HOSMERIT
ENPC 6TH EDITION EXAM QUESTIONS AND
CORRECT ANSWERS 2024-2025// GRADED A+
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?
- CORRECT ANSWER-Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include
signs of dehydration ( dry mucous membranes, hypotension, tachycardia), 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.
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
antibiotics with subsequent increasing manifestations instead of improvement. Which of the
following would be considered to be definitive treatment for the suspected diagnosis? -
CORRECT ANSWER-Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with subsequent
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.
,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? - CORRECT ANSWER-Establishing a
secure airway
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? - CORRECT 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.
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? - CORRECT ANSWER- Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
following intravenous medication orders should the nurse question? - CORRECT 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.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-
smelling urine. The child is hypotensive and tachycardic. Which of the following methods for
obtaining a urine sample is most appropriate in this circumstance? - CORRECT ANSWER-
Urinary catherization
A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - CORRECT ANSWER-Performing a suicide risk
assessment
, You are discharging a patient home who has a history of depression. Discharge teaching
should include which of the following? - CORRECT ANSWER-Ensuring all firearms in the
home are locked up with no access available by the patient.
A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and
having vaginal bleeding. The patient is unsure of the gestational age and has not had any
prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions.
Which of the following is the most appropriate action for the nurse to take at this point? -
CORRECT ANSWER-Have the boyfriend leave the room during the pelvic exam.
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
several attempts, your team has been unsuccessful at establishing vascular access. Of the
following, which is the next best option for establishing access quickly? - CORRECT
ANSWER-Intraosseous in the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of
specimen samples would provide visual information regarding a potential complication of this
injury? - CORRECT ANSWER-Sputum (wrong)
Remediation feedback:
Electrical injuries, though they may appear to be small, can produce large amounts of damage
internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by
dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive
procedures appear to be distressed and withdrawn. Which of the following interventions would
best ensure a sense of comfort and control for these parents? - CORRECT ANSWER-
Providing frequent updates and re- educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
CORRECT ANSWER-Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations
for topical anesthesia would be the best choice for this procedure? - CORRECT ANSWER-
LET (lidocaine/epinephrine/tetracaine)
ENPC 6TH EDITION EXAM QUESTIONS AND
CORRECT ANSWERS 2024-2025// GRADED A+
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?
- CORRECT ANSWER-Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include
signs of dehydration ( dry mucous membranes, hypotension, tachycardia), 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.
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
antibiotics with subsequent increasing manifestations instead of improvement. Which of the
following would be considered to be definitive treatment for the suspected diagnosis? -
CORRECT ANSWER-Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with subsequent
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.
,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? - CORRECT ANSWER-Establishing a
secure airway
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? - CORRECT 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.
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? - CORRECT ANSWER- Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
following intravenous medication orders should the nurse question? - CORRECT 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.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-
smelling urine. The child is hypotensive and tachycardic. Which of the following methods for
obtaining a urine sample is most appropriate in this circumstance? - CORRECT ANSWER-
Urinary catherization
A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - CORRECT ANSWER-Performing a suicide risk
assessment
, You are discharging a patient home who has a history of depression. Discharge teaching
should include which of the following? - CORRECT ANSWER-Ensuring all firearms in the
home are locked up with no access available by the patient.
A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and
having vaginal bleeding. The patient is unsure of the gestational age and has not had any
prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions.
Which of the following is the most appropriate action for the nurse to take at this point? -
CORRECT ANSWER-Have the boyfriend leave the room during the pelvic exam.
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
several attempts, your team has been unsuccessful at establishing vascular access. Of the
following, which is the next best option for establishing access quickly? - CORRECT
ANSWER-Intraosseous in the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of
specimen samples would provide visual information regarding a potential complication of this
injury? - CORRECT ANSWER-Sputum (wrong)
Remediation feedback:
Electrical injuries, though they may appear to be small, can produce large amounts of damage
internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by
dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive
procedures appear to be distressed and withdrawn. Which of the following interventions would
best ensure a sense of comfort and control for these parents? - CORRECT ANSWER-
Providing frequent updates and re- educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
CORRECT ANSWER-Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations
for topical anesthesia would be the best choice for this procedure? - CORRECT ANSWER-
LET (lidocaine/epinephrine/tetracaine)
