ENPC 6TH EDITION EXAM 2026/2027 |
PRACTICE QUESTIONS, VERIFIED ANSWERS
& DETAILED RATIONALES | EMERGENCY
NURSING PEDIATRIC COURSE STUDY GUIDE
| JUST RELEASED PDF
ENPC 6TH EDITION EXAM 2026/2027 | PRACTICE QUESTIONS, VERIFIED
ANSWERS & DETAILED RATIONALES | EMERGENCY NURSING PEDIATRIC
COURSE STUDY GUIDE
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════════════════════════════════
DOCUMENT OVERVIEW:
• This comprehensive study guide contains practice questions specifically designed
for the ENPC 6th Edition examination, featuring verified answers with detailed
rationales to reinforce critical emergency nursing knowledge and clinical decision-
making skills
• Study these questions systematically by reviewing each rationale carefully,
identifying knowledge gaps, and using this material for targeted review sessions
before your examination to build confidence and competency in pediatric
emergency nursing care
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PRACTICE QUESTIONS BEGIN:
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QUESTION 1
A 6-year-old child presents to the emergency department with stridor and
respiratory distress. The child is drooling and appears anxious. What is the
most appropriate initial management?
A) Immediate intubation with sedation
B) Neck X-ray to confirm epiglottitis
,C) Keep child calm, prepare for airway management, obtain lateral neck X-ray if
diagnosis uncertain
D) Start antibiotics immediately before diagnosis
E) Have child lie flat to ease breathing
✓ CORRECT ANSWER: C
RATIONALE: In suspected epiglottitis, maintaining the child's calm demeanor is
essential because agitation can worsen airway obstruction. Intubation should be
prepared but not forced; rather, the child should be kept upright and calm while
diagnostic imaging is obtained if diagnosis is uncertain. Immediate intubation
without proper preparation risks complete airway obstruction. Antibiotics come
after airway stabilization. Positioning flat worsens obstruction.
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QUESTION 2
Which finding is most consistent with croup in a 2-year-old child?
A) Sudden onset of high fever and dysphagia
B) Barky, seal-like cough with inspiratory stridor
C) Severe drooling and inability to swallow
D) Unilateral airway obstruction
E) No fever with acute cyanosis
✓ CORRECT ANSWER: B
RATIONALE: Croup presents classically with a barky or seal-like cough combined
with inspiratory stridor, typically occurring in children 6 months to 3 years old. This
presentation is caused by subglottic inflammation. Sudden high fever with
dysphagia suggests epiglottitis. Severe drooling indicates possible epiglottitis.
Unilateral obstruction suggests foreign body. Croup typically includes fever, not the
absence of it with cyanosis.
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QUESTION 3
A 4-year-old aspirated a peanut 2 hours ago. Which finding would most likely
indicate right mainstem bronchus foreign body placement?
A) Decreased air entry bilaterally
B) Increased breath sounds on the right
C) Decreased air entry on the right with hyperinflation
D) Wheezing throughout all lung fields
E) Stridor with no lung findings
✓ CORRECT ANSWER: C
RATIONALE: Right mainstem bronchus foreign body typically causes decreased
breath sounds on the right side with hyperinflation of the right lung due to air
trapping from one-way valve obstruction. The right mainstem is the most common
location because of its more vertical angle. Bilateral decreased entry suggests other
pathology. Increased breath sounds are unlikely. Stridor indicates upper airway
involvement, not lower airway foreign body.
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QUESTION 4
An 8-month-old infant with bronchiolitis is experiencing respiratory distress.
Which assessment finding would indicate severe disease?
A) Mild intercostal retractions with good air entry
B) Grunting, nasal flaring, and severe retractions with decreased air movement
C) Cough with fever and normal oxygen saturation
D) Wheezing heard at end-expiration only
E) Tachypnea of 40 breaths per minute
, ✓ CORRECT ANSWER: B
RATIONALE: Severe bronchiolitis is characterized by grunting (sign of increased
work of breathing), nasal flaring (accessory muscle use), severe retractions, and
most importantly, decreased air movement (indicating severe obstruction and poor
gas exchange). This clinical triad indicates need for aggressive intervention. Mild
retractions suggest mild disease. Normal oxygen saturation indicates
compensation. End-expiratory wheezing is less concerning. Mild tachypnea alone
doesn't indicate severity.
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QUESTION 5
What is the initial dose of epinephrine for a 5-year-old child in cardiac arrest?
A) 0.01 mg/kg IV/IO of 1:10,000 solution
B) 0.1 mg/kg IV/IO of 1:1,000 solution
C) 1 mg IV/IO regardless of weight
D) 0.02 mg/kg IV/IO of 1:1,000 solution
E) Weight in kg × 0.1 mg of 1:100,000 solution
✓ CORRECT ANSWER: A
RATIONALE: The IV/IO dose of epinephrine for pediatric cardiac arrest is 0.01
mg/kg of the 1:10,000 solution (0.1 mL/kg). This concentration is used
intravenously. The 1:1,000 concentration is only for endotracheal administration.
Using wrong concentration or wrong dose significantly affects cardiac resuscitation
outcomes. The other options represent incorrect concentrations or wrong dosing
calculations for IV/IO administration.
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QUESTION 6
A 3-year-old is brought to the ED following a 15-foot fall. Which sign would
most suggest head injury with increased intracranial pressure?
PRACTICE QUESTIONS, VERIFIED ANSWERS
& DETAILED RATIONALES | EMERGENCY
NURSING PEDIATRIC COURSE STUDY GUIDE
| JUST RELEASED PDF
ENPC 6TH EDITION EXAM 2026/2027 | PRACTICE QUESTIONS, VERIFIED
ANSWERS & DETAILED RATIONALES | EMERGENCY NURSING PEDIATRIC
COURSE STUDY GUIDE
═══════════════════════════════════════════════════════
════════════════════════════════
DOCUMENT OVERVIEW:
• This comprehensive study guide contains practice questions specifically designed
for the ENPC 6th Edition examination, featuring verified answers with detailed
rationales to reinforce critical emergency nursing knowledge and clinical decision-
making skills
• Study these questions systematically by reviewing each rationale carefully,
identifying knowledge gaps, and using this material for targeted review sessions
before your examination to build confidence and competency in pediatric
emergency nursing care
═══════════════════════════════════════════════════════
════════════════════════════════
PRACTICE QUESTIONS BEGIN:
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 1
A 6-year-old child presents to the emergency department with stridor and
respiratory distress. The child is drooling and appears anxious. What is the
most appropriate initial management?
A) Immediate intubation with sedation
B) Neck X-ray to confirm epiglottitis
,C) Keep child calm, prepare for airway management, obtain lateral neck X-ray if
diagnosis uncertain
D) Start antibiotics immediately before diagnosis
E) Have child lie flat to ease breathing
✓ CORRECT ANSWER: C
RATIONALE: In suspected epiglottitis, maintaining the child's calm demeanor is
essential because agitation can worsen airway obstruction. Intubation should be
prepared but not forced; rather, the child should be kept upright and calm while
diagnostic imaging is obtained if diagnosis is uncertain. Immediate intubation
without proper preparation risks complete airway obstruction. Antibiotics come
after airway stabilization. Positioning flat worsens obstruction.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 2
Which finding is most consistent with croup in a 2-year-old child?
A) Sudden onset of high fever and dysphagia
B) Barky, seal-like cough with inspiratory stridor
C) Severe drooling and inability to swallow
D) Unilateral airway obstruction
E) No fever with acute cyanosis
✓ CORRECT ANSWER: B
RATIONALE: Croup presents classically with a barky or seal-like cough combined
with inspiratory stridor, typically occurring in children 6 months to 3 years old. This
presentation is caused by subglottic inflammation. Sudden high fever with
dysphagia suggests epiglottitis. Severe drooling indicates possible epiglottitis.
Unilateral obstruction suggests foreign body. Croup typically includes fever, not the
absence of it with cyanosis.
,═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 3
A 4-year-old aspirated a peanut 2 hours ago. Which finding would most likely
indicate right mainstem bronchus foreign body placement?
A) Decreased air entry bilaterally
B) Increased breath sounds on the right
C) Decreased air entry on the right with hyperinflation
D) Wheezing throughout all lung fields
E) Stridor with no lung findings
✓ CORRECT ANSWER: C
RATIONALE: Right mainstem bronchus foreign body typically causes decreased
breath sounds on the right side with hyperinflation of the right lung due to air
trapping from one-way valve obstruction. The right mainstem is the most common
location because of its more vertical angle. Bilateral decreased entry suggests other
pathology. Increased breath sounds are unlikely. Stridor indicates upper airway
involvement, not lower airway foreign body.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 4
An 8-month-old infant with bronchiolitis is experiencing respiratory distress.
Which assessment finding would indicate severe disease?
A) Mild intercostal retractions with good air entry
B) Grunting, nasal flaring, and severe retractions with decreased air movement
C) Cough with fever and normal oxygen saturation
D) Wheezing heard at end-expiration only
E) Tachypnea of 40 breaths per minute
, ✓ CORRECT ANSWER: B
RATIONALE: Severe bronchiolitis is characterized by grunting (sign of increased
work of breathing), nasal flaring (accessory muscle use), severe retractions, and
most importantly, decreased air movement (indicating severe obstruction and poor
gas exchange). This clinical triad indicates need for aggressive intervention. Mild
retractions suggest mild disease. Normal oxygen saturation indicates
compensation. End-expiratory wheezing is less concerning. Mild tachypnea alone
doesn't indicate severity.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 5
What is the initial dose of epinephrine for a 5-year-old child in cardiac arrest?
A) 0.01 mg/kg IV/IO of 1:10,000 solution
B) 0.1 mg/kg IV/IO of 1:1,000 solution
C) 1 mg IV/IO regardless of weight
D) 0.02 mg/kg IV/IO of 1:1,000 solution
E) Weight in kg × 0.1 mg of 1:100,000 solution
✓ CORRECT ANSWER: A
RATIONALE: The IV/IO dose of epinephrine for pediatric cardiac arrest is 0.01
mg/kg of the 1:10,000 solution (0.1 mL/kg). This concentration is used
intravenously. The 1:1,000 concentration is only for endotracheal administration.
Using wrong concentration or wrong dose significantly affects cardiac resuscitation
outcomes. The other options represent incorrect concentrations or wrong dosing
calculations for IV/IO administration.
═══════════════════════════════════════════════════════
════════════════════════════════
QUESTION 6
A 3-year-old is brought to the ED following a 15-foot fall. Which sign would
most suggest head injury with increased intracranial pressure?
