BARKLEY EMERGENCY NURSE
PRACTITIONER (ENP-C)
CERTIFICATION COMPREHENSIVE
MOCK EXAM
1. A 58-year-old male presents with acute chest pain. The EKG reveals ST-segment elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left Anterior Descending (LAD) artery
B. Left Main Coronary Artery
C. Circumflex Artery
D. Right Coronary Artery (RCA)
Answer: D
Conceptual Explanation: ST-segment elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction, which is most commonly supplied by the Right
Coronary Artery (RCA).
2. According to the NEXUS criteria, which of the following patients requires cervical spine
imaging?
A. A patient with a GCS of 15 and no midline tenderness
,B. A patient with a distracting painful injury (e.g., femur fracture)
C. A patient who is not intoxicated and has no focal neuro deficits
D. A patient who can actively rotate their neck 45 degrees without pain
Answer: B
Conceptual Explanation: The NEXUS criteria state that imaging is required if any of the
following are present: midline tenderness, focal neurologic deficit, altered level of
consciousness, intoxication, or a distracting painful injury.
3. A 4-year-old child presents with sudden onset of high fever, drooling, and inspiratory
stridor. The child is sitting in a ‘tripod position’. What is the most appropriate next step?
A. Perform a thorough oral examination with a tongue blade
B. Keep the child calm and prepare for emergent airway management
C. Obtain a lateral neck X-ray immediately in the radiology suite
D. Administer nebulized racemic epinephrine
Answer: B
Conceptual Explanation: The clinical presentation is highly suggestive of epiglottitis.
Agitating the child (e.g., oral exams) can trigger laryngospasm. Airway stabilization in a
controlled environment is the priority.
4. Which of the following findings is part of Beck’s Triad for cardiac tamponade?
A. Hypertension
, B. Bradycardia
C. Flattened neck veins
D. Muffled heart sounds
Answer: D
Conceptual Explanation: Beck’s Triad includes hypotension, muffled heart sounds, and
distended neck veins (JVD).
5. A patient presents after a high-speed motor vehicle collision. On exam, they exhibit
hypotension, JVD, and absent breath sounds on the right side. What is the immediate
treatment?
A. Perform a pericardiocentesis
B. Wait for a portable chest X-ray to confirm the diagnosis
C. Administer a 2L bolus of Normal Saline
D. Perform a needle decompression in the 5th intercostal space, mid-axillary line
Answer: D
Conceptual Explanation: This patient has signs of a tension pneumothorax (hypotension,
JVD, absent breath sounds). Immediate needle decompression is required based on clinical
diagnosis before imaging.
PRACTITIONER (ENP-C)
CERTIFICATION COMPREHENSIVE
MOCK EXAM
1. A 58-year-old male presents with acute chest pain. The EKG reveals ST-segment elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left Anterior Descending (LAD) artery
B. Left Main Coronary Artery
C. Circumflex Artery
D. Right Coronary Artery (RCA)
Answer: D
Conceptual Explanation: ST-segment elevation in leads II, III, and aVF indicates an
inferior wall myocardial infarction, which is most commonly supplied by the Right
Coronary Artery (RCA).
2. According to the NEXUS criteria, which of the following patients requires cervical spine
imaging?
A. A patient with a GCS of 15 and no midline tenderness
,B. A patient with a distracting painful injury (e.g., femur fracture)
C. A patient who is not intoxicated and has no focal neuro deficits
D. A patient who can actively rotate their neck 45 degrees without pain
Answer: B
Conceptual Explanation: The NEXUS criteria state that imaging is required if any of the
following are present: midline tenderness, focal neurologic deficit, altered level of
consciousness, intoxication, or a distracting painful injury.
3. A 4-year-old child presents with sudden onset of high fever, drooling, and inspiratory
stridor. The child is sitting in a ‘tripod position’. What is the most appropriate next step?
A. Perform a thorough oral examination with a tongue blade
B. Keep the child calm and prepare for emergent airway management
C. Obtain a lateral neck X-ray immediately in the radiology suite
D. Administer nebulized racemic epinephrine
Answer: B
Conceptual Explanation: The clinical presentation is highly suggestive of epiglottitis.
Agitating the child (e.g., oral exams) can trigger laryngospasm. Airway stabilization in a
controlled environment is the priority.
4. Which of the following findings is part of Beck’s Triad for cardiac tamponade?
A. Hypertension
, B. Bradycardia
C. Flattened neck veins
D. Muffled heart sounds
Answer: D
Conceptual Explanation: Beck’s Triad includes hypotension, muffled heart sounds, and
distended neck veins (JVD).
5. A patient presents after a high-speed motor vehicle collision. On exam, they exhibit
hypotension, JVD, and absent breath sounds on the right side. What is the immediate
treatment?
A. Perform a pericardiocentesis
B. Wait for a portable chest X-ray to confirm the diagnosis
C. Administer a 2L bolus of Normal Saline
D. Perform a needle decompression in the 5th intercostal space, mid-axillary line
Answer: D
Conceptual Explanation: This patient has signs of a tension pneumothorax (hypotension,
JVD, absent breath sounds). Immediate needle decompression is required based on clinical
diagnosis before imaging.
