ENPC 6th Edition Course Exam Newest
2025/2026
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous
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membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg,
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and HR of 144 beats per minute. Which of the following laboratory values would be most
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
expected in this child? - Correct Answers Hypoglycemia (wrong)
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Remediation feedback: II!
Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include
II! II! II! II! II! II! II! II! II! II! II!
signs of dehydration ( dry mucous membranes, hypotension, tachycardia), incontinence
II! II! II! II! II! II! II! II! II! II!
(polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the acidosis), polydipsia,
II! II! II! II! II! II! II! II! II! II! II!
anorexia, and weight loss. Expected laboratory values would reveal an acidotic state with a pH
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
level below 7.3, an elevated serum bIcarbonate level, and an elevated blood glucose level > 200
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
mg.dL.
II!
II! An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on
II! II! II! II! II! II! II! II! II! II! II! II!
II! auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The white II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! blood cell count is elevated and the patient noted to be tachypneic, tachycardic, agitated, and has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! an increased respiratory effort. At the time of the event, the patient was started on antibiotics
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! with subsequent increasing manifestations instead of improvement. Which of the following
II! II! II! II! II! II! II! II! II! II!
II! would be considered to be definitive treatment for the suspected diagnosis? - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Computed tomography (wrong) II! II!
Remediation feedback: II!
Manifestations of a lower airway foreign body include a choking incident with subsequent failure II! II! II! II! II! II! II! II! II! II! II! II! II!
to improve on antibiotics. Wheezing or decreased lung sounds in one area of the pulmonary
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
system is a high indicator for a foreign body along with signs of hypoxia such as cyanosis,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and elevated white
II! II! II! II! II! II! II! II! II! II! II!
blood cell counts indicating an infectious process. The definitive treatment would be a
II! II! II! II! II! II! II! II! II! II! II! II! II!
bronchoscopy in order to retrieve the suspected foreign body instead of diagnostic tests to locate
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the foreign body itself.
II! II! II! II!
, II! A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! bag-mask device. Once return of spontaneous circulation has been confirmed, which of the
II! II! II! II! II! II! II! II! II! II! II! II!
II! following would be the priority intervention? - Correct Answers Establishing a secure airway
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Parents report their 3-year-old child has developed noisy breathing. On assessment, high-pitched
II! II! II! II! II! II! II! II! II! II! II!
II! wheezes are audible and auscultated on inspiration and expiration. What medication would be
II! II! II! II! II! II! II! II! II! II! II! II!
II! appropriate to administer first? - Correct Answers Humidified oxygen (wrong)
II! II! II! II! II! II! II! II! II! II! II! II! II!
Remediation feedback: II!
Wheezing is most often identified with asthma in the pediatric population. Initial medication
II! II! II! II! II! II! II! II! II! II! II! II!
intervention includes an inhaled short-acting beta agonist.
II! II! II! II! II! II! II!
II! A 6-week-old is brought to the emergency department by the caregivers for poor feeding,
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52
II! II! II! II! II! II! II! II! II! II! II! II!
II! breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel. Capillary II! II! II! II! II! II! II! II! II! II! II! II! II!
II! refill is 4 seconds. Based on these findings what is the most likely diagnostic test the nurse should
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! anticipate? - Correct Answers Lumbar puncture II! II! II! II! II! II! II! II! II!
II! A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following intravenous medication orders should the nurse question? - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Hydromorphone (wrong) II!
Remediation feedback: II!
Ketorolac is an appropriate medication for moderate to severe pain, however, it should not be
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
used pre-operatively due to its potential to increase the bleeding risk.
II! II! II! II! II! II! II! II! II! II! II!
II! A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and having
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! vaginal bleeding. The patient is unsure of the gestational age and has not had any prenatal
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! treatment. The patient is quiet and lets her boyfriend answer most of the questions. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
2025/2026
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous
II! II! II! II! II! II! II! II! II! II! II! II!
membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
and HR of 144 beats per minute. Which of the following laboratory values would be most
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
expected in this child? - Correct Answers Hypoglycemia (wrong)
II! II! II! II! II! II! II! II! II! II! II! II! II!
Remediation feedback: II!
Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include
II! II! II! II! II! II! II! II! II! II! II!
signs of dehydration ( dry mucous membranes, hypotension, tachycardia), incontinence
II! II! II! II! II! II! II! II! II! II!
(polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the acidosis), polydipsia,
II! II! II! II! II! II! II! II! II! II! II!
anorexia, and weight loss. Expected laboratory values would reveal an acidotic state with a pH
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
level below 7.3, an elevated serum bIcarbonate level, and an elevated blood glucose level > 200
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
mg.dL.
II!
II! An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on
II! II! II! II! II! II! II! II! II! II! II! II!
II! auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The white II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! blood cell count is elevated and the patient noted to be tachypneic, tachycardic, agitated, and has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! an increased respiratory effort. At the time of the event, the patient was started on antibiotics
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! with subsequent increasing manifestations instead of improvement. Which of the following
II! II! II! II! II! II! II! II! II! II!
II! would be considered to be definitive treatment for the suspected diagnosis? - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Computed tomography (wrong) II! II!
Remediation feedback: II!
Manifestations of a lower airway foreign body include a choking incident with subsequent failure II! II! II! II! II! II! II! II! II! II! II! II! II!
to improve on antibiotics. Wheezing or decreased lung sounds in one area of the pulmonary
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
system is a high indicator for a foreign body along with signs of hypoxia such as cyanosis,
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and elevated white
II! II! II! II! II! II! II! II! II! II! II!
blood cell counts indicating an infectious process. The definitive treatment would be a
II! II! II! II! II! II! II! II! II! II! II! II! II!
bronchoscopy in order to retrieve the suspected foreign body instead of diagnostic tests to locate
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
the foreign body itself.
II! II! II! II!
, II! A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! bag-mask device. Once return of spontaneous circulation has been confirmed, which of the
II! II! II! II! II! II! II! II! II! II! II! II!
II! following would be the priority intervention? - Correct Answers Establishing a secure airway
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Parents report their 3-year-old child has developed noisy breathing. On assessment, high-pitched
II! II! II! II! II! II! II! II! II! II! II!
II! wheezes are audible and auscultated on inspiration and expiration. What medication would be
II! II! II! II! II! II! II! II! II! II! II! II!
II! appropriate to administer first? - Correct Answers Humidified oxygen (wrong)
II! II! II! II! II! II! II! II! II! II! II! II! II!
Remediation feedback: II!
Wheezing is most often identified with asthma in the pediatric population. Initial medication
II! II! II! II! II! II! II! II! II! II! II! II!
intervention includes an inhaled short-acting beta agonist.
II! II! II! II! II! II! II!
II! A 6-week-old is brought to the emergency department by the caregivers for poor feeding,
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52
II! II! II! II! II! II! II! II! II! II! II! II!
II! breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel. Capillary II! II! II! II! II! II! II! II! II! II! II! II! II!
II! refill is 4 seconds. Based on these findings what is the most likely diagnostic test the nurse should
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! anticipate? - Correct Answers Lumbar puncture II! II! II! II! II! II! II! II! II!
II! A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! following intravenous medication orders should the nurse question? - Correct Answers
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Hydromorphone (wrong) II!
Remediation feedback: II!
Ketorolac is an appropriate medication for moderate to severe pain, however, it should not be
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
used pre-operatively due to its potential to increase the bleeding risk.
II! II! II! II! II! II! II! II! II! II! II!
II! A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and having
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! vaginal bleeding. The patient is unsure of the gestational age and has not had any prenatal
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! treatment. The patient is quiet and lets her boyfriend answer most of the questions. Which of the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
