ENPC 6th Edition Course Exam Questions and answers Updated

ENPC 6th Edition Course Exam
Questions and answers Updated
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
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mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of
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70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory values
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would be most expected in this child? - Correct Answers Hypoglycemia (wrong)
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Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations
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include signs of dehydration ( dry mucous membranes, hypotension, tachycardia),
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incontinence (polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the
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acidosis), polydipsia, anorexia, and weight loss. Expected laboratory values would reveal
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an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate level, and an
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elevated blood glucose level > 200 mg.dL.
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An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on
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auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The
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white blood cell count is elevated and the patient noted to be tachypneic, tachycardic,
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agitated, and has an increased respiratory effort. At the time of the event, the patient was
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started on antibiotics with subsequent increasing manifestations instead of improvement.
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Which of the following would be considered to be definitive treatment for the suspected
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diagnosis? - Correct Answers Computed tomography (wrong)
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Manifestations of a lower airway foreign body include a choking incident with subsequent I I I I I I I I I I I I



failure to improve on antibiotics. Wheezing or decreased lung sounds in one area of the
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pulmonary system is a high indicator for a foreign body along with signs of hypoxia such as
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cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and
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elevated white blood cell counts indicating an infectious process. The definitive treatment
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would be a bronchoscopy in order to retrieve the suspected foreign body instead of
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diagnostic tests to locate the foreign body itself.
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A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations
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with a bag-mask device. Once return of spontaneous circulation has been confirmed, which
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of the following would be the priority intervention? - Correct Answers Establishing a secure
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airway
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Parents report their 3-year-old child has developed noisy breathing. On assessment, high-
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pitched wheezes are audible and auscultated on inspiration and expiration. What
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medication would be appropriate to administer first? - Correct Answers Humidified oxygen
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(wrong)
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Wheezing is most often identified with asthma in the pediatric population. Initial medication
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intervention includes an inhaled short-acting beta agonist.
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A 6-week-old is brought to the emergency department by the caregivers for poor feeding,
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listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52
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breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel.
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Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test
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the nurse should anticipate? - Correct Answers Lumbar puncture
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A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
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following intravenous medication orders should the nurse question? - Correct Answers
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Hydromorphone (wrong)
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Ketorolac is an appropriate medication for moderate to severe pain, however, it should not
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be used pre-operatively due to its potential to increase the bleeding risk.
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A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and
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having vaginal bleeding. The patient is unsure of the gestational age and has not had any
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prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions.
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Which of the following is the most appropriate action for the nurse to take at this point? -
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Correct Answers Have the boyfriend leave the room during the pelvic exam.
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A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
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several attempts, your team has been unsuccessful at establishing vascular access. Of the
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following, which is the next best option for establishing access quickly? - Correct Answers
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Intraosseous in the patient's medial tibia.
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A child with an electrical injury is seen 1 hour post event. Which of the following types of
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specimen samples would provide visual information regarding a potential complication of
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this injury? - Correct Answers Sputum (wrong)
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Electrical injuries, though they may appear to be small, can produce large amounts of
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damage internally, including muscle damage. Myoglobin is excreted in the urine and is
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evidenced by dark, red-tinged urine.
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Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive
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procedures appear to be distressed and withdrawn. Which of the following interventions
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would best ensure a sense of comfort and control for these parents? - Correct Answers
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Providing frequent updates and re-educating them on the care that is being provided
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When taking vital signs on a stable infant, which of the following should be done first? -
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Correct Answers Respiratory rate
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