ENPC exam answers
1. Which of the following would be an abnormal finding in a patient with
glomerulonephritis?
Clear urine There is a decrease in urine output for patient's with glomerulonephritis.
Urine would be concentrated and dark brown/tea-colored.
Decreased energy
Hypertension
Nausea, vomiting
2. A 3-year-old is brought to the emergency department with a 2-day history of a
runny nose, low- grade fever, and a "barky" cough at night. The caregiver tells the
emergency department nurse the coughing is getting worse. The child is awake
and alert, with stridor. The nurse should anticipate which of the following?
Administration of nebulized epinephrine Moderate to severe croup is
treated with dexamethasone and nebulized epinephrine.
Delivery of humidified oxygen
Bag-valve-mask ventilations
Suctioning secretions from the oropharynx
3. The neurosurgeon has decided to perform an invasive procedure in the emergency
department to monitor the intracranial pressure on a 5-year-old patient. The family
does not speak English and has identified their religion as Muslim. Which of the
following interventions is most supportive of the family?
Allow the extended to family members to serve as interpreters during the
procedure.
Dedicate a healthcare team member to be with the family during the
procedure.
, Allowing caregivers to remain with the pediatric patient is more supportive
in this situation. Allow family members to serve as interpreters during the procedure
Provide access to nondenominational clergy in a quiet area
4. Which of the following patient presentations should increase suspicion of
potential child maltreatment?
Right radial spiral fracture in a 10-year-old practicing martial arts
Bruising to the left ear of a newborn from sleeping on his side Any bruise in
a non- exploratory location in children younger than 4 years and any bruising in a child
younger than 4 months (TEN-4) are cause for suspicion of abuse.
Closed greenstick wrist fracture in a 4 year old who fell off his bicycle
Bruises in various stages of healing to the lower extremities of a 2-year-old
5. 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?
Aortic Dissection
Commotio cordis Commotio cordis occurs when the chest is struck during the
refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or
asystole. This type of injury usually occurs in recreational sports such as baseball or ice
hockey.
Pericardial Tamponade
, Blunt Aortic Injury
6. A 12-year-old who was recently started on anti-psychotic medication for
schizophrenia is brought to the emergency department with severe muscle rigidity
and hyperthermia. These symptoms are most likely caused by which of the
following?
Ecstasy overdose
Neuroleptic malignant syndrome These are classic symptoms of neuroleptic
malignant syndrome, which is a rare reaction to antipsychotic medications.
Serotonin syndrome
Nicotine overdose
7. Which of the following patients should be evaluated first?
A 3-year-old with a dislodged gastrostomy tube
A 12-year-old with left shoulder pain after a handlebar injury
An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always
considered an emergent symptom indicative of a life-threatening bowel obstruction.
A 3-month-old with periods of inconsolable crying
8. Which of the following tasks can the nurse do to decrease adverse medication
events?
1. Which of the following would be an abnormal finding in a patient with
glomerulonephritis?
Clear urine There is a decrease in urine output for patient's with glomerulonephritis.
Urine would be concentrated and dark brown/tea-colored.
Decreased energy
Hypertension
Nausea, vomiting
2. A 3-year-old is brought to the emergency department with a 2-day history of a
runny nose, low- grade fever, and a "barky" cough at night. The caregiver tells the
emergency department nurse the coughing is getting worse. The child is awake
and alert, with stridor. The nurse should anticipate which of the following?
Administration of nebulized epinephrine Moderate to severe croup is
treated with dexamethasone and nebulized epinephrine.
Delivery of humidified oxygen
Bag-valve-mask ventilations
Suctioning secretions from the oropharynx
3. The neurosurgeon has decided to perform an invasive procedure in the emergency
department to monitor the intracranial pressure on a 5-year-old patient. The family
does not speak English and has identified their religion as Muslim. Which of the
following interventions is most supportive of the family?
Allow the extended to family members to serve as interpreters during the
procedure.
Dedicate a healthcare team member to be with the family during the
procedure.
, Allowing caregivers to remain with the pediatric patient is more supportive
in this situation. Allow family members to serve as interpreters during the procedure
Provide access to nondenominational clergy in a quiet area
4. Which of the following patient presentations should increase suspicion of
potential child maltreatment?
Right radial spiral fracture in a 10-year-old practicing martial arts
Bruising to the left ear of a newborn from sleeping on his side Any bruise in
a non- exploratory location in children younger than 4 years and any bruising in a child
younger than 4 months (TEN-4) are cause for suspicion of abuse.
Closed greenstick wrist fracture in a 4 year old who fell off his bicycle
Bruises in various stages of healing to the lower extremities of a 2-year-old
5. 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?
Aortic Dissection
Commotio cordis Commotio cordis occurs when the chest is struck during the
refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or
asystole. This type of injury usually occurs in recreational sports such as baseball or ice
hockey.
Pericardial Tamponade
, Blunt Aortic Injury
6. A 12-year-old who was recently started on anti-psychotic medication for
schizophrenia is brought to the emergency department with severe muscle rigidity
and hyperthermia. These symptoms are most likely caused by which of the
following?
Ecstasy overdose
Neuroleptic malignant syndrome These are classic symptoms of neuroleptic
malignant syndrome, which is a rare reaction to antipsychotic medications.
Serotonin syndrome
Nicotine overdose
7. Which of the following patients should be evaluated first?
A 3-year-old with a dislodged gastrostomy tube
A 12-year-old with left shoulder pain after a handlebar injury
An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always
considered an emergent symptom indicative of a life-threatening bowel obstruction.
A 3-month-old with periods of inconsolable crying
8. Which of the following tasks can the nurse do to decrease adverse medication
events?
