ULTIMATE ENPC EXAM QUESTIONS
AND CORRECT ANSWERS
A school-aged child arrives in the emergency department with a 2-day history of
vomiting. The child is cool and pale, with weak pulses, elevated heart rate, and capillary
refill of 4 to 5 seconds. Which of the following is the priority intervention for the child? -
Answer-Initiate a fluid bolus
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is
noted to have hypotension, tachycardia, and contusions and discoloration across the
lap area. On exam a splenic rupture is suspected. Which of the following diagnoses
should be suspected as a companion injury with these findings and associated
mechanism of injury? - Answer-A chance fracture (fracture of the lumbar spine) is often
associated with belted passengers. Injuries associated with the "seatbelt sign" are small
bowel, abdominal vasculature, ureteral, and splenic and liver injuries.
A caregiver states their 3-year-old child ate some marijuana gummies approximately 3
hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of
breathing is normal. What is your initial intervention? - Answer-You should check blood
sugar for any altered level of consciousness.
A child with an injury to the lower cervical spine with spinal cord involvment would most
likely demonstrate which of the following findings during assessment? - Answer-
Decreased respiratory effort
A 4-week-old infant born prematurely is brought to the emergency department due to
the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of
shock. Based on these findings, what condition should the nurse suspect? - Answer-
Necrotizing enterocolitis
An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of
the following findings would be most indicative that respiratory failure is developing? -
Answer-Extreme lethargy
An anxious 12-year-old child presents to the emergency department with a sudden
onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms
started about 60 minutes after lunch. Which of the following conditions is the most likely
cause of these symptoms? - Answer-Anaphylaxis
,Which of the following is the highest priority intervention for a well-appearing 2-month-
old with a fever? - Answer-Urine culture
A fertilizer silo exploded during a school tour of a working farm. The children are able to
manage their own secretions but all are incontinent and salivating, with excess tearing.
Which of the following is the priority intervention? - Answer-Removal of clothing and
decontamination
Which patient reflects an EMTALA compliant transfer? - Answer-An infant with
respiratory difficulties being transferred to another hospital with the same level of
pediatric care. Parents are not present, and records are copied. (wrong)
Remediation feedback:
Which of the following is the priority intervention for the nurse caring for an
immunocompromised pediatric patient with a fever? - Answer-Placement in a negative
pressure room
A 2-year-old arrives with parents stating the child may have ingested a button battery.
The patient initially choked and coughed and is now drooling with bloody sputum. Which
of the following is the priority intervention? - Answer-Prepare the patient for
hospitalization
During the assessment of a 16-year-old patient, the ED nurse identifies them as a
potential sex trafficking victim. Which of the following trauma-informed care principles
has the highest priority for this patient? - Answer-Physical and psychological safety
A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives,
and hypotension after eating lunch. Which of the following is the priority intervention? -
Answer-Intramuscular epinephrine
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is
noted: hypotension, tachycardia, absent breath sounds from the left chest with an
increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the
urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry
of 86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow
Coma Score of 7. Which of the following orders will prompt the nurse to have a
discussion with the provider before initiating? - Answer-Assist with chest tube insertion
(wrong)
Remediation feedback:
Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood
is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the
areas is also a contraindication for this adjunct.
, A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - Answer-Performing a suicide risk
assessment
A 5-year-old child presents with hives, swelling of the lips and face, and stridor that
developed about an hour after eating lunch. The child has no known allergies. Which of
the following is the priority intervention? - Answer-Administer intramuscular epinephrine
Which of the following pathologic processes would most likely be attributed to a primary
diagnosis of cystic fibrosis? - Answer-Constipation
Which of the following is a family-centered care concept ? - Answer-Cultural
backgrounds are assessed and incorporated into the plan of care.
A caregiver presents to the emergency department with an 18-month-old and reports
the child is not using their left arm after playing a game with an older sibling. The child is
alert and curious, with regular, even respirations, and skin color is appropriate. Using
the Pediatric Assessment Triangle (PAT), how would you categorize this patient? -
Answer-Sick
Components in the prioritization of pediatric emergency care (4) - Answer-PAT,
Focused Assessment (objective information), Focused pediatric Hx(subjective
information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components - Answer-Appearance. Work of
Breathing. Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
PQRST for Pain - Answer-(pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
What age is the respiratory system considered fully developed? - Answer-8 years old
6P's Assessment for Musculoskeletal Trauma - Answer-(pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
AND CORRECT ANSWERS
A school-aged child arrives in the emergency department with a 2-day history of
vomiting. The child is cool and pale, with weak pulses, elevated heart rate, and capillary
refill of 4 to 5 seconds. Which of the following is the priority intervention for the child? -
Answer-Initiate a fluid bolus
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is
noted to have hypotension, tachycardia, and contusions and discoloration across the
lap area. On exam a splenic rupture is suspected. Which of the following diagnoses
should be suspected as a companion injury with these findings and associated
mechanism of injury? - Answer-A chance fracture (fracture of the lumbar spine) is often
associated with belted passengers. Injuries associated with the "seatbelt sign" are small
bowel, abdominal vasculature, ureteral, and splenic and liver injuries.
A caregiver states their 3-year-old child ate some marijuana gummies approximately 3
hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of
breathing is normal. What is your initial intervention? - Answer-You should check blood
sugar for any altered level of consciousness.
A child with an injury to the lower cervical spine with spinal cord involvment would most
likely demonstrate which of the following findings during assessment? - Answer-
Decreased respiratory effort
A 4-week-old infant born prematurely is brought to the emergency department due to
the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of
shock. Based on these findings, what condition should the nurse suspect? - Answer-
Necrotizing enterocolitis
An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of
the following findings would be most indicative that respiratory failure is developing? -
Answer-Extreme lethargy
An anxious 12-year-old child presents to the emergency department with a sudden
onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms
started about 60 minutes after lunch. Which of the following conditions is the most likely
cause of these symptoms? - Answer-Anaphylaxis
,Which of the following is the highest priority intervention for a well-appearing 2-month-
old with a fever? - Answer-Urine culture
A fertilizer silo exploded during a school tour of a working farm. The children are able to
manage their own secretions but all are incontinent and salivating, with excess tearing.
Which of the following is the priority intervention? - Answer-Removal of clothing and
decontamination
Which patient reflects an EMTALA compliant transfer? - Answer-An infant with
respiratory difficulties being transferred to another hospital with the same level of
pediatric care. Parents are not present, and records are copied. (wrong)
Remediation feedback:
Which of the following is the priority intervention for the nurse caring for an
immunocompromised pediatric patient with a fever? - Answer-Placement in a negative
pressure room
A 2-year-old arrives with parents stating the child may have ingested a button battery.
The patient initially choked and coughed and is now drooling with bloody sputum. Which
of the following is the priority intervention? - Answer-Prepare the patient for
hospitalization
During the assessment of a 16-year-old patient, the ED nurse identifies them as a
potential sex trafficking victim. Which of the following trauma-informed care principles
has the highest priority for this patient? - Answer-Physical and psychological safety
A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives,
and hypotension after eating lunch. Which of the following is the priority intervention? -
Answer-Intramuscular epinephrine
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is
noted: hypotension, tachycardia, absent breath sounds from the left chest with an
increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the
urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry
of 86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow
Coma Score of 7. Which of the following orders will prompt the nurse to have a
discussion with the provider before initiating? - Answer-Assist with chest tube insertion
(wrong)
Remediation feedback:
Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood
is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the
areas is also a contraindication for this adjunct.
, A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - Answer-Performing a suicide risk
assessment
A 5-year-old child presents with hives, swelling of the lips and face, and stridor that
developed about an hour after eating lunch. The child has no known allergies. Which of
the following is the priority intervention? - Answer-Administer intramuscular epinephrine
Which of the following pathologic processes would most likely be attributed to a primary
diagnosis of cystic fibrosis? - Answer-Constipation
Which of the following is a family-centered care concept ? - Answer-Cultural
backgrounds are assessed and incorporated into the plan of care.
A caregiver presents to the emergency department with an 18-month-old and reports
the child is not using their left arm after playing a game with an older sibling. The child is
alert and curious, with regular, even respirations, and skin color is appropriate. Using
the Pediatric Assessment Triangle (PAT), how would you categorize this patient? -
Answer-Sick
Components in the prioritization of pediatric emergency care (4) - Answer-PAT,
Focused Assessment (objective information), Focused pediatric Hx(subjective
information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components - Answer-Appearance. Work of
Breathing. Circulation to the skin. This forms the "general impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
PQRST for Pain - Answer-(pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
What age is the respiratory system considered fully developed? - Answer-8 years old
6P's Assessment for Musculoskeletal Trauma - Answer-(pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
