ENPC FINAL EXAM WITH QUESTIONS AND ANSWERS (VERIFIED
ANSWERS GRADED A+) LATEST UPDATE 2024/2025
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% - CORRECT 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 - CORRECT 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. - CORRECT
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 - CORRECT 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 -
CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than
three weeks
A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations,
diminished breath sounds, and an occasional cough. Which of the following
interventions is the initial management priority?
ANSWERS GRADED A+) LATEST UPDATE 2024/2025
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% - CORRECT 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 - CORRECT 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. - CORRECT
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 - CORRECT 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 -
CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than
three weeks
A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations,
diminished breath sounds, and an occasional cough. Which of the following
interventions is the initial management priority?
