ENPC 6TH EDITION EXAM STUDY GUIDE 2026 –
COMPLETE CONCEPT REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
ENPC 6th Edition: Core Concept Practice Questions
201. The foundation of the pediatric assessment triangle (PAT) is:
A. A detailed physical exam.
B. A quick, hands-on evaluation of vital signs.
C. A visual, hands-off assessment of appearance, work of breathing, and circulation. ✓
D. A focused history obtained from the parents.
202. In the Pediatric Assessment Triangle, "Appearance" is assessed using the TICLS
mnemonic. What does TICLS stand for?
A. Tone, Interaction, Consolability, Look, Speech
B. Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry ✓
C. Temperature, Inspection, Color, Lung sounds, Saturation
D. Trauma, Infection, Congestion, Level of consciousness, Seizure
203. A 3-year-old presents with a sudden onset of stridor and a barky cough at night. The
child is alert and has mild intercostal retractions. Your initial priority is to:
A. Start an IV and administer antibiotics.
B. Provide nebulized epinephrine and corticosteroids. ✓
C. Perform a detailed throat exam to look for a foreign body.
D. Obtain a chest X-ray to confirm croup.
204. The most reliable indicator of perfusion in an infant is:
A. Blood pressure.
B. Skin temperature and capillary refill. ✓
C. Heart rate.
D. Urine output.
205. A 6-month-old with a history of fever and irritability presents with a bulging fontanelle.
This is most suggestive of:
A. Dehydration.
B. Meningitis. ✓
C. Simple febrile seizure.
D. Skull fracture.
,206. The correct order of the nursing process in a pediatric emergency is:
A. Intervention, Assessment, Reassessment, Triage
B. History, Diagnosis, Intervention, Evaluation
C. Assessment, Problem Identification, Intervention, Evaluation ✓
D. Triage, Vital Signs, Treatment, Discharge
207. During the primary assessment of an unresponsive infant, the priority after ensuring
scene safety is to:
A. Check for a pulse.
B. Assess for responsiveness and open the airway. ✓
C. Begin chest compressions immediately.
D. Look for signs of bleeding.
208. In a pediatric patient, compensated shock is characterized by:
A. Hypotension and tachycardia.
B. Bradycardia and apnea.
C. Tachycardia with normal blood pressure. ✓
D. Hypertension and bradypnea.
209. The most common cause of cardiac arrest in infants and children is:
A. Primary cardiac arrhythmia.
B. Respiratory failure or shock. ✓
C. Severe head trauma.
D. Electrolyte imbalance.
210. For a 4-year-old in respiratory distress, a pulse oximetry reading of 90% on room air
indicates:
A. Mild distress; provide supplemental oxygen via nasal cannula at 2 LPM.
B. Significant hypoxemia; provide high-flow oxygen via non-rebreather mask. ✓
C. Accurate reading; no oxygen needed if the child is alert.
D. Probe error; obtain an arterial blood gas instead.
211. When using a length-based resuscitation tape (e.g., Broselow Tape), you are determining:
A. Only drug dosages.
B. Equipment sizes, drug dosages, and fluid volumes. ✓
C. Only appropriate endotracheal tube size.
D. The child's exact age.
212. A 2-year-old is found submerged in a pool. On arrival, he is unresponsive, pulseless, and
apneic. After initiating CPR, your next critical action is to:
,A. Wait for the code team to arrive.
B. Attach the AED/defibrillator and analyze the rhythm. ✓
C. Insert an orogastric tube to decompress the stomach.
D. Start a peripheral IV line.
213. The appropriate depth for chest compressions in an infant is:
A. ½ inch (1.3 cm).
B. Approximately 1.5 inches (4 cm). ✓
C. 2 inches (5 cm).
D. One-third the depth of the chest.
214. For a pediatric patient with a suspected cervical spine injury, the preferred method of
opening the airway is:
A. Head-tilt, chin-lift.
B. Jaw-thrust without head extension. ✓
C. Placing the child in the recovery position.
D. Using an oral airway.
215. A child with acute respiratory failure will typically demonstrate:
A. Hypoxemia and/or hypercarbia. ✓
B. Hypertension and bradycardia.
C. Hypocarbia and alkalosis.
D. Normal breath sounds and pulse ox.
216. The medication of choice for a pediatric patient with symptomatic bradycardia (with
poor perfusion) that is unresponsive to effective oxygenation and ventilation is:
A. Atropine.
B. Epinephrine. ✓
C. Dopamine.
D. Lidocaine.
217. Signs of increased intracranial pressure (ICP) in an older child include all EXCEPT:
A. Headache and vomiting.
B. Cushing's triad (hypertension, bradycardia, irregular respirations).
C. Hypertension and tachycardia. ✓
D. Decreased level of consciousness.
218. The initial fluid bolus for a pediatric patient in hypovolemic shock is:
A. 10 mL/kg of 5% Dextrose in Water.
B. 20 mL/kg of isotonic crystalloid (e.g., Normal Saline or Lactated Ringer's). ✓
, C. 20 mL/kg of 0.45% Normal Saline.
D. 5 mL/kg of colloid.
219. A 9-month-old with a 3-day history of cough and rhinorrhea presents with tachypnea,
nasal flaring, and wheezing. The most likely etiology is:
A. Foreign body aspiration.
B. Asthma.
C. Bronchiolitis (often caused by RSV). ✓
D. Pneumothorax.
220. When assessing a pediatric burn using the Rule of Nines, the entire head and neck of an
infant accounts for what percentage?
A. 9%
B. 18% ✓
C. 12%
D. 14%
221. In a stable child with a simple febrile seizure, the priority nursing action is:
A. Administer IV phenobarbital.
B. Place a tongue depressor in the mouth.
C. Focus on identifying and treating the source of the fever. ✓
D. Obtain an immediate stat head CT.
222. The classic presentation of intussusception includes:
A. Projectile vomiting and olive-shaped mass.
B. Intermittent, colicky abdominal pain and currant jelly stools. ✓
C. Rigid abdomen and fever.
D. Bloody diarrhea and severe tenesmus.
223. A child with diabetic ketoacidosis (DKA) will most likely present with:
A. Hypoglycemia, shallow respirations.
B. Hyperglycemia, Kussmaul respirations, and dehydration. ✓
C. Hypokalemia and bradycardia.
D. Hypertension and edema.
224. The priority intervention for a child experiencing a severe anaphylactic reaction is:
A. Administer IV diphenhydramine.
B. Administer intramuscular epinephrine. ✓
C. Start a nebulized albuterol treatment.
D. Obtain a detailed allergy history.
COMPLETE CONCEPT REVIEW & PRACTICE
MATERIALS (LATEST EDITION)
ENPC 6th Edition: Core Concept Practice Questions
201. The foundation of the pediatric assessment triangle (PAT) is:
A. A detailed physical exam.
B. A quick, hands-on evaluation of vital signs.
C. A visual, hands-off assessment of appearance, work of breathing, and circulation. ✓
D. A focused history obtained from the parents.
202. In the Pediatric Assessment Triangle, "Appearance" is assessed using the TICLS
mnemonic. What does TICLS stand for?
A. Tone, Interaction, Consolability, Look, Speech
B. Tone, Interactiveness, Consolability, Look/Gaze, Speech/Cry ✓
C. Temperature, Inspection, Color, Lung sounds, Saturation
D. Trauma, Infection, Congestion, Level of consciousness, Seizure
203. A 3-year-old presents with a sudden onset of stridor and a barky cough at night. The
child is alert and has mild intercostal retractions. Your initial priority is to:
A. Start an IV and administer antibiotics.
B. Provide nebulized epinephrine and corticosteroids. ✓
C. Perform a detailed throat exam to look for a foreign body.
D. Obtain a chest X-ray to confirm croup.
204. The most reliable indicator of perfusion in an infant is:
A. Blood pressure.
B. Skin temperature and capillary refill. ✓
C. Heart rate.
D. Urine output.
205. A 6-month-old with a history of fever and irritability presents with a bulging fontanelle.
This is most suggestive of:
A. Dehydration.
B. Meningitis. ✓
C. Simple febrile seizure.
D. Skull fracture.
,206. The correct order of the nursing process in a pediatric emergency is:
A. Intervention, Assessment, Reassessment, Triage
B. History, Diagnosis, Intervention, Evaluation
C. Assessment, Problem Identification, Intervention, Evaluation ✓
D. Triage, Vital Signs, Treatment, Discharge
207. During the primary assessment of an unresponsive infant, the priority after ensuring
scene safety is to:
A. Check for a pulse.
B. Assess for responsiveness and open the airway. ✓
C. Begin chest compressions immediately.
D. Look for signs of bleeding.
208. In a pediatric patient, compensated shock is characterized by:
A. Hypotension and tachycardia.
B. Bradycardia and apnea.
C. Tachycardia with normal blood pressure. ✓
D. Hypertension and bradypnea.
209. The most common cause of cardiac arrest in infants and children is:
A. Primary cardiac arrhythmia.
B. Respiratory failure or shock. ✓
C. Severe head trauma.
D. Electrolyte imbalance.
210. For a 4-year-old in respiratory distress, a pulse oximetry reading of 90% on room air
indicates:
A. Mild distress; provide supplemental oxygen via nasal cannula at 2 LPM.
B. Significant hypoxemia; provide high-flow oxygen via non-rebreather mask. ✓
C. Accurate reading; no oxygen needed if the child is alert.
D. Probe error; obtain an arterial blood gas instead.
211. When using a length-based resuscitation tape (e.g., Broselow Tape), you are determining:
A. Only drug dosages.
B. Equipment sizes, drug dosages, and fluid volumes. ✓
C. Only appropriate endotracheal tube size.
D. The child's exact age.
212. A 2-year-old is found submerged in a pool. On arrival, he is unresponsive, pulseless, and
apneic. After initiating CPR, your next critical action is to:
,A. Wait for the code team to arrive.
B. Attach the AED/defibrillator and analyze the rhythm. ✓
C. Insert an orogastric tube to decompress the stomach.
D. Start a peripheral IV line.
213. The appropriate depth for chest compressions in an infant is:
A. ½ inch (1.3 cm).
B. Approximately 1.5 inches (4 cm). ✓
C. 2 inches (5 cm).
D. One-third the depth of the chest.
214. For a pediatric patient with a suspected cervical spine injury, the preferred method of
opening the airway is:
A. Head-tilt, chin-lift.
B. Jaw-thrust without head extension. ✓
C. Placing the child in the recovery position.
D. Using an oral airway.
215. A child with acute respiratory failure will typically demonstrate:
A. Hypoxemia and/or hypercarbia. ✓
B. Hypertension and bradycardia.
C. Hypocarbia and alkalosis.
D. Normal breath sounds and pulse ox.
216. The medication of choice for a pediatric patient with symptomatic bradycardia (with
poor perfusion) that is unresponsive to effective oxygenation and ventilation is:
A. Atropine.
B. Epinephrine. ✓
C. Dopamine.
D. Lidocaine.
217. Signs of increased intracranial pressure (ICP) in an older child include all EXCEPT:
A. Headache and vomiting.
B. Cushing's triad (hypertension, bradycardia, irregular respirations).
C. Hypertension and tachycardia. ✓
D. Decreased level of consciousness.
218. The initial fluid bolus for a pediatric patient in hypovolemic shock is:
A. 10 mL/kg of 5% Dextrose in Water.
B. 20 mL/kg of isotonic crystalloid (e.g., Normal Saline or Lactated Ringer's). ✓
, C. 20 mL/kg of 0.45% Normal Saline.
D. 5 mL/kg of colloid.
219. A 9-month-old with a 3-day history of cough and rhinorrhea presents with tachypnea,
nasal flaring, and wheezing. The most likely etiology is:
A. Foreign body aspiration.
B. Asthma.
C. Bronchiolitis (often caused by RSV). ✓
D. Pneumothorax.
220. When assessing a pediatric burn using the Rule of Nines, the entire head and neck of an
infant accounts for what percentage?
A. 9%
B. 18% ✓
C. 12%
D. 14%
221. In a stable child with a simple febrile seizure, the priority nursing action is:
A. Administer IV phenobarbital.
B. Place a tongue depressor in the mouth.
C. Focus on identifying and treating the source of the fever. ✓
D. Obtain an immediate stat head CT.
222. The classic presentation of intussusception includes:
A. Projectile vomiting and olive-shaped mass.
B. Intermittent, colicky abdominal pain and currant jelly stools. ✓
C. Rigid abdomen and fever.
D. Bloody diarrhea and severe tenesmus.
223. A child with diabetic ketoacidosis (DKA) will most likely present with:
A. Hypoglycemia, shallow respirations.
B. Hyperglycemia, Kussmaul respirations, and dehydration. ✓
C. Hypokalemia and bradycardia.
D. Hypertension and edema.
224. The priority intervention for a child experiencing a severe anaphylactic reaction is:
A. Administer IV diphenhydramine.
B. Administer intramuscular epinephrine. ✓
C. Start a nebulized albuterol treatment.
D. Obtain a detailed allergy history.
