ENPC 6TH EDITION COURSE EXAM
Questions & Answers
1.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.
Manifesta- tions include signs of dehydration ( dry mucous membranes,
hypotension, tachycar- dia), 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.
2.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
1/
16
,antibiotics with subsequent increasing manifestations instead of
improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis
Answer Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident
with subse- quent failure to improve on antibiotics. Wheezing or
decreased lung sounds in one area of the pulmonary system is a high
indicator for a foreign body along with signs of hypoxia such as
cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation
or lethargy, and elevated white blood cell counts indicating an
infectious process. 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.
3.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
4.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
2/
16
, Answer - Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population
Initial medication intervention includes an inhaled short-acting beta
agonist.
5.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
6.A 12-year-old is being prepped for surgical intervention of acute
appendici- tis. Which of the following intravenous medication orders should
the nurse question
Answer Hydromorphone (wrong)
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.
7.A 17-year-old female arrives in the ED with her boyfriend who states she
3/
16
Questions & Answers
1.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.
Manifesta- tions include signs of dehydration ( dry mucous membranes,
hypotension, tachycar- dia), 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.
2.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
1/
16
,antibiotics with subsequent increasing manifestations instead of
improvement. Which of the following would be considered to be definitive
treatment for the suspected diagnosis
Answer Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident
with subse- quent failure to improve on antibiotics. Wheezing or
decreased lung sounds in one area of the pulmonary system is a high
indicator for a foreign body along with signs of hypoxia such as
cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation
or lethargy, and elevated white blood cell counts indicating an
infectious process. 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.
3.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
4.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
2/
16
, Answer - Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population
Initial medication intervention includes an inhaled short-acting beta
agonist.
5.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
6.A 12-year-old is being prepped for surgical intervention of acute
appendici- tis. Which of the following intravenous medication orders should
the nurse question
Answer Hydromorphone (wrong)
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.
7.A 17-year-old female arrives in the ED with her boyfriend who states she
3/
16
