ENPC Examination Questions and
Complete Solutions Graded A+
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"
Pediatric Assessment Triangle : Appearance - Answer: Most important. Reflects adequacy of ventilation,
oxygenation, brain perfusion, and central nervous system function.
Assess for : tone, interactiveness, consolability, look/gaze, and speech/cry.
Pediatric Assessment Triangle : Work of Breathing - Answer: Breathing easy, even, and unlabored or
tripod position, nasal flaring, retractions, supraclavicular retractions
Pediatric Assessment Triangle : Circulation to the skin - Answer: Mottling or PWD
PQRST for Pain - Answer: (pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
Verbal Report for pain - Answer: (pg86)
,Self-report is the most reliable indicatior of pain; however not all pediatric pt are capable or wiling to
verbalize their discomfort.
What age is the respiratory system considered fully developed? - Answer: 8 years old
Most ______ age __to____, are concrete thinkers and interpret words literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers. They often confuse coincidence
with causation, and have difficulty distinguising fantasy from reality. - Answer: (pg36)
Most Toddlers age 1yo to 3yo , are concrete thinkers and interpret words literally.
Where as, most Preschoolers age 3yo to 5yo, are magical and illogical thinkers. They often confuse
coincidence with causation, and have difficulty distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____ sign and may indicate a loss
of ___% to ___% of their circulating blood volume. - Answer: (pg262)
Late sign.
20% to 25% of circulating blood volume
6P's Assessment for Musculoskeletal Trauma - Answer: (pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - Answer: 1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
, 6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or
mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
If live interpreter not available for 15mins use ________ - Answer: Language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________ - Answer: suction nose
Opiod antidote - Answer: Narcan
Benzo antidote - Answer: Romazicon
Neutropenic pt with a temperature - Answer: Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern - Answer: Meningocoxcemia
Petiachia/Purpura
Bicycle accident concerns - Answer: Did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal Urine Output for child - Answer: 1 to 2ml / Kg / Hr
Differences of child vs adult : BSA, blood volume, glycogen storage, metabolic rate - Answer: Children
have : increased BSA(predispose to temp dysregulation), decreased circulation blood volume(predispose
to hypovolemia), decreased glycogen storage(predisoposed to hypoglycemia), Increased metabolic rate.
Complete Solutions Graded A+
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"
Pediatric Assessment Triangle : Appearance - Answer: Most important. Reflects adequacy of ventilation,
oxygenation, brain perfusion, and central nervous system function.
Assess for : tone, interactiveness, consolability, look/gaze, and speech/cry.
Pediatric Assessment Triangle : Work of Breathing - Answer: Breathing easy, even, and unlabored or
tripod position, nasal flaring, retractions, supraclavicular retractions
Pediatric Assessment Triangle : Circulation to the skin - Answer: Mottling or PWD
PQRST for Pain - Answer: (pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
Verbal Report for pain - Answer: (pg86)
,Self-report is the most reliable indicatior of pain; however not all pediatric pt are capable or wiling to
verbalize their discomfort.
What age is the respiratory system considered fully developed? - Answer: 8 years old
Most ______ age __to____, are concrete thinkers and interpret words literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers. They often confuse coincidence
with causation, and have difficulty distinguising fantasy from reality. - Answer: (pg36)
Most Toddlers age 1yo to 3yo , are concrete thinkers and interpret words literally.
Where as, most Preschoolers age 3yo to 5yo, are magical and illogical thinkers. They often confuse
coincidence with causation, and have difficulty distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____ sign and may indicate a loss
of ___% to ___% of their circulating blood volume. - Answer: (pg262)
Late sign.
20% to 25% of circulating blood volume
6P's Assessment for Musculoskeletal Trauma - Answer: (pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - Answer: 1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
, 6. Burn injury in pt with preexisting medical disorders that could complicate tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the greatest risk of morbidity or
mortality.
8. Burned children in hospital wo qualified equipment or personnel to care for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
If live interpreter not available for 15mins use ________ - Answer: Language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________ - Answer: suction nose
Opiod antidote - Answer: Narcan
Benzo antidote - Answer: Romazicon
Neutropenic pt with a temperature - Answer: Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern - Answer: Meningocoxcemia
Petiachia/Purpura
Bicycle accident concerns - Answer: Did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal Urine Output for child - Answer: 1 to 2ml / Kg / Hr
Differences of child vs adult : BSA, blood volume, glycogen storage, metabolic rate - Answer: Children
have : increased BSA(predispose to temp dysregulation), decreased circulation blood volume(predispose
to hypovolemia), decreased glycogen storage(predisoposed to hypoglycemia), Increased metabolic rate.
