ENPC 5th Edition Questions & Answers
1.A 5 year-old with no health problems presents to the Emergency
Department with a sudden onset of chest pain and shortness of breath.
Parents state that the family was involved in a bad car crash one week ago.
A thorough assessment and workup has not revealed any abnormalities.
Which of the following steps is the best next step to take?
Answer Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical
complaints. Assess for other behavioral symptoms to facilitate
appropriate care and follow-up.
2.You are discharging a patient to home with a history of depression. Dis-
charge teaching should include which of the following?
Answer Ensuring all firearms in the home are locked in a safe place
with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of
depression or suicidal ideation by encouraging that all firearms and
medications are under lock to prevent overdoses or suicide attempt.
3.A 2-year old has uniformly demarcated burns to bilateral lower
extremities, approximately 30% of the childs total body surface area. The
1/
18
,father states he briefly left the room while the child was in the bath and the
child apparently played with the faucet. Which of the following interventions
has the highest priority?
Answer Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority
interventions.
4.A 7-year-old arrives via ambulance. The patient's mother reports
witnessing a seizure at home. The patient has no seizure history. Upon
examination, the patient is post-ictal with a heart rate of 142 beats per
minute, respiratory rate of 36 breaths per minute, and blood pressure of
86/72 mm Hg. Significant burns are noted to the patient's back and lower
extremities. The mother states the burns accidentally occurred 3 days ago,
but she was afraid to bring patient in due to an ongoing child welfare
investigation. Which of the following are the MOST appropriate immediate
interventions?
Answer Draw and send a metabolic panel and venous blood gas,
administer a fluid bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent
another seizure.
5.What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
2/
18
, Answer ventilation to address hypoxia is the priority intervention.
6.A 14-year-old high school student who was pitching for his baseball
team was hit in the chest by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of the cardiac arrest?
Answer Commotio
cordis
Comotio Cordis "occurs when chest is struck during the refractory period
of the cardiac conduction cycle. This type of injury usually occurs in
recreational sports such as baseball or ice hockey."
7.A 5-year-old child presents to the emergency department after being hit
by a car. She complains of left upper quadrant pain and the focused
assessment with sonography for trauma (FAST) exam shows fluid around
her spleen. Which of the following findings would be an early indication of
ongoing blood loss?
Answer Focused Assessment
Vital Signs
"As the patient compensates for altered tissue perfusion, the pulse
pressure narrows and the heart rate increases" - (need to rewrite either
the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse
pressure) Bradycardia - not correct
3/
18
1.A 5 year-old with no health problems presents to the Emergency
Department with a sudden onset of chest pain and shortness of breath.
Parents state that the family was involved in a bad car crash one week ago.
A thorough assessment and workup has not revealed any abnormalities.
Which of the following steps is the best next step to take?
Answer Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical
complaints. Assess for other behavioral symptoms to facilitate
appropriate care and follow-up.
2.You are discharging a patient to home with a history of depression. Dis-
charge teaching should include which of the following?
Answer Ensuring all firearms in the home are locked in a safe place
with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of
depression or suicidal ideation by encouraging that all firearms and
medications are under lock to prevent overdoses or suicide attempt.
3.A 2-year old has uniformly demarcated burns to bilateral lower
extremities, approximately 30% of the childs total body surface area. The
1/
18
,father states he briefly left the room while the child was in the bath and the
child apparently played with the faucet. Which of the following interventions
has the highest priority?
Answer Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority
interventions.
4.A 7-year-old arrives via ambulance. The patient's mother reports
witnessing a seizure at home. The patient has no seizure history. Upon
examination, the patient is post-ictal with a heart rate of 142 beats per
minute, respiratory rate of 36 breaths per minute, and blood pressure of
86/72 mm Hg. Significant burns are noted to the patient's back and lower
extremities. The mother states the burns accidentally occurred 3 days ago,
but she was afraid to bring patient in due to an ongoing child welfare
investigation. Which of the following are the MOST appropriate immediate
interventions?
Answer Draw and send a metabolic panel and venous blood gas,
administer a fluid bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent
another seizure.
5.What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
2/
18
, Answer ventilation to address hypoxia is the priority intervention.
6.A 14-year-old high school student who was pitching for his baseball
team was hit in the chest by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of the cardiac arrest?
Answer Commotio
cordis
Comotio Cordis "occurs when chest is struck during the refractory period
of the cardiac conduction cycle. This type of injury usually occurs in
recreational sports such as baseball or ice hockey."
7.A 5-year-old child presents to the emergency department after being hit
by a car. She complains of left upper quadrant pain and the focused
assessment with sonography for trauma (FAST) exam shows fluid around
her spleen. Which of the following findings would be an early indication of
ongoing blood loss?
Answer Focused Assessment
Vital Signs
"As the patient compensates for altered tissue perfusion, the pulse
pressure narrows and the heart rate increases" - (need to rewrite either
the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse
pressure) Bradycardia - not correct
3/
18
