ENPC QUESTIONS WITH CORRECT ANSWERS

ENPC QUESTIONS WITH CORRECT
ANSWERS


A64-day-
old6who6is6brought6to6the6emergency6department6with6the6parental6complaint6of6"not6acti
ng6right"6is6found6to6be6hypoglycemic.6What6is6the6appropriate6glucose6concentration6to6
administer6to6this6neonate?
A.Dextrose65%
B.Dextrose610%
C.Dextrose625%
D.Dextrose650%6-6ans--B

Dextrose610%6is6the6preferred6concentration6for6neonates6with6hypoglycemia6to6protect6t
heir6fragile6vasculature6while6providing6needed6glucose.6Dextrose65%6is6not6used6to6trea
t6hypoglycemia6in6children.6Dextrose625%6is6used6for6children6above6the6age6of656years.6
Dextrose650%6is6not6recommended6for6use6in6pediatrics6unless6it6is6diluted.

Assessment6of6the6fontanelle6provides6the6most6useful6information6for6which6two6compo
nents6of6the6primary6survey?
A.Circulation6and6disability
B.Breathing6and6circulation
C.Disability6and6exposure
D.Circulation6and6exposure6-6ans--A

A6sunken6fontanelle6is6a6red6flag6for6circulation6assessment6in6pediatric6triage6and6may6i
ndicate6dehydration6.6A6bulging6fontanel6is6a6red6flag6for6disability6assessment6in6pediatri
c6triage6and6can6indicate6increased6intracranial6pressure.

Which6of6the6following6indicates6the6need6for6additional6caregiver6education6regarding6a6
urinary6tract6infection?
A.I6should6encourage6my6child6to6drink6extra6fluids.
B.I6need6to6make6a6follow-up6appointment6with6child's6physician.
C.My6child6will6grow6out6of6their6frequent6urinary6tract6infections.
D.My6child6should6complete6all6of6their6antibiotic6medication.6-6ans--C

A6nurse6providing6trauma6informed6care6to6the6family6of6a6seriously6ill6child6should6be6doi
ng6which6of6the6following?
A.Placing6the6family6in6a6quiet,6secluded6room

,B.Referring6to6their6child6as6"the6patient"
C.Making6sure6the6family6does6not6stay6at6the6bedside.
D.Appointing6one6staff6member6to6stay6with6the6family6-6ans--D

Caregivers6experiencing6the6crisis6of6a6critically6ill6child6have6low6attentiveness6and6incre
ased6stress6so6would6benefit6from6having6a6member6of6the6healthcare6team6to6stay6with6t
hem6as6much6as6possible6and6communicate6updates6on6the6plan6of6care.6Caregivers6sh
ould6be6allowed6to6stay6with6their6child6as6much6as6possible6and6not6placed6in6a6seclude
d6room6away6for6them.

The6caregiver6of6a67-
year6old6reports6witnessing6a6seizure6at6home,6but6no6seizure6history.6The6patient6is6post
-
ictal6with6a6heart6rate6of61426beats6per6minute,6respiratory6rate6of6366breaths6per6minute,6
and6blood6pressure6of686/726mm6Hg.6Significant6burns6are6noted6to6the6patient's6back6an
d6lower6extremities.6The6caregiver6states6the6burns6accidentally6occurred6three6days6ago
,6but6was6afraid6to6bring6the6patient6in6due6to6an6ongoing6child6welfare6investigation.Whic
h6of6the6following6groups6of6interventions6are6the6priority6for6this6patient?
A.Call6police6and6child6welfare6authorities6and6have6security6detain6the6caregiver
B.Administer6intravenous6analgesics6and6obtain6a6point6of6care6glucose
C.Draw6a6metabolic6panel,6point6of6care6glucose,6and6administer6a6fluid6bolus
D.Administer6lorazepam6and6a6fluid6bolus6and6place6on6seizure6precautions6-6ans--C

Burn6injuries6result6in6fluid6and6electrolyte6shifts6leading6to6hypovolemia6and6electrolyte6i
mbalances.6Early6identification6and6treatment6of6electrolyte6imbalances6can6help6prevent
6further6seizures.6Contacting6child6protective6services6and6other6authorities6can6wait.6Th

e6patient6is6post-
ictal6so6does6not6require6lorazepam6medication6at6this6time.6Pain6medication6can6and6sh
ould6be6considered6with6significant6burns,6but6is6not6a6priority.

What6is6the6priority6intervention6for6symptomatic6bradycardia6in6a6four-year-old6child?
A.Administer6intravenous6atropine
B.Administer6intravenous6epinephrine
C.Initiate6bag-mask6ventilation
D.Initiate6transcutaneous6pacing6-6ans--C
\
Identifying6and6treating6other6causes,6chest6compressions,6and6epinephrine6are6interven
tions6for6pediatric6bradycardia6with6signs6of6poor6perfusion6that6are6not6improved6by6ade
quate6oxygenation6and6ventilation.6Atropine6and6pacing6may6be6considered6if6there6is6no
6response6to6the6other6interventions.



A65-year-
old6child6presents6to6the6emergency6department6after6being6hit6by6a6car.6The6patient6co
mplains6of6left6upper6quadrant6pain,6and6the6focused6assessment6with6sonography6for6tr
auma6(FAST)6exam6shows6fluid6around6her6spleen.6Which6of6the6following6findings6woul
d6be6an6early6indication6of6ongoing6blood6loss?

, A.Widening6pulse6pressure
B.Bradycardia
C.Decreasing6diastolic6blood6pressure
D.Weak6peripheral6pulses6-6ans--D

Early6signs6of6hypovolemic6shock6include6tachycardia6and6delayed6capillary6refill.6The6n
urse6may6note6a6strong6central6pulse6but6weaker6peripheral6pulses,6indicating6the6child6i
s6compensating6by6shunting6blood6to6their6core.

Which6of6the6following6patients6should6be6evaluated6first?
A.A63-year-old6with6a6dislodged6gastrostomy6tube
B.An618-month-old6with6bilious6emesis
C.A612-year-old6with6vomiting6after6a6handlebar6injury
D.A63-month-old6with6periods6of6inconsolable6crying6-6ans--B

The6presence6of6bilious6emesis6is6especially6concerning6because6it6may6be6indicative6of6
an6immediately6life-
threatening6bowel6obstruction.6A6dislodged6gastrostomy6tube6should6be6reinserted6within
64-

66hours6to6prevent6stoma6closure.6Vomiting6following6a6handlebar6injury6may6be6indicativ
e6of6many6possible6injuries,6but6does6not6take6precedence6unless6other6symptoms6are6p
resent.6Infantile6colic6is6described6as6inconsolable6crying6in6infants,626weeks6to646months
6old,6for6up6to636hours6per6day,6more6than636days6per6week,6and6lasting6for6more6than636

weeks.

inconsolable6crying6-6ans--rule6of63s:

crying6more6than636hours6per6day,6more6than6three6days6per6week,6for6longer6than6three6
weeks

A6three-year-
old6is6rescued6after6being6submerged6in6a6pool6for6several6minutes.6On6arrival6the6patien
t6is6responsive6to6painful6stimuli6with6shallow6respirations,6diminished6breath6sounds,6an
d6an6occasional6cough.6Which6of6the6following6interventions6is6the6initial6management6pri
ority?
A.Initiation6of6abdominal6thrusts6to6remove6fluid6from6the6lungs
B.Insertion6of6orogastric6to6remove6of6water6and6debris6from6stomach
C.Endotracheal6intubation6to6provide6positive6pressure6ventilation
D.Removal6of6wet6clothing6to6prevent6hypothermia6-6ans--C

The6primary6survey6assessment6and6treatment6of6deficits6are6the6priority.6Airway6control6
and6positive6pressure6ventilation6while6preparing6for6intubation6of6a6child6who6meets6intu
bation6criteria6(GCS6<68)6should6be6performed6while6also6maintaining6cervical6spine6stab
ilization.6The6child6is6responsive6only6to6painful6stimuli,6has6shallow6respirations,6and6dim
inished6breath6sounds.6All6of6these6are6breathing6problems6and6must6be6addressed6imm
ediately.6Removing6wet6clothing6is6necessary,6but6is6not6the6main6priority6initially.6With6in