ENPC 6TH EDITION PROVIDER STUDY GUIDE 2026 –
SELF-REVIEW & PEDIATRIC EMERGENCY
PREPARATION
Instructions: Choose the single best answer for each question.
1. The initial, rapid "across-the-room" assessment in the pediatric triangle is designed to
identify:
A. The child's exact diagnosis.
B. The child's name and age.
C. General severity of illness or injury through appearance, work of breathing, and circulation.
D. The need for a full set of vital signs.
Answer: C
2. A 4-year-old child presents with a high fever, drooling, and a tripod sitting position. Your
immediate action should be to:
A. Perform a detailed throat examination.
B. Provide supplemental oxygen and prepare for advanced airway management.
C. Encourage the child to drink fluids.
D. Administer an antipyretic for the fever.
Answer: B
3. The most reliable indicator of perfusion in an infant is:
A. Capillary refill.
B. Blood pressure.
C. Heart rate.
D. Skin temperature.
Answer: A
4. When using the Pediatric Assessment Triangle (PAT), "Work of Breathing" includes all of the
following EXCEPT:
A. Abnormal airway sounds.
B. Pale skin color.
C. Retractions.
D. Nasal flaring.
Answer: B
,5. The first step in the management of a pediatric patient in septic shock is:
A. Administer broad-spectrum antibiotics.
B. Obtain intravenous access and administer a 20 mL/kg isotonic fluid bolus.
C. Start a dopamine infusion.
D. Obtain a blood culture.
Answer: B
6. A 2-month-old infant is brought in with lethargy and a weak cry. The fontanelle is bulging.
The most likely cause is:
A. Dehydration.
B. Increased intracranial pressure.
C. Hypoglycemia.
D. Sepsis.
Answer: B
7. The preferred order for intraosseous (IO) insertion sites in a pediatric patient is:
A. Distal femur, proximal tibia, distal tibia.
B. Proximal tibia, distal tibia, proximal humerus.
C. Sternum, proximal tibia, distal femur.
D. Distal tibia, proximal humerus, proximal tibia.
Answer: B
8. A 7-year-old child is struck by a car. The primary survey reveals a patent airway, but absent
breath sounds on the left side. The next immediate action is:
A. Obtain a chest x-ray.
B. Perform needle decompression.
C. Start two large-bore IVs.
D. Apply a cervical collar.
Answer: B
9. The "T" in the SAMPLE history stands for:
A. Trauma.
B. Tetanus immunization.
C. Things that make the condition better or worse.
D. Time of last meal.
Answer: C
10. In a pediatric patient, early compensated shock is characterized by:
A. Hypotension and tachycardia.
B. Bradycardia and apnea.
,C. Tachycardia and cool extremities with normal blood pressure.
D. Lethargy and weak pulses.
Answer: C
11. The dose for adenosine in a stable, narrow-complex tachycardia in a child is:
A. 0.1 mg/kg
B. 0.01 mg/kg
C. 0.5 mg/kg
D. 1.0 mg/kg
Answer: A
12. A child with status asthmaticus is not improving with nebulized albuterol. The next line
medication to consider is:
A. Epinephrine 1:1,000 IM.
B. Ipratropium bromide.
C. Methylprednisolone IV.
D. Magnesium sulfate IV.
Answer: C
13. The Glasgow Coma Scale (GCS) assesses which three functions?
A. Pulse, Respirations, Blood Pressure
B. Appearance, Work of Breathing, Circulation
C. Eyes, Verbal, Motor
D. Orientation, Memory, Speech
Answer: C
14. When managing a newborn in the delivery room who is apneic and pulseless, the initial
steps are:
A. Chest compressions and epinephrine.
B. Provide warmth, dry, stimulate.
C. Provide warmth, position head, suction, dry, stimulate.
D. Intubate and administer epinephrine.
Answer: C
15. The most common cause of cardiac arrest in the pediatric population is:
A. Primary cardiac arrhythmia.
B. Respiratory failure or shock.
C. Severe head trauma.
D. Anaphylaxis.
Answer: B
, 16. For a 10 kg child in cardiac arrest, the appropriate depth for chest compressions is
approximately:
A. ½ inch (1.3 cm)
B. 1 inch (2.5 cm)
C. 1.5 inches (4 cm)
D. 2 inches (5 cm)
Answer: B
17. Which finding is a late sign of respiratory failure in a child?
A. Tachypnea
B. Bradycardia
C. Nasal flaring
D. Retractions
Answer: B
18. The medication of choice for a simple febrile seizure is:
A. Lorazepam.
B. Ibuprofen.
C. Acetaminophen.
D. Focus is on identifying the cause of the fever; no specific medication stops a simple febrile
seizure.
Answer: D
19. In a trauma patient, hypotension that responds only transiently to fluid boluses is
suggestive of:
A. Neurogenic shock.
B. Septic shock.
C. Cardiogenic shock.
D. Ongoing hemorrhagic shock.
Answer: D
20. The "E" in the AVPU scale stands for:
A. Emergency.
B. Eyes.
C. Alert.
D. Unresponsive.
Answer: C
21. When calculating a pediatric fluid bolus for shock, the initial volume is:
A. 10 mL/kg
SELF-REVIEW & PEDIATRIC EMERGENCY
PREPARATION
Instructions: Choose the single best answer for each question.
1. The initial, rapid "across-the-room" assessment in the pediatric triangle is designed to
identify:
A. The child's exact diagnosis.
B. The child's name and age.
C. General severity of illness or injury through appearance, work of breathing, and circulation.
D. The need for a full set of vital signs.
Answer: C
2. A 4-year-old child presents with a high fever, drooling, and a tripod sitting position. Your
immediate action should be to:
A. Perform a detailed throat examination.
B. Provide supplemental oxygen and prepare for advanced airway management.
C. Encourage the child to drink fluids.
D. Administer an antipyretic for the fever.
Answer: B
3. The most reliable indicator of perfusion in an infant is:
A. Capillary refill.
B. Blood pressure.
C. Heart rate.
D. Skin temperature.
Answer: A
4. When using the Pediatric Assessment Triangle (PAT), "Work of Breathing" includes all of the
following EXCEPT:
A. Abnormal airway sounds.
B. Pale skin color.
C. Retractions.
D. Nasal flaring.
Answer: B
,5. The first step in the management of a pediatric patient in septic shock is:
A. Administer broad-spectrum antibiotics.
B. Obtain intravenous access and administer a 20 mL/kg isotonic fluid bolus.
C. Start a dopamine infusion.
D. Obtain a blood culture.
Answer: B
6. A 2-month-old infant is brought in with lethargy and a weak cry. The fontanelle is bulging.
The most likely cause is:
A. Dehydration.
B. Increased intracranial pressure.
C. Hypoglycemia.
D. Sepsis.
Answer: B
7. The preferred order for intraosseous (IO) insertion sites in a pediatric patient is:
A. Distal femur, proximal tibia, distal tibia.
B. Proximal tibia, distal tibia, proximal humerus.
C. Sternum, proximal tibia, distal femur.
D. Distal tibia, proximal humerus, proximal tibia.
Answer: B
8. A 7-year-old child is struck by a car. The primary survey reveals a patent airway, but absent
breath sounds on the left side. The next immediate action is:
A. Obtain a chest x-ray.
B. Perform needle decompression.
C. Start two large-bore IVs.
D. Apply a cervical collar.
Answer: B
9. The "T" in the SAMPLE history stands for:
A. Trauma.
B. Tetanus immunization.
C. Things that make the condition better or worse.
D. Time of last meal.
Answer: C
10. In a pediatric patient, early compensated shock is characterized by:
A. Hypotension and tachycardia.
B. Bradycardia and apnea.
,C. Tachycardia and cool extremities with normal blood pressure.
D. Lethargy and weak pulses.
Answer: C
11. The dose for adenosine in a stable, narrow-complex tachycardia in a child is:
A. 0.1 mg/kg
B. 0.01 mg/kg
C. 0.5 mg/kg
D. 1.0 mg/kg
Answer: A
12. A child with status asthmaticus is not improving with nebulized albuterol. The next line
medication to consider is:
A. Epinephrine 1:1,000 IM.
B. Ipratropium bromide.
C. Methylprednisolone IV.
D. Magnesium sulfate IV.
Answer: C
13. The Glasgow Coma Scale (GCS) assesses which three functions?
A. Pulse, Respirations, Blood Pressure
B. Appearance, Work of Breathing, Circulation
C. Eyes, Verbal, Motor
D. Orientation, Memory, Speech
Answer: C
14. When managing a newborn in the delivery room who is apneic and pulseless, the initial
steps are:
A. Chest compressions and epinephrine.
B. Provide warmth, dry, stimulate.
C. Provide warmth, position head, suction, dry, stimulate.
D. Intubate and administer epinephrine.
Answer: C
15. The most common cause of cardiac arrest in the pediatric population is:
A. Primary cardiac arrhythmia.
B. Respiratory failure or shock.
C. Severe head trauma.
D. Anaphylaxis.
Answer: B
, 16. For a 10 kg child in cardiac arrest, the appropriate depth for chest compressions is
approximately:
A. ½ inch (1.3 cm)
B. 1 inch (2.5 cm)
C. 1.5 inches (4 cm)
D. 2 inches (5 cm)
Answer: B
17. Which finding is a late sign of respiratory failure in a child?
A. Tachypnea
B. Bradycardia
C. Nasal flaring
D. Retractions
Answer: B
18. The medication of choice for a simple febrile seizure is:
A. Lorazepam.
B. Ibuprofen.
C. Acetaminophen.
D. Focus is on identifying the cause of the fever; no specific medication stops a simple febrile
seizure.
Answer: D
19. In a trauma patient, hypotension that responds only transiently to fluid boluses is
suggestive of:
A. Neurogenic shock.
B. Septic shock.
C. Cardiogenic shock.
D. Ongoing hemorrhagic shock.
Answer: D
20. The "E" in the AVPU scale stands for:
A. Emergency.
B. Eyes.
C. Alert.
D. Unresponsive.
Answer: C
21. When calculating a pediatric fluid bolus for shock, the initial volume is:
A. 10 mL/kg
