ENPC FINAL EXAM 2023-2024 ENPC
EXAM LATEST QUESTIONS AND
CORRECT ANSWER RATED A+
A 4-day-old who is brought to the emergency department with the parental
complaint of "not acting right" is found to be hypoglycemic. What is the
appropriate glucose concentration to administer to this neonate?
A.Dextrose 5%
B.Dextrose 10%
C.Dextrose 25%
D.Dextrose 50% - ANSWER-B
Dextrose 10% is the preferred concentration for neonates with
hypoglycemia to protect their fragile vasculature while providing needed
glucose. Dextrose 5% is not used to treat hypoglycemia in children.
Dextrose 25% is used for children above the age of 5 years. Dextrose 50%
is not recommended for use in pediatrics unless it is diluted.
Assessment of the fontanelle provides the most useful information for
which two components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure - ANSWER-A
A sunken fontanelle is a red flag for circulation assessment in pediatric
triage and may indicate dehydration . A bulging fontanel is a red flag for
disability assessment in pediatric triage and can indicate increased
intracranial pressure.
Which of the following indicates the need for additional caregiver education
regarding a urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication. - ANSWER-C
,A nurse providing trauma informed care to the family of a seriously ill child
should be doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family - ANSWER-D
Caregivers experiencing the crisis of a critically ill child have low
attentiveness and increased stress so would benefit from having a member
of the healthcare team to stay with them as much as possible and
communicate updates on the plan of care. Caregivers should be allowed to
stay with their child as much as possible and not placed in a secluded room
away for them.
The caregiver of a 7-year old reports witnessing a seizure at home, but no
seizure history. 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 caregiver states the burns accidentally occurred three
days ago, but was afraid to bring the patient in due to an ongoing child
welfare investigation.Which of the following groups of interventions are the
priority for this patient?
A.Call police and child welfare authorities and have security detain the
caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid
bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions
- ANSWER-C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and
electrolyte imbalances. Early identification and treatment of electrolyte
imbalances can help prevent further seizures. Contacting child protective
services and other authorities can wait. The patient is post-ictal so does not
require lorazepam medication at this time. Pain medication can and should
be considered with significant burns, but is not a priority.
What is the priority intervention for symptomatic bradycardia in a four-year-
old child?
A.Administer intravenous atropine
, B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - ANSWER-C
\
Identifying and treating other causes, chest compressions, and epinephrine
are interventions for pediatric bradycardia with signs of poor perfusion that
are not improved by adequate oxygenation and ventilation. Atropine and
pacing may be considered if there is no response to the other interventions.
A 5-year-old child presents to the emergency department after being hit by
a car. The patient complains of left upper quadrant pain, and the focused
assessment with sonography for trauma (FAST) exam shows fluid around
her spleen. Which of the following findings would be an early indication of
ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - ANSWER-D
Early signs of hypovolemic shock include tachycardia and delayed capillary
refill. The nurse may note a strong central pulse but weaker peripheral
pulses, indicating the child is compensating by shunting blood to their core.
Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - ANSWER-B
The presence of bilious emesis is especially concerning because it may be
indicative of an immediately life-threatening bowel obstruction. A dislodged
gastrostomy tube should be reinserted within 4-6 hours to prevent stoma
closure. Vomiting following a handlebar injury may be indicative of many
possible injuries, but does not take precedence unless other symptoms are
present. Infantile colic is described as inconsolable crying in infants, 2
weeks to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
Inconsolable crying - ANSWER-rule of 3s:
EXAM LATEST QUESTIONS AND
CORRECT ANSWER RATED A+
A 4-day-old who is brought to the emergency department with the parental
complaint of "not acting right" is found to be hypoglycemic. What is the
appropriate glucose concentration to administer to this neonate?
A.Dextrose 5%
B.Dextrose 10%
C.Dextrose 25%
D.Dextrose 50% - ANSWER-B
Dextrose 10% is the preferred concentration for neonates with
hypoglycemia to protect their fragile vasculature while providing needed
glucose. Dextrose 5% is not used to treat hypoglycemia in children.
Dextrose 25% is used for children above the age of 5 years. Dextrose 50%
is not recommended for use in pediatrics unless it is diluted.
Assessment of the fontanelle provides the most useful information for
which two components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure - ANSWER-A
A sunken fontanelle is a red flag for circulation assessment in pediatric
triage and may indicate dehydration . A bulging fontanel is a red flag for
disability assessment in pediatric triage and can indicate increased
intracranial pressure.
Which of the following indicates the need for additional caregiver education
regarding a urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication. - ANSWER-C
,A nurse providing trauma informed care to the family of a seriously ill child
should be doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family - ANSWER-D
Caregivers experiencing the crisis of a critically ill child have low
attentiveness and increased stress so would benefit from having a member
of the healthcare team to stay with them as much as possible and
communicate updates on the plan of care. Caregivers should be allowed to
stay with their child as much as possible and not placed in a secluded room
away for them.
The caregiver of a 7-year old reports witnessing a seizure at home, but no
seizure history. 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 caregiver states the burns accidentally occurred three
days ago, but was afraid to bring the patient in due to an ongoing child
welfare investigation.Which of the following groups of interventions are the
priority for this patient?
A.Call police and child welfare authorities and have security detain the
caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid
bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions
- ANSWER-C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and
electrolyte imbalances. Early identification and treatment of electrolyte
imbalances can help prevent further seizures. Contacting child protective
services and other authorities can wait. The patient is post-ictal so does not
require lorazepam medication at this time. Pain medication can and should
be considered with significant burns, but is not a priority.
What is the priority intervention for symptomatic bradycardia in a four-year-
old child?
A.Administer intravenous atropine
, B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - ANSWER-C
\
Identifying and treating other causes, chest compressions, and epinephrine
are interventions for pediatric bradycardia with signs of poor perfusion that
are not improved by adequate oxygenation and ventilation. Atropine and
pacing may be considered if there is no response to the other interventions.
A 5-year-old child presents to the emergency department after being hit by
a car. The patient complains of left upper quadrant pain, and the focused
assessment with sonography for trauma (FAST) exam shows fluid around
her spleen. Which of the following findings would be an early indication of
ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - ANSWER-D
Early signs of hypovolemic shock include tachycardia and delayed capillary
refill. The nurse may note a strong central pulse but weaker peripheral
pulses, indicating the child is compensating by shunting blood to their core.
Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - ANSWER-B
The presence of bilious emesis is especially concerning because it may be
indicative of an immediately life-threatening bowel obstruction. A dislodged
gastrostomy tube should be reinserted within 4-6 hours to prevent stoma
closure. Vomiting following a handlebar injury may be indicative of many
possible injuries, but does not take precedence unless other symptoms are
present. Infantile colic is described as inconsolable crying in infants, 2
weeks to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
Inconsolable crying - ANSWER-rule of 3s:
