ENPC PEDIATRIC EMERGENCY CARE EXAM 2025 ,191
QUESTIONS WITH VERIFIED ACCURATE SOLUTIONS
1. A 10-year-old male has been struck by a car while riding his bicycle. He
has a minor hemorrhage on his lower left leg and complains of abdominal
pain. He is awake and has pale skin. His vital signs are P 130, R 32, BP
100/60. These findings are most likely the result of:
A fracture in the leg.
Hypothermia as evidenced by his pale skin.
Pain associated with his abdomen.
Shock.
2. Which site is commonly used for intraosseous access in infants
during pediatric emergencies?
Lateral malleolus
Iliac crest
Proximal femur
Anteromedial tibia
3. In a scenario where a child presents with altered mental status and
respiratory depression after suspected opioid ingestion, which immediate
action should be prioritized following the assessment using the PAT?
Administer intravenous fluids
Provide supplemental
oxygen
Administer Narcan as indicated
Initiate a full neurological examination
4. An infant suffered a significant head injury in a motor vehicle crash and
has been unresponsive. A neck injury was ruled out, so spinal
immobilization is no longer needed. When positioning the patient in the
,crib, the nurse is
,considering placing some padding under the shoulders. What is the purpose
of the padding?
To provide a comfortable position for the patient To
prevent the patient from slipping down in bed
To maintain the patient's head in the neutral position
To prevent aspiration of formula
5. A 9-month-old child is brought to the emergency room by her parents.
They state the child has been irritable for the last several days and
progressively lethargic. The infant vomited several times in the car on the way to
the hospital. The parents state that the infant has not been
previously ill. They deny any history of trauma or accidental ingestion of
medication or poisons. On physical examination, the child is lethargic and
difficult to arouse. Her vital signs are normal. There is no evidence of
external trauma, but retinal hemorrhages are visible on funduscopic
examination. Her fontanel is bulging. What is the most likely diagnosis?
Bacterial meningitis
Oligodendroglioma
DiGeorge
syndrome
Fetal alcohol syndrome
Shaken baby syndrome
6. It's early in the morning and you have just learned that one of your
patients was transported to the hospital during the night after receiving
emergency medical services for a cardiopulmonary arrest. You recall that
the most common form of cardiopulmonary arrest in children is
cardiac arrhythmia
long QT syndrome
anaphylaxis
respiratory failure
, shock
7. A 4-year-old girl presents to the emergency department with difficulty
breathing and a history of asthma. After performing the Pediatric
Assessment Triangle (PAT), you note her appearance is lethargic, her
work of breathing is labored, and her circulation to the skin is poor. What
should be your immediate course of action?
Administer oral antihistamines and monitor her condition.
Initiate oxygen therapy and prepare for possible intubation.
Ask the caregivers about her recent activities and exposures.
Provide reassurance to the caregivers and wait for further
assessment.
8. A mother presents to the emergency department with a 6-week-old infant
with no medical issues after a normal delivery, until yesterday. Mom
states he has been eating poorly, vomiting, and that 'he's hard to wake
up.' The infant is responsive only to painful stimuli. The anterior fontanel
is bulging.
He is mildly tachycardic, but otherwise vital signs are normal. What
diagnostic evaluation will the nurse expect for this infant?
Upper gastrointestinal (GI) series
Rationale: While the infant has been vomiting, this is likely from
increased intracranial pressure, as indicated by the bulging fontanel,
not from any gastrointestinal process. An upper GI series is not
indicated at this time.
Skeletal survey
Rationale: The infant is exhibiting signs and symptoms of abusive
head trauma, formerly known as shaken baby syndrome. A
skeletal survey should be done to detect any rib fractures, which
can be a concurrent injury with abusive head trauma. Other signs
and symptoms consistent with abusive head trauma include
bruising consistent with grip marks around the chest, fixed and
dilated pupils, and retinal hemorrhages. In addition, a skeletal
survey may reveal healing fractures from previous abuse.
QUESTIONS WITH VERIFIED ACCURATE SOLUTIONS
1. A 10-year-old male has been struck by a car while riding his bicycle. He
has a minor hemorrhage on his lower left leg and complains of abdominal
pain. He is awake and has pale skin. His vital signs are P 130, R 32, BP
100/60. These findings are most likely the result of:
A fracture in the leg.
Hypothermia as evidenced by his pale skin.
Pain associated with his abdomen.
Shock.
2. Which site is commonly used for intraosseous access in infants
during pediatric emergencies?
Lateral malleolus
Iliac crest
Proximal femur
Anteromedial tibia
3. In a scenario where a child presents with altered mental status and
respiratory depression after suspected opioid ingestion, which immediate
action should be prioritized following the assessment using the PAT?
Administer intravenous fluids
Provide supplemental
oxygen
Administer Narcan as indicated
Initiate a full neurological examination
4. An infant suffered a significant head injury in a motor vehicle crash and
has been unresponsive. A neck injury was ruled out, so spinal
immobilization is no longer needed. When positioning the patient in the
,crib, the nurse is
,considering placing some padding under the shoulders. What is the purpose
of the padding?
To provide a comfortable position for the patient To
prevent the patient from slipping down in bed
To maintain the patient's head in the neutral position
To prevent aspiration of formula
5. A 9-month-old child is brought to the emergency room by her parents.
They state the child has been irritable for the last several days and
progressively lethargic. The infant vomited several times in the car on the way to
the hospital. The parents state that the infant has not been
previously ill. They deny any history of trauma or accidental ingestion of
medication or poisons. On physical examination, the child is lethargic and
difficult to arouse. Her vital signs are normal. There is no evidence of
external trauma, but retinal hemorrhages are visible on funduscopic
examination. Her fontanel is bulging. What is the most likely diagnosis?
Bacterial meningitis
Oligodendroglioma
DiGeorge
syndrome
Fetal alcohol syndrome
Shaken baby syndrome
6. It's early in the morning and you have just learned that one of your
patients was transported to the hospital during the night after receiving
emergency medical services for a cardiopulmonary arrest. You recall that
the most common form of cardiopulmonary arrest in children is
cardiac arrhythmia
long QT syndrome
anaphylaxis
respiratory failure
, shock
7. A 4-year-old girl presents to the emergency department with difficulty
breathing and a history of asthma. After performing the Pediatric
Assessment Triangle (PAT), you note her appearance is lethargic, her
work of breathing is labored, and her circulation to the skin is poor. What
should be your immediate course of action?
Administer oral antihistamines and monitor her condition.
Initiate oxygen therapy and prepare for possible intubation.
Ask the caregivers about her recent activities and exposures.
Provide reassurance to the caregivers and wait for further
assessment.
8. A mother presents to the emergency department with a 6-week-old infant
with no medical issues after a normal delivery, until yesterday. Mom
states he has been eating poorly, vomiting, and that 'he's hard to wake
up.' The infant is responsive only to painful stimuli. The anterior fontanel
is bulging.
He is mildly tachycardic, but otherwise vital signs are normal. What
diagnostic evaluation will the nurse expect for this infant?
Upper gastrointestinal (GI) series
Rationale: While the infant has been vomiting, this is likely from
increased intracranial pressure, as indicated by the bulging fontanel,
not from any gastrointestinal process. An upper GI series is not
indicated at this time.
Skeletal survey
Rationale: The infant is exhibiting signs and symptoms of abusive
head trauma, formerly known as shaken baby syndrome. A
skeletal survey should be done to detect any rib fractures, which
can be a concurrent injury with abusive head trauma. Other signs
and symptoms consistent with abusive head trauma include
bruising consistent with grip marks around the chest, fixed and
dilated pupils, and retinal hemorrhages. In addition, a skeletal
survey may reveal healing fractures from previous abuse.
