ENPC Exam Prep Questions and Answers

Which of the following would be an abnormal finding in a patient with glomerulonephritis? - Answer Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. - Answer Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? - Answer Allow the extended to family members to serve as interpreters during the procedure. Which of the following patient presentations should increase suspicion of potential child maltreatment? - Answer Bruising to the left ear of a newborn from sleeping on his side Any bruise in a non-exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse Bruising to the left ear of a newborn from sleeping on his side Any bruise in a non-exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse - Answer Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is brought to the emergency department with severe muscle rigidity and hyperthermia. These symptoms are most likely caused by which of the following? - Answer Neuroleptic malignant syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare reaction to antipsychotic medications. Which of the following patients should be evaluated first - Answer An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always considered an emergent symptom indicative of a life-threatening bowel obstruction. 1. Which of the following tasks can the nurse do to decrease adverse medication events? - Answer Obtain the patient's weight in kilograms This is the preferred measurement for medication calculations for pediatric and adult patients Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases? - Answer Sickle cell anemia These are all complications of sickle cell anemia. During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential sex trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for these types of patients. Which of the following care principles has the highest priority? - Answer Physical and psychological safety Create an environment where patients feel safe, both physically and psychologically. Increase awareness of the patient's interpersonal interactions with others to screen for risk of harm. Prioritize the patient being in a safe location A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes? - Answer Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis. The emergency nurse is caring for a patient with significant facial trauma and a suspected globe rupture. Which of the following medication orders would the nurse question? - Answer Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided. A 7-year-old arrives via ambulance. The patient's mother reports witnessing a seizure at home. The patient has no seizure history. Upon examination, the patient is post-ictal with a heart rate of 142 beats per minute, respiratory rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg. Significant burns are noted to the patient's back and lower extremities. The mother states the burns accidentally occurred 3 days ago, but she was afraid to bring patient in due to an ongoing child welfare investigation. Which of the following are the MOST appropriate immediate interventions? - Answer Draw and send a metabolic panel, administer a fluid bolus, and obtain a point of care glucose Significant burns can cause electrolyte imbalances. Electrolyte imbalances may be the cause of the patient's seizure. Electrolyte imbalances need to be identified and treated. In which of the following primary survey components can assessment of the fontanel provide the most useful information? - Answer Circulation and disability A sunken fontanel may indicate dehydration; a bulging fontanel can indicate increased intracranial pressure. A 5-year-old patient presents to the emergency department with severe dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the following physiologic responses to shock has the greatest impact on improving cardiac output in the pediatric patient? - Answer Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. A toddler has a chemical eye injury. Which of the following is the priority intervention? - Answer Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. A 5 year-old with no health problems presents to the Emergency Department with a sudden onset of chest pain and shortness of breath. Parents state that the family was involved in a bad car crash one week ago. A thorough assessment and workup has not revealed any abnormalities. Which of the following steps is the best next step to take? - Answer Ask about any new bed-wetting or sleep disturbances Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other behavioral symptoms to facilitate appropriate care and follow-up. Which of the following is the most appropriate intervention for a child experiencing a seizure? - Answer Prepare to administer intranasal midazolam Midazolam has gained favor because of its ease of use and quick onset of action. An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated prior to arrival. Which of the following is the priority assessment or intervention? - Answer Assess the endotracheal tube placement and patency If a patient arrives with an artificial airway (endotracheal tube or tracheostomy) in place, assess its placement, tube patency, and the oral airway (in that order) before moving to the next step of the primary survey. A three-year-old is rescued after being submerged in a residential pool for several minutes. On arrival at the Emergency Department he is responsive to painful stimuli, has shallow respirations with diminished breath sounds throughout, and has an occasional cough. What is the initial management priority? - Answer Endotracheal intubation with positive pressure ventilation Airway control and positive pressure ventilation are the priority interventions for this patient. A nurse providing crisis intervention to the family of a seriously ill child can best keep the family informed of the child's condition by doing which of the following? - Answer Appointing one staff member to communicate with them. This will help create a solid patient-staff bond and facilitate communication. You are discharging a patient to home with a history of depression. Discharge teaching should include which of the following? - Answer Ensuring all firearms in the home are locked in a safe place with no access by the patient. Promote injury prevention with caregivers of patients with a history of depression or suicidal ideation by encouraging that all firearms and medications are under lock to prevent overdoses or suicide attempt.