ENPC,//6th,//Edition,//Course,//Exam
A,//4-year-
old,//presents,//with,//vomiting,,//lethargy,,//frequent,//urination,,//weigh
t,//loss,,//and,//dry,//mucous,//membranes.,//Vital,//signs,//reveal,//deep,/
/respirations,//at,//44,//breaths,//per,//minute,,//BP,//of,//70/44,//mm,//Hg
,,//and,//HR,//of,//144,//beats,//per,//minute.,//Which,//of,//the,//following
,//laboratory,//values,//would,//be,//most,//expected,//in,//this,//child?,//-
,//correct,//answer,//✔ ✔ Hypoglycemia,//(wrong)
Remediation,//feedback:
Children,//can,//present,//with,//new,//onset,//diabetes,//in,//diabetic,//ket
oacidosis.,//Manifestations,//include,//signs,//of,//dehydration,//(,//dry,//
mucous,//membranes,,//hypotension,,//tachycardia),,//incontinence,//(pol
yuria),,//vomiting,,//abdominal,//pain,,//Kussmaul,//respirations,//(to,//co
unter,//the,//acidosis),,//polydipsia,,//anorexia,,//and,//weight,//loss.,//Exp
ected,//laboratory,//values,//would,//reveal,//an,//acidotic,//state,//with,//a
,//pH,//level,//below,//7.3,,//an,//elevated,//serum,//bIcarbonate,//level,,//a
nd,//an,//elevated,//blood,//glucose,//level,//>,//200,//mg.dL.
An,//18-month-
old,//is,//seen,//for,//fever,,//slight,//circumoral,//cyanosis,,//and,//wheezi
ng,//noted,//on,//auscultation,//in,//the,//right,//upper,//lobe,//of,//the,//lun
g,//field,//after,//a,//choking,//event,//4,//days,//ago.,//The,//white,//blood,
//cell,//count,//is,//elevated,//and,//the,//patient,//noted,//to,//be,//tachypne
ic,,//tachycardic,,//agitated,,//and,//has,//an,//increased,//respiratory,//effo
rt.,//At,//the,//time,//of,//the,//event,,//the,//patient,//was,//started,//on,//an
tibiotics,//with,//subsequent,//increasing,//manifestations,//instead,//of,//i
,mprovement.,//Which,//of,//the,//following,//would,//be,//considered,//to,
//be,//definitive,//treatment,//for,//the,//suspected,//diagnosis?,//-
,//correct,//answer,//✔ ✔ Computed,//tomography,//(wrong)
Remediation,//feedback:
Manifestations,//of,//a,//lower,//airway,//foreign,//body,//include,//a,//cho
king,//incident,//with,//subsequent,//failure,//to,//improve,//on,//antibiotic
s.,//Wheezing,//or,//decreased,//lung,//sounds,//in,//one,//area,//of,//the,//
pulmonary,//system,//is,//a,//high,//indicator,//for,//a,//foreign,//body,//al
ong,//with,//signs,//of,//hypoxia,//such,//as,//cyanosis,,//tachypnea,,//tach
ycardia,,//increased,//respiratory,//effort,,//agitation,//or,//lethargy,,//and,/
/elevated,//white,//blood,//cell,//counts,//indicating,//an,//infectious,//pro
cess.,//The,//definitive,//treatment,//would,//be,//a,//bronchoscopy,//in,//o
rder,//to,//retrieve,//the,//suspected,//foreign,//body,//instead,//of,//diagno
stic,//tests,//to,//locate,//the,//foreign,//body,//itself.
A,//child,//in,//cardiopulmonary,//arrest,//is,//receiving,//chest,//compress
ions,//and,//manual,//ventilations,//with,//a,//bag-
mask,//device.,//Once,//return,//of,//spontaneous,//circulation,//has,//been
,//confirmed,,//which,//of,//the,//following,//would,//be,//the,//priority,//in
tervention?,//-,//correct,//answer,//✔ ✔
Establishing,//a,//secure,//airway
Parents,//report,//their,//3-year-
old,//child,//has,//developed,//noisy,//breathing.,//On,//assessment,,//high
-
pitched,//wheezes,//are,//audible,//and,//auscultated,//on,//inspiration,//an
, d,//expiration.,//What,//medication,//would,//be,//appropriate,//to,//admin
ister,//first?,//-,//correct,//answer,//✔ ✔
Humidified,//oxygen,//(wrong)
Remediation,//feedback:
Wheezing,//is,//most,//often,//identified,//with,//asthma,//in,//the,//pediatr
ic,//population.,//Initial,//medication,//intervention,//includes,//an,//inhal
ed,//short-acting,//beta,//agonist.
A,//6-week-
old,//is,//brought,//to,//the,//emergency,//department,//by,//the,//caregiver
s,//for,//poor,//feeding,,//listlessness,,//and,//fever.,//Assessment,//reveals
,//a,//crying,//infant,,//HR,//160,//beats/minute,,//RR,//52,//breaths/minut
e,,//rectal,//temperature,//of,//96.0,//F,//(35.5,//C),,//and,//a,//bulging,//ant
erior,//fontanel.,//Capillary,//refill,//is,//4,//seconds.,//Based,//on,//these,//
findings,//what,//is,//the,//most,//likely,//diagnostic,//test,//the,//nurse,//sh
ould,//anticipate?,//-,//correct,//answer,//✔ ✔ Lumbar,//puncture
A,//12-year-
old,//is,//being,//prepped,//for,//surgical,//intervention,//of,//acute,//appen
dicitis.,//Which,//of,//the,//following,//intravenous,//medication,//orders,/
/should,//the,//nurse,//question?,//-,//correct,//answer,//✔ ✔
Hydromorphone,//(wrong)
Remediation,//feedback:
A,//4-year-
old,//presents,//with,//vomiting,,//lethargy,,//frequent,//urination,,//weigh
t,//loss,,//and,//dry,//mucous,//membranes.,//Vital,//signs,//reveal,//deep,/
/respirations,//at,//44,//breaths,//per,//minute,,//BP,//of,//70/44,//mm,//Hg
,,//and,//HR,//of,//144,//beats,//per,//minute.,//Which,//of,//the,//following
,//laboratory,//values,//would,//be,//most,//expected,//in,//this,//child?,//-
,//correct,//answer,//✔ ✔ Hypoglycemia,//(wrong)
Remediation,//feedback:
Children,//can,//present,//with,//new,//onset,//diabetes,//in,//diabetic,//ket
oacidosis.,//Manifestations,//include,//signs,//of,//dehydration,//(,//dry,//
mucous,//membranes,,//hypotension,,//tachycardia),,//incontinence,//(pol
yuria),,//vomiting,,//abdominal,//pain,,//Kussmaul,//respirations,//(to,//co
unter,//the,//acidosis),,//polydipsia,,//anorexia,,//and,//weight,//loss.,//Exp
ected,//laboratory,//values,//would,//reveal,//an,//acidotic,//state,//with,//a
,//pH,//level,//below,//7.3,,//an,//elevated,//serum,//bIcarbonate,//level,,//a
nd,//an,//elevated,//blood,//glucose,//level,//>,//200,//mg.dL.
An,//18-month-
old,//is,//seen,//for,//fever,,//slight,//circumoral,//cyanosis,,//and,//wheezi
ng,//noted,//on,//auscultation,//in,//the,//right,//upper,//lobe,//of,//the,//lun
g,//field,//after,//a,//choking,//event,//4,//days,//ago.,//The,//white,//blood,
//cell,//count,//is,//elevated,//and,//the,//patient,//noted,//to,//be,//tachypne
ic,,//tachycardic,,//agitated,,//and,//has,//an,//increased,//respiratory,//effo
rt.,//At,//the,//time,//of,//the,//event,,//the,//patient,//was,//started,//on,//an
tibiotics,//with,//subsequent,//increasing,//manifestations,//instead,//of,//i
,mprovement.,//Which,//of,//the,//following,//would,//be,//considered,//to,
//be,//definitive,//treatment,//for,//the,//suspected,//diagnosis?,//-
,//correct,//answer,//✔ ✔ Computed,//tomography,//(wrong)
Remediation,//feedback:
Manifestations,//of,//a,//lower,//airway,//foreign,//body,//include,//a,//cho
king,//incident,//with,//subsequent,//failure,//to,//improve,//on,//antibiotic
s.,//Wheezing,//or,//decreased,//lung,//sounds,//in,//one,//area,//of,//the,//
pulmonary,//system,//is,//a,//high,//indicator,//for,//a,//foreign,//body,//al
ong,//with,//signs,//of,//hypoxia,//such,//as,//cyanosis,,//tachypnea,,//tach
ycardia,,//increased,//respiratory,//effort,,//agitation,//or,//lethargy,,//and,/
/elevated,//white,//blood,//cell,//counts,//indicating,//an,//infectious,//pro
cess.,//The,//definitive,//treatment,//would,//be,//a,//bronchoscopy,//in,//o
rder,//to,//retrieve,//the,//suspected,//foreign,//body,//instead,//of,//diagno
stic,//tests,//to,//locate,//the,//foreign,//body,//itself.
A,//child,//in,//cardiopulmonary,//arrest,//is,//receiving,//chest,//compress
ions,//and,//manual,//ventilations,//with,//a,//bag-
mask,//device.,//Once,//return,//of,//spontaneous,//circulation,//has,//been
,//confirmed,,//which,//of,//the,//following,//would,//be,//the,//priority,//in
tervention?,//-,//correct,//answer,//✔ ✔
Establishing,//a,//secure,//airway
Parents,//report,//their,//3-year-
old,//child,//has,//developed,//noisy,//breathing.,//On,//assessment,,//high
-
pitched,//wheezes,//are,//audible,//and,//auscultated,//on,//inspiration,//an
, d,//expiration.,//What,//medication,//would,//be,//appropriate,//to,//admin
ister,//first?,//-,//correct,//answer,//✔ ✔
Humidified,//oxygen,//(wrong)
Remediation,//feedback:
Wheezing,//is,//most,//often,//identified,//with,//asthma,//in,//the,//pediatr
ic,//population.,//Initial,//medication,//intervention,//includes,//an,//inhal
ed,//short-acting,//beta,//agonist.
A,//6-week-
old,//is,//brought,//to,//the,//emergency,//department,//by,//the,//caregiver
s,//for,//poor,//feeding,,//listlessness,,//and,//fever.,//Assessment,//reveals
,//a,//crying,//infant,,//HR,//160,//beats/minute,,//RR,//52,//breaths/minut
e,,//rectal,//temperature,//of,//96.0,//F,//(35.5,//C),,//and,//a,//bulging,//ant
erior,//fontanel.,//Capillary,//refill,//is,//4,//seconds.,//Based,//on,//these,//
findings,//what,//is,//the,//most,//likely,//diagnostic,//test,//the,//nurse,//sh
ould,//anticipate?,//-,//correct,//answer,//✔ ✔ Lumbar,//puncture
A,//12-year-
old,//is,//being,//prepped,//for,//surgical,//intervention,//of,//acute,//appen
dicitis.,//Which,//of,//the,//following,//intravenous,//medication,//orders,/
/should,//the,//nurse,//question?,//-,//correct,//answer,//✔ ✔
Hydromorphone,//(wrong)
Remediation,//feedback:
