Page 1 of 49
ENPC Pre-Course EXAM UPDATED THIS YEAR WITH
250 QUESTIONS AND CORRECT ANSWERS WITH
JUST RELEASED
Question: 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 two weeks ago. A thorough assessment and workup has not revealed any
abnormalities. Which of the following is the best next step to take?
a. ask about any new bed-wetting or sleep disturbances
b. discharge to home and follow up with PCP
c. repeat a head to toe exam to identify any missed traumatic injuries
d. consult cardiology for appropriate follow-up - CORRECT ANSWER✔✔A.
Physical complaints are not uncommon in children following a traumatic event. Once any
physical injuries or illnesses have been ruled out, assessment for any behavioral concerns such
as anxiety would be indicated to facilitate appropriate care and follow-up. The incident occurred
two weeks prior, so the likelihood any severe medical issues is low.
Question: The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. 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 caregiver states the burns accidentally occurred three
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days ago, but was afraid to bring the patient in due to an ongoing child welfare investigation.
Which of the following groups of interventions are the priority for this patient?
a. call PD and child welfare and have security detain the caregiver
b. administer IV analgesics and obtain POCT glucose
c. draw metabolic panel, POCT glucose, and administer fluids
d. administer lorazepam and fluids and place of seizure precautions - CORRECT ANSWER✔✔C.
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help prevent
further seizures. Contacting child protective services and other authorities can wait. The patient
is post-ictal so does not require lorazepam medication at this time. Pain medication can and
should be considered with significant burns, but is not a priority.
Question: A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations, diminished breath
sounds, and an occasional cough. Which of the following interventions is the initial
management priority?
a. initiation of abdominal thrusts to remove fluid from lungs
b. insertion of OG to remove water and debris from stomach
c. ETT intubation to provide PP ventilation
d. removal of wet clothes to prevent hypothermia - CORRECT ANSWER✔✔C.
The primary survey assessment and treatment of deficits are the priority. Airway control and
positive pressure ventilation while preparing for intubation of a child who meets intubation
criteria (GCS < 8) should be performed while also maintaining cervical spine stabilization. The
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child is responsive only to painful stimuli, has shallow respirations, and diminished breath
sounds. All of these are breathing problems and must be addressed immediately. Removing wet
clothing is necessary, but is not the main priority initially. With intubation an orogastric tube will
be placed and abdominal thrusts are not necessary to remove fluid from the lungs.
Question: The caregiver of a 2-month-old infant states the patient has had trouble breathing for
the past two days. Pediatric assessment triangle (PAT) reveals an age-appropriate general
appearance, rapid breathing with mild distress, and pink skin. Mucous is noted in both nares.
Which of the following is the best next step?
a. obtain history including immunization status
b. suction nasal passages using a bulb syringe
c. administer oxygen by nasal cannula with pt in caregiver's arms
d. respiratory assessment is completed to move to circulatory - CORRECT ANSWER✔✔B.
Infants up to four months old are obligate nose breathers and can have respiratory distress
when nares are occluded. Mucous can be gently suctioned using a bulb syringe or suction
catheter. A good, thorough history should always include immunization status for pediatric
patients. The nose needs to be clear before applying oxygen via nasal cannula. Respiratory
assessment includes interventions to improve breathing so you would not move to move to
circulation until that is accomplished.
Question: A 4-day-old who is brought to the emergency department with the parental
complaint of "not acting right" is found to be hypoglycemic. What is the appropriate glucose
concentration to administer to this neonate?
a. D5
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b. D10
c. D25
d. D50 - CORRECT ANSWER✔✔B.
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect their
fragile vasculature while providing needed glucose. Dextrose 5% is not used to treat
hypoglycemia in children. Dextrose 25% is used for children above the age of 5 years. Dextrose
50% is not recommended for use in pediatrics unless it is diluted.
Question:What is the priority intervention for symptomatic bradycardia in a four-year-old child?
a. IV atropine
b. IV epinephrine
c. bag-mask ventilation
d. transcutaneous pacing - CORRECT ANSWER✔✔C.
Identifying and treating other causes, chest compressions, and epinephrine are interventions
for pediatric bradycardia with signs of poor perfusion that are not improved by adequate
oxygenation and ventilation. Atropine and pacing may be considered if there is no response to
the other interventions.
Question: Which of the following patients should be evaluated first?
a. 3 yo with dislodged G-tube
b. 18m with bilious emesis
4
SUCCESS!
ENPC Pre-Course EXAM UPDATED THIS YEAR WITH
250 QUESTIONS AND CORRECT ANSWERS WITH
JUST RELEASED
Question: 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 two weeks ago. A thorough assessment and workup has not revealed any
abnormalities. Which of the following is the best next step to take?
a. ask about any new bed-wetting or sleep disturbances
b. discharge to home and follow up with PCP
c. repeat a head to toe exam to identify any missed traumatic injuries
d. consult cardiology for appropriate follow-up - CORRECT ANSWER✔✔A.
Physical complaints are not uncommon in children following a traumatic event. Once any
physical injuries or illnesses have been ruled out, assessment for any behavioral concerns such
as anxiety would be indicated to facilitate appropriate care and follow-up. The incident occurred
two weeks prior, so the likelihood any severe medical issues is low.
Question: The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. 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 caregiver states the burns accidentally occurred three
1
SUCCESS!
,Page 2 of 49
days ago, but was afraid to bring the patient in due to an ongoing child welfare investigation.
Which of the following groups of interventions are the priority for this patient?
a. call PD and child welfare and have security detain the caregiver
b. administer IV analgesics and obtain POCT glucose
c. draw metabolic panel, POCT glucose, and administer fluids
d. administer lorazepam and fluids and place of seizure precautions - CORRECT ANSWER✔✔C.
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help prevent
further seizures. Contacting child protective services and other authorities can wait. The patient
is post-ictal so does not require lorazepam medication at this time. Pain medication can and
should be considered with significant burns, but is not a priority.
Question: A three-year-old is rescued after being submerged in a pool for several minutes. On
arrival the patient is responsive to painful stimuli with shallow respirations, diminished breath
sounds, and an occasional cough. Which of the following interventions is the initial
management priority?
a. initiation of abdominal thrusts to remove fluid from lungs
b. insertion of OG to remove water and debris from stomach
c. ETT intubation to provide PP ventilation
d. removal of wet clothes to prevent hypothermia - CORRECT ANSWER✔✔C.
The primary survey assessment and treatment of deficits are the priority. Airway control and
positive pressure ventilation while preparing for intubation of a child who meets intubation
criteria (GCS < 8) should be performed while also maintaining cervical spine stabilization. The
2
SUCCESS!
,Page 3 of 49
child is responsive only to painful stimuli, has shallow respirations, and diminished breath
sounds. All of these are breathing problems and must be addressed immediately. Removing wet
clothing is necessary, but is not the main priority initially. With intubation an orogastric tube will
be placed and abdominal thrusts are not necessary to remove fluid from the lungs.
Question: The caregiver of a 2-month-old infant states the patient has had trouble breathing for
the past two days. Pediatric assessment triangle (PAT) reveals an age-appropriate general
appearance, rapid breathing with mild distress, and pink skin. Mucous is noted in both nares.
Which of the following is the best next step?
a. obtain history including immunization status
b. suction nasal passages using a bulb syringe
c. administer oxygen by nasal cannula with pt in caregiver's arms
d. respiratory assessment is completed to move to circulatory - CORRECT ANSWER✔✔B.
Infants up to four months old are obligate nose breathers and can have respiratory distress
when nares are occluded. Mucous can be gently suctioned using a bulb syringe or suction
catheter. A good, thorough history should always include immunization status for pediatric
patients. The nose needs to be clear before applying oxygen via nasal cannula. Respiratory
assessment includes interventions to improve breathing so you would not move to move to
circulation until that is accomplished.
Question: A 4-day-old who is brought to the emergency department with the parental
complaint of "not acting right" is found to be hypoglycemic. What is the appropriate glucose
concentration to administer to this neonate?
a. D5
3
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, Page 4 of 49
b. D10
c. D25
d. D50 - CORRECT ANSWER✔✔B.
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect their
fragile vasculature while providing needed glucose. Dextrose 5% is not used to treat
hypoglycemia in children. Dextrose 25% is used for children above the age of 5 years. Dextrose
50% is not recommended for use in pediatrics unless it is diluted.
Question:What is the priority intervention for symptomatic bradycardia in a four-year-old child?
a. IV atropine
b. IV epinephrine
c. bag-mask ventilation
d. transcutaneous pacing - CORRECT ANSWER✔✔C.
Identifying and treating other causes, chest compressions, and epinephrine are interventions
for pediatric bradycardia with signs of poor perfusion that are not improved by adequate
oxygenation and ventilation. Atropine and pacing may be considered if there is no response to
the other interventions.
Question: Which of the following patients should be evaluated first?
a. 3 yo with dislodged G-tube
b. 18m with bilious emesis
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