the emergency department?
A. Positive Seidel sign
B. IOP measurement of less than 10 mmHg
C. Hyphema on slit lamp exam
D. Teardrop pupil shape
Answer: A
, Conceptual Explanation: A positive Seidel sign, where fluorescein is diluted by leaking
aqueous humor under a cobalt blue light, indicates globe perforation.
4. A 3-year-old child presents with sudden onset of colicky abdominal pain, vomiting, and a
‘sausage-shaped’ mass in the right upper quadrant. What is the most appropriate initial
diagnostic and therapeutic intervention?
A. Air or ultrasound-guided hydrostatic enema
B. Abdominal CT scan with oral contrast
C. Emergent surgical laparotomy
D. Observation and serial abdominal X-rays
Answer: A
Conceptual Explanation: Intussusception is the most likely diagnosis. Air or hydrostatic
enema is both diagnostic and often curative (therapeutic) for reducing the invagination.
5. A patient presents with symptomatic bradycardia after an accidental overdose of a beta-
blocker. After atropine fails, which medication is the first-line antidote for increasing heart
rate and contractility?
A. Calcium gluconate
B. Glucagon
C. Epinephrine infusion
D. Sodium bicarbonate
PRACTITIONER (ENP-C)
CERTIFICATION REVIEW EXAM
QUESTIONS AND ANSWERS
1. A 45-year-old male presents with acute onset of mid-sternal chest pain. The EKG shows ST-
segment depression in leads V1-V3 and tall R waves in V1-V2. Which coronary artery is most
likely occluded?
A. Left anterior descending artery
B. Left main coronary artery
C. Right coronary artery or Left circumflex artery
D. Posterior descending artery only
Answer: C
Conceptual Explanation: Tall R waves and ST depression in V1-V3 are indicative of a
posterior wall myocardial infarction, which is typically supplied by the RCA or the LCx.
,2. A patient presents with a facial injury. On examination, the hard palate and upper teeth
are mobile when grasping the maxillary incisors, but the zygoma remains stable. This is
characteristic of which Le Fort fracture?
A. Le Fort II
B. Le Fort I
C. Le Fort III
D. Le Fort IV
Answer: B
Conceptual Explanation: Le Fort I is a transverse fracture separating the alveolar process
and hard palate from the rest of the maxilla. Le Fort II involves the nasal bones and
infraorbital rim.
3. Which of the following findings is considered the ‘gold standard’ for diagnosing a globe
rupture in the emergency department?
A. Positive Seidel sign
B. IOP measurement of less than 10 mmHg
C. Hyphema on slit lamp exam
D. Teardrop pupil shape
Answer: A
, Conceptual Explanation: A positive Seidel sign, where fluorescein is diluted by leaking
aqueous humor under a cobalt blue light, indicates globe perforation.
4. A 3-year-old child presents with sudden onset of colicky abdominal pain, vomiting, and a
‘sausage-shaped’ mass in the right upper quadrant. What is the most appropriate initial
diagnostic and therapeutic intervention?
A. Air or ultrasound-guided hydrostatic enema
B. Abdominal CT scan with oral contrast
C. Emergent surgical laparotomy
D. Observation and serial abdominal X-rays
Answer: A
Conceptual Explanation: Intussusception is the most likely diagnosis. Air or hydrostatic
enema is both diagnostic and often curative (therapeutic) for reducing the invagination.
5. A patient presents with symptomatic bradycardia after an accidental overdose of a beta-
blocker. After atropine fails, which medication is the first-line antidote for increasing heart
rate and contractility?
A. Calcium gluconate
B. Glucagon
C. Epinephrine infusion
D. Sodium bicarbonate
