ULTIMATE ENPC QUESTIONS AND
ANSWERS 2024/2025 REVISED GRADED
100% PASS.
A 4-year-old presents with vomiting, lethargy, frequent urination, weight
loss, and dry mucous membranes. Vital signs reveal deep respirations at
44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per
minute. Which of the following laboratory values would be most expected in
this child? - Answer Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence (polyuria), vomiting, abdominal
pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia,
and weight loss. Expected laboratory values would reveal an acidotic state
with a pH level below 7.3, an elevated serum bIcarbonate level, and an
elevated blood glucose level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and
wheezing noted on auscultation in the right upper lobe of the lung field after
a choking event 4 days ago. The white blood cell count is elevated and the
patient noted to be tachypneic, tachycardic, agitated, and has an increased
respiratory effort. At the time of the event, the patient was started on
antibiotics with subsequent increasing manifestations instead of
improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis? - Answer The definitive treatment
would be a bronchoscopy in order to retrieve the suspected foreign body
instead of diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and
manual ventilations with a bag-mask device. Once return of spontaneous
circulation has been confirmed, which of the following would be the priority
intervention? - Answer Establishing a secure airway
Parents report their 3-year-old child has developed noisy breathing. On
assessment, high-pitched wheezes are audible and auscultated on
,inspiration and expiration. What medication would be appropriate to
administer first? - Answer initial medication intervention includes an
inhaled short-acting beta agonist.
A 6-week-old is brought to the emergency department by the caregivers for
poor feeding, listlessness, and fever. Assessment reveals a crying infant,
HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F
(35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds.
Based on these findings what is the most likely diagnostic test the nurse
should anticipate? - Answer Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute
appendicitis. Which of the following intravenous medication orders should
the nurse question? - Answer Ketorolac
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
A 17-year-old female arrives in the ED with her boyfriend who states she is
pregnant and having vaginal bleeding. The patient is unsure of the
gestational age and has not had any prenatal treatment. The patient is
quiet and lets her boyfriend answer most of the questions. Which of the
following is the most appropriate action for the nurse to take at this point? -
Answer Have the boyfriend leave the room during the pelvic exam.
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids
immediately. After several attempts, your team has been unsuccessful at
establishing vascular access. Of the following, which is the next best option
for establishing access quickly? - Answer Intraosseous in the patient's
medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the
following types of specimen samples would provide visual information
regarding a potential complication of this injury? - Answer Myoglobin is
excreted in the urine and is evidenced by dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic
studies, and invasive procedures appear to be distressed and withdrawn.
, Which of the following interventions would best ensure a sense of comfort
and control for these parents? - Answer Providing frequent updates and
re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be
done first? - Answer Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the
following preparations for topical anesthesia would be the best choice for
this procedure? - Answer LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine
(NAC) for an acetaminophen overdose? - Answer A bolus infusion of 150
mg/kg NAC should be administered.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the
presence of foul-smelling urine. The child is hypotensive and tachycardic.
Which of the following methods for obtaining a urine sample is most
appropriate in this circumstance? - Answer Urinary catherization
You are discharging a patient home who has a history of depression.
Discharge teaching should include which of the following? - Answer
Ensuring all firearms in the home are locked up with no access available by
the patient.
A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The
patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute,
RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg.
Assessment reveals a capillary refill time of > 5 seconds. Which of the
following would be most indicative of the need for intravenous rehydration
therapy for this patient? - Answer Capillary refill
An 8-month-old arrives with a 12-hour history of intermittent abdominal
pain, non-bilious vomiting, and a low grade fever. On assessment the child
is intermittently inconsolable followed by periods of normal activity. A
sausage-shaped mass is noted during palpation of the abdomen. The
nurse should prepare for which of the following? - Answer Enema with air
A 13-year -old male presents to the triage desk complaining of nausea and
vomiting. The patient looks distressed and pale. He complains of spasming
ANSWERS 2024/2025 REVISED GRADED
100% PASS.
A 4-year-old presents with vomiting, lethargy, frequent urination, weight
loss, and dry mucous membranes. Vital signs reveal deep respirations at
44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per
minute. Which of the following laboratory values would be most expected in
this child? - Answer Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence (polyuria), vomiting, abdominal
pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia,
and weight loss. Expected laboratory values would reveal an acidotic state
with a pH level below 7.3, an elevated serum bIcarbonate level, and an
elevated blood glucose level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and
wheezing noted on auscultation in the right upper lobe of the lung field after
a choking event 4 days ago. The white blood cell count is elevated and the
patient noted to be tachypneic, tachycardic, agitated, and has an increased
respiratory effort. At the time of the event, the patient was started on
antibiotics with subsequent increasing manifestations instead of
improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis? - Answer The definitive treatment
would be a bronchoscopy in order to retrieve the suspected foreign body
instead of diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and
manual ventilations with a bag-mask device. Once return of spontaneous
circulation has been confirmed, which of the following would be the priority
intervention? - Answer Establishing a secure airway
Parents report their 3-year-old child has developed noisy breathing. On
assessment, high-pitched wheezes are audible and auscultated on
,inspiration and expiration. What medication would be appropriate to
administer first? - Answer initial medication intervention includes an
inhaled short-acting beta agonist.
A 6-week-old is brought to the emergency department by the caregivers for
poor feeding, listlessness, and fever. Assessment reveals a crying infant,
HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F
(35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds.
Based on these findings what is the most likely diagnostic test the nurse
should anticipate? - Answer Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute
appendicitis. Which of the following intravenous medication orders should
the nurse question? - Answer Ketorolac
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
A 17-year-old female arrives in the ED with her boyfriend who states she is
pregnant and having vaginal bleeding. The patient is unsure of the
gestational age and has not had any prenatal treatment. The patient is
quiet and lets her boyfriend answer most of the questions. Which of the
following is the most appropriate action for the nurse to take at this point? -
Answer Have the boyfriend leave the room during the pelvic exam.
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids
immediately. After several attempts, your team has been unsuccessful at
establishing vascular access. Of the following, which is the next best option
for establishing access quickly? - Answer Intraosseous in the patient's
medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the
following types of specimen samples would provide visual information
regarding a potential complication of this injury? - Answer Myoglobin is
excreted in the urine and is evidenced by dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic
studies, and invasive procedures appear to be distressed and withdrawn.
, Which of the following interventions would best ensure a sense of comfort
and control for these parents? - Answer Providing frequent updates and
re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be
done first? - Answer Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the
following preparations for topical anesthesia would be the best choice for
this procedure? - Answer LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine
(NAC) for an acetaminophen overdose? - Answer A bolus infusion of 150
mg/kg NAC should be administered.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the
presence of foul-smelling urine. The child is hypotensive and tachycardic.
Which of the following methods for obtaining a urine sample is most
appropriate in this circumstance? - Answer Urinary catherization
You are discharging a patient home who has a history of depression.
Discharge teaching should include which of the following? - Answer
Ensuring all firearms in the home are locked up with no access available by
the patient.
A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The
patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute,
RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg.
Assessment reveals a capillary refill time of > 5 seconds. Which of the
following would be most indicative of the need for intravenous rehydration
therapy for this patient? - Answer Capillary refill
An 8-month-old arrives with a 12-hour history of intermittent abdominal
pain, non-bilious vomiting, and a low grade fever. On assessment the child
is intermittently inconsolable followed by periods of normal activity. A
sausage-shaped mass is noted during palpation of the abdomen. The
nurse should prepare for which of the following? - Answer Enema with air
A 13-year -old male presents to the triage desk complaining of nausea and
vomiting. The patient looks distressed and pale. He complains of spasming
