ENPC 6TH EDITION EXAM FULL QUESTIONS
AND ANSWERS 2026 GRADED A+
◉ Which of the following patients should be evaluated first?
a. 3 yo with dislodged G-tube
b. 18m with bilious emesis
c. 12 you with vomiting after handlebar injury
d. 3m with periods of inconsolable crying. Answer: B.
The presence of bilious emesis is especially concerning because it
may be indicative of an immediately life-threatening bowel
obstruction. A dislodged gastrostomy tube should be reinserted
within 4-6 hours to prevent stoma closure. Vomiting following a
handlebar injury may be indicative of many possible injuries, but
does not take precedence unless other symptoms are present.
Infantile colic is described as inconsolable crying in infants, 2 weeks
to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
◉ You need to draw blood from a 2-year-old. Which of the following
is the best approach for this patient?
a. allow them to hold the blood tubes before drawing
b. have them watch a cartoon on an ipad or cellphone
c. give them an explanation of what will happen
d. prepare the equipment in the room so they can see. Answer: B.
, The best approach to a toddler who requires interventions is to
provide distractions whenever possible. They are in the cognitive
development phase of "sensorimotor/preoperational" so having the
caregiver present is helpful. You should move from the least invasive
to most invasive tasks, and don't let them watch you prepare since it
will increase anxiety.
◉ A 3-month-old is brought to the emergency department with new
onset of fever. You note the child to be pale, tachypneic, and
tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
a. administer an appropriate dose of an antipyretic
b. infuse rapid 10-20 mL/kg bolus of isotonic crystalloid
c. prepare a broad spectrum antibiotic infusion
d. administer a vasoactive medication. Answer: B.
This patient most likely has septic shock. An immediate goal is to
reverse shock and restore tissue perfusion with fluids. An
antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and
vasoactive medications may not be needed if fluid resuscitation is
successful.
◉ A 5-year-old with no health problems presents to the emergency
department with a sudden onset of chest pain and shortness of
breath. Parents state that the family was involved in a bad car crash
two weeks ago. A thorough assessment and workup has not revealed
AND ANSWERS 2026 GRADED A+
◉ Which of the following patients should be evaluated first?
a. 3 yo with dislodged G-tube
b. 18m with bilious emesis
c. 12 you with vomiting after handlebar injury
d. 3m with periods of inconsolable crying. Answer: B.
The presence of bilious emesis is especially concerning because it
may be indicative of an immediately life-threatening bowel
obstruction. A dislodged gastrostomy tube should be reinserted
within 4-6 hours to prevent stoma closure. Vomiting following a
handlebar injury may be indicative of many possible injuries, but
does not take precedence unless other symptoms are present.
Infantile colic is described as inconsolable crying in infants, 2 weeks
to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
◉ You need to draw blood from a 2-year-old. Which of the following
is the best approach for this patient?
a. allow them to hold the blood tubes before drawing
b. have them watch a cartoon on an ipad or cellphone
c. give them an explanation of what will happen
d. prepare the equipment in the room so they can see. Answer: B.
, The best approach to a toddler who requires interventions is to
provide distractions whenever possible. They are in the cognitive
development phase of "sensorimotor/preoperational" so having the
caregiver present is helpful. You should move from the least invasive
to most invasive tasks, and don't let them watch you prepare since it
will increase anxiety.
◉ A 3-month-old is brought to the emergency department with new
onset of fever. You note the child to be pale, tachypneic, and
tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
a. administer an appropriate dose of an antipyretic
b. infuse rapid 10-20 mL/kg bolus of isotonic crystalloid
c. prepare a broad spectrum antibiotic infusion
d. administer a vasoactive medication. Answer: B.
This patient most likely has septic shock. An immediate goal is to
reverse shock and restore tissue perfusion with fluids. An
antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and
vasoactive medications may not be needed if fluid resuscitation is
successful.
◉ A 5-year-old with no health problems presents to the emergency
department with a sudden onset of chest pain and shortness of
breath. Parents state that the family was involved in a bad car crash
two weeks ago. A thorough assessment and workup has not revealed
