ENPC 6TH EDITION COURSE EXAM 2025/2026 QUESTIONS
WITH ANSWERS GRADED A+
✔✔A 3-year-old is brought by caregivers with generalized tonic-clonic activity,
unresponsiveness, and drooling that began 6 minutes prior to arrival. Which of the
following interventions would be most appropriate for this event? - ✔✔Administer
intranasal midazolam
✔✔A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic
event. Assessment findings include a patient who is active and alert, in the 10th
percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture
of the left femur. Which of the following is the most likely cause? - ✔✔Ehlers-Danlos
syndrome (wrong)
Remediation feedback:
Osteogenesis imperfecta is a genetic disorder that includes short stature, blue-grey
color to the sclera, discolored teeth, and laxity of the ligaments. Such patients are
susceptible to fractures, especially of the midshaft of long bones. These patients are
often mistaken for victims of child maltreatment.
✔✔A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the
ED. Which of the following should be included in the discharge instructions? -
✔✔Practice yawning three to four times a day (wrong)
Remediation feedback:
Patients with temporomandibular joint dislocation should avoid activities that involve
extreme jaw joint opening. Cold or warm, not hot, compresses are recommended along
with nonsteroidal anti-inflammatory medications for pain control.
✔✔A 5-year-old patient presents with severe dehydration and signs of shock due to
viral gastroenteritis. Which of the following physiologic responses by this patient will
have the greatest impact on improving their cardiac output? - ✔✔Increased heart rate
✔✔An 8-year-old male presents to the emergency department with incoherent speech,
hallucinations, and violent behavior. What is the priority in caring for this patient? -
✔✔Ensure safety of the patient and staff
✔✔A 12-year-old presents to the emergency department with a severe headache. The
mother reports that the child has been experiencing headaches and has had multiple
seizures for the past several months. The child was seen by their primary doctor and
prescribed an anti-seizure medication, but the prescription was not filled because "the
doctor just wants money." This is an example of what type of neglect? - ✔✔Medical
, ✔✔A 14-year-old patient with Down syndrome presents with an abnormal gait, head
tilted to the left, decreased sensation to the extremities, and urinary incontinence. The
patient has no history of trauma. Which of the following diagnostics is the priority for this
patient? - ✔✔Cervical spine radiographs
✔✔The nurse is triaging an infant brought to the emergency department by their
caregiver. Which finding by the nurse leads the infant to be placed in isolation? -
✔✔Barking cough (wrong)
Remediation feedback
Triage begins when the child is initially visualized using the pediatric assessment
triangle. Appearance, work of breathing, and circulation to the skin are components that
guide the prioritization of the child's care. The presence of a purpuric rash necessitates
the infant to be placed in isolation immediately as this is a symptom of possible
meningitis.
✔✔EMS is transporting a 12-year-old restrained passenger involved in a high-speed
motor vehicle collision. The patient complains of increasing dyspnea. Breath sounds are
clear and equal, and heart sounds are difficult to auscultate. Vitals include HR 132
beats/minute, RR 36 breaths/minute, and BP 80/55 mm Hg. Which of the following is
the priority intervention? - ✔✔Pericardiocentesis
✔✔A 3-year-old is assessed for the presence of increasing amounts of
serosanguineous drainage from his left nares over the past 6 hours. Which of the
following foreign bodies is the most likely etiology? - ✔✔Button battery
✔✔An infant presents to the emergency department with difficulty breathing. The patient
is pale and respirations appear rapid and shallow. Which location on the torso is the
most effective site for assessing bilateral breath sounds? - ✔✔Bilateral midaxillary
✔✔A child presents with a history of poor oral intake. The patient is pale, lethargic, and
has shallow, rapid respirations. Central pulses are weak and capillary refill time is four
seconds. Which of the following interventions has the highest priority? - ✔✔Initiate an
intravenous fluid bolus
✔✔A 5-year-old arrives in the ED with a 4 day history of vomiting. Vital signs: HR 136
beats/minute, RR 36 breaths/minute, BP 92/56 mm Hg, T 38oC (100.4oF), and pulse
oximetry 93% on room air. The child is pale with warm, dry skin and a capillary refill of 3
seconds. A fluid bolus is completed. Which of the following reassessment findings
indicate that a second fluid bolus is necessary? - ✔✔Blood pressure of 92/78 mm Hg
✔✔A 3-week old is brought to the emergency department with a history of fussiness,
spitting up, crying, and watery stools. Assessment reveals an alert child with moist
WITH ANSWERS GRADED A+
✔✔A 3-year-old is brought by caregivers with generalized tonic-clonic activity,
unresponsiveness, and drooling that began 6 minutes prior to arrival. Which of the
following interventions would be most appropriate for this event? - ✔✔Administer
intranasal midazolam
✔✔A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic
event. Assessment findings include a patient who is active and alert, in the 10th
percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture
of the left femur. Which of the following is the most likely cause? - ✔✔Ehlers-Danlos
syndrome (wrong)
Remediation feedback:
Osteogenesis imperfecta is a genetic disorder that includes short stature, blue-grey
color to the sclera, discolored teeth, and laxity of the ligaments. Such patients are
susceptible to fractures, especially of the midshaft of long bones. These patients are
often mistaken for victims of child maltreatment.
✔✔A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the
ED. Which of the following should be included in the discharge instructions? -
✔✔Practice yawning three to four times a day (wrong)
Remediation feedback:
Patients with temporomandibular joint dislocation should avoid activities that involve
extreme jaw joint opening. Cold or warm, not hot, compresses are recommended along
with nonsteroidal anti-inflammatory medications for pain control.
✔✔A 5-year-old patient presents with severe dehydration and signs of shock due to
viral gastroenteritis. Which of the following physiologic responses by this patient will
have the greatest impact on improving their cardiac output? - ✔✔Increased heart rate
✔✔An 8-year-old male presents to the emergency department with incoherent speech,
hallucinations, and violent behavior. What is the priority in caring for this patient? -
✔✔Ensure safety of the patient and staff
✔✔A 12-year-old presents to the emergency department with a severe headache. The
mother reports that the child has been experiencing headaches and has had multiple
seizures for the past several months. The child was seen by their primary doctor and
prescribed an anti-seizure medication, but the prescription was not filled because "the
doctor just wants money." This is an example of what type of neglect? - ✔✔Medical
, ✔✔A 14-year-old patient with Down syndrome presents with an abnormal gait, head
tilted to the left, decreased sensation to the extremities, and urinary incontinence. The
patient has no history of trauma. Which of the following diagnostics is the priority for this
patient? - ✔✔Cervical spine radiographs
✔✔The nurse is triaging an infant brought to the emergency department by their
caregiver. Which finding by the nurse leads the infant to be placed in isolation? -
✔✔Barking cough (wrong)
Remediation feedback
Triage begins when the child is initially visualized using the pediatric assessment
triangle. Appearance, work of breathing, and circulation to the skin are components that
guide the prioritization of the child's care. The presence of a purpuric rash necessitates
the infant to be placed in isolation immediately as this is a symptom of possible
meningitis.
✔✔EMS is transporting a 12-year-old restrained passenger involved in a high-speed
motor vehicle collision. The patient complains of increasing dyspnea. Breath sounds are
clear and equal, and heart sounds are difficult to auscultate. Vitals include HR 132
beats/minute, RR 36 breaths/minute, and BP 80/55 mm Hg. Which of the following is
the priority intervention? - ✔✔Pericardiocentesis
✔✔A 3-year-old is assessed for the presence of increasing amounts of
serosanguineous drainage from his left nares over the past 6 hours. Which of the
following foreign bodies is the most likely etiology? - ✔✔Button battery
✔✔An infant presents to the emergency department with difficulty breathing. The patient
is pale and respirations appear rapid and shallow. Which location on the torso is the
most effective site for assessing bilateral breath sounds? - ✔✔Bilateral midaxillary
✔✔A child presents with a history of poor oral intake. The patient is pale, lethargic, and
has shallow, rapid respirations. Central pulses are weak and capillary refill time is four
seconds. Which of the following interventions has the highest priority? - ✔✔Initiate an
intravenous fluid bolus
✔✔A 5-year-old arrives in the ED with a 4 day history of vomiting. Vital signs: HR 136
beats/minute, RR 36 breaths/minute, BP 92/56 mm Hg, T 38oC (100.4oF), and pulse
oximetry 93% on room air. The child is pale with warm, dry skin and a capillary refill of 3
seconds. A fluid bolus is completed. Which of the following reassessment findings
indicate that a second fluid bolus is necessary? - ✔✔Blood pressure of 92/78 mm Hg
✔✔A 3-week old is brought to the emergency department with a history of fussiness,
spitting up, crying, and watery stools. Assessment reveals an alert child with moist
