2024 ENPC Comprehensive Exam Mastery: Complete
Test Bank for the 6th Edition of the Emergency
Nursing Pediatric Course – Essential Resource for
Pediatric Emergency Care Students.
Ay4-year-
oldypresentsywithyvomiting,ylethargy,yfrequentyurination,yweightyloss,yandydryymucousymembranes
.yVitalysignsyrevealydeepyrespirationsyaty44ybreathsyperyminute,yBPyofy70/44ymmyHg,yandyHRyofy14
4ybeatsyperyminute.yWhichyofytheyfollowingylaboratoryyvaluesywouldybeymostyexpectedyinythisychil
d?
Hypoglycemiay(wrong)
Remediationyfeedback:
Childrenycanypresentywithynewyonsetydiabetesyinydiabeticyketoacidosis.yManifestationsyinclu
deysignsyofydehydrationy(ydryymucousymembranes,yhypotension,ytachycardia),yincontinencey
(polyuria),yvomiting,yabdominalypain,yKussmaulyrespirationsy(toycounterytheyacidosis),ypoly
dipsia,yanorexia,yandyweightyloss.yExpectedylaboratoryyvaluesywouldyrevealyanyacidoticystate
ywithyaypHylevelybelowy7.3,yanyelevatedyserumybIcarbonateylevel,yandyanyelevatedybloodygluc
oseylevely>y200ymg.dL.
Any18-month-
oldyisyseenyforyfever,yslightycircumoralycyanosis,yandywheezingynotedyonyauscultationyinytheyrighty
upperylobeyofytheylungyfieldyafteryaychokingyeventy4ydaysyago.yTheywhiteybloodycellycountyisyelevat
edyandytheypatientynotedytoybeytachypneic,ytachycardic,yagitated,yandyhasyanyincreasedyrespiratoryy
effort.yAtytheytimeyofytheyevent,ytheypatientywasystartedyonyantibioticsywithysubsequentyincreasingy
manifestationsyinsteadyofyimprovement.yWhichyofytheyfollowingywouldybeyconsideredytoybeydefinit
iveytreatmentyforytheysuspectedydiagnosis?
Computedytomographyy(wrong)
,Remediationyfeedback:
Manifestationsyofyayloweryairwayyforeignybodyyincludeyaychokingyincidentywithysubsequentyf
ailureytoyimproveyonyantibiotics.yWheezingyorydecreasedylungysoundsyinyoneyareayofytheypul
monaryysystemyisyayhighyindicatoryforyayforeignybodyyalongywithysignsyofyhypoxiaysuchyasycy
anosis,ytachypnea,ytachycardia,yincreasedyrespiratoryyeffort,yagitationyorylethargy,yandyelev
atedywhiteybloodycellycountsyindicatingyanyinfectiousyprocess.yTheydefinitiveytreatmentywoul
dybeyaybronchoscopyyinyorderytoyretrieveytheysuspectedyforeignybodyyinsteadyofydiagnosticyte
stsytoylocateytheyforeignybodyyitself.
Aychildyinycardiopulmonaryyarrestyisyreceivingychestycompressionsyandymanualyventilationsywithya
ybag-
maskydevice.yOnceyreturnyofyspontaneousycirculationyhasybeenyconfirmed,ywhichyofytheyfollowingy
wouldybeytheypriorityyintervention?
Establishingyaysecureyairway
Parentsyreportytheiry3-year-oldychildyhasydevelopedynoisyybreathing.yOnyassessment,yhigh-
pitchedywheezesyareyaudibleyandyauscultatedyonyinspirationyandyexpiration.yWhatymedicationywou
ldybeyappropriateytoyadministeryfirst?
Humidifiedyoxygeny(wrong)
Remediationyfeedback:
Wheezingyisymostyoftenyidentifiedywithyasthmayinytheypediatricypopulation.yInitialymedicatio
nyinterventionyincludesyanyinhaledyshort-actingybetayagonist.
Ay6-week-
oldyisybroughtytoytheyemergencyydepartmentybyytheycaregiversyforypooryfeeding,ylistlessness,yandyf
ever.yAssessmentyrevealsyaycryingyinfant,yHRy160ybeats/minute,yRRy52ybreaths/
minute,yrectalytemperatureyofy96.0yFy(35.5yC),yandyaybulgingyanterioryfontanel.yCapillaryyrefillyisy4
,yseconds.yBasedyonytheseyfindingsywhatyisytheymostylikelyydiagnosticytestytheynurseyshouldyanticipa
te?
Lumbarypuncture
Ay12-year-
oldyisybeingypreppedyforysurgicalyinterventionyofyacuteyappendicitis.yWhichyofytheyfollowingyintrav
enousymedicationyordersyshouldytheynurseyquestion?
Hydromorphoney(wrong)
Remediationyfeedback:
Ketorolacyisyanyappropriateymedicationyforymoderateytoysevereypain,yhowever,yityshouldynoty
beyusedypre-operativelyydueytoyitsypotentialytoyincreaseytheybleedingyrisk.
Ay17-year-
oldyfemaleyarrivesyinytheyEDywithyheryboyfriendywhoystatesysheyisypregnantyandyhavingyvaginalyble
eding.yTheypatientyisyunsureyofytheygestationalyageyandyhasynotyhadyanyyprenatalytreatment.yTheypa
tientyisyquietyandyletsyheryboyfriendyanswerymostyofytheyquestions.yWhichyofytheyfollowingyisythey
mostyappropriateyactionyforytheynurseytoytakeyatythisypoint?
Haveytheyboyfriendyleaveytheyroomyduringytheypelvicyexam.
Ay2-year-
oldyarrivesyatytheyEDyinyhypovolemicyshockyandyneedsyfluidsyimmediately.yAfteryseveralyattempts,
yyouryteamyhasybeenyunsuccessfulyatyestablishingyvascularyaccess.yOfytheyfollowing,ywhichyisytheyn
extybestyoptionyforyestablishingyaccessyquickly?
Intraosseousyinytheypatient'symedialytibia.
, Aychildywithyanyelectricalyinjuryyisyseeny1yhourypostyevent.yWhichyofytheyfollowingytypesyofyspeci
menysamplesywouldyprovideyvisualyinformationyregardingyaypotentialycomplicationyofythisyinjury?
Sputumy(wrong)
Remediationyfeedback:
Electricalyinjuries,ythoughytheyymayyappearytoybeysmall,ycanyproduceylargeyamountsyofydam
ageyinternally,yincludingymuscleydamage.yMyoglobinyisyexcretedyinytheyurineyandyisyevidence
dybyydark,yred-tingedyurine.
Parentsywithyanyinfantyrequiringymultipleylaboratoryytests,yradiographicystudies,yandyinvasiveyproc
eduresyappearytoybeydistressedyandywithdrawn.yWhichyofytheyfollowingyinterventionsywouldybestye
nsureyaysenseyofycomfortyandycontrolyforytheseyparents?
Providingyfrequentyupdatesyandyre-educatingythemyonytheycareythatyisybeingyprovided
Whenytakingyvitalysignsyonyaystableyinfant,ywhichyofytheyfollowingyshouldybeydoneyfirst?
Respiratoryyrate
Aylacerationyonyaytoddler'syarmyisypreparedyforysuturing.yWhichyofytheyfollowingypreparationsyforyt
opicalyanesthesiaywouldybeytheybestychoiceyforythisyprocedure?
LETy(lidocaine/epinephrine/tetracaine)
WhichyofytheyfollowingyisyappropriateyadministrationyofyN-
acetylcysteiney(NAC)yforyanyacetaminophenyoverdose?
Aybolusyinfusionyofy150ymg/kgyNACyshouldybeyadministered.
Test Bank for the 6th Edition of the Emergency
Nursing Pediatric Course – Essential Resource for
Pediatric Emergency Care Students.
Ay4-year-
oldypresentsywithyvomiting,ylethargy,yfrequentyurination,yweightyloss,yandydryymucousymembranes
.yVitalysignsyrevealydeepyrespirationsyaty44ybreathsyperyminute,yBPyofy70/44ymmyHg,yandyHRyofy14
4ybeatsyperyminute.yWhichyofytheyfollowingylaboratoryyvaluesywouldybeymostyexpectedyinythisychil
d?
Hypoglycemiay(wrong)
Remediationyfeedback:
Childrenycanypresentywithynewyonsetydiabetesyinydiabeticyketoacidosis.yManifestationsyinclu
deysignsyofydehydrationy(ydryymucousymembranes,yhypotension,ytachycardia),yincontinencey
(polyuria),yvomiting,yabdominalypain,yKussmaulyrespirationsy(toycounterytheyacidosis),ypoly
dipsia,yanorexia,yandyweightyloss.yExpectedylaboratoryyvaluesywouldyrevealyanyacidoticystate
ywithyaypHylevelybelowy7.3,yanyelevatedyserumybIcarbonateylevel,yandyanyelevatedybloodygluc
oseylevely>y200ymg.dL.
Any18-month-
oldyisyseenyforyfever,yslightycircumoralycyanosis,yandywheezingynotedyonyauscultationyinytheyrighty
upperylobeyofytheylungyfieldyafteryaychokingyeventy4ydaysyago.yTheywhiteybloodycellycountyisyelevat
edyandytheypatientynotedytoybeytachypneic,ytachycardic,yagitated,yandyhasyanyincreasedyrespiratoryy
effort.yAtytheytimeyofytheyevent,ytheypatientywasystartedyonyantibioticsywithysubsequentyincreasingy
manifestationsyinsteadyofyimprovement.yWhichyofytheyfollowingywouldybeyconsideredytoybeydefinit
iveytreatmentyforytheysuspectedydiagnosis?
Computedytomographyy(wrong)
,Remediationyfeedback:
Manifestationsyofyayloweryairwayyforeignybodyyincludeyaychokingyincidentywithysubsequentyf
ailureytoyimproveyonyantibiotics.yWheezingyorydecreasedylungysoundsyinyoneyareayofytheypul
monaryysystemyisyayhighyindicatoryforyayforeignybodyyalongywithysignsyofyhypoxiaysuchyasycy
anosis,ytachypnea,ytachycardia,yincreasedyrespiratoryyeffort,yagitationyorylethargy,yandyelev
atedywhiteybloodycellycountsyindicatingyanyinfectiousyprocess.yTheydefinitiveytreatmentywoul
dybeyaybronchoscopyyinyorderytoyretrieveytheysuspectedyforeignybodyyinsteadyofydiagnosticyte
stsytoylocateytheyforeignybodyyitself.
Aychildyinycardiopulmonaryyarrestyisyreceivingychestycompressionsyandymanualyventilationsywithya
ybag-
maskydevice.yOnceyreturnyofyspontaneousycirculationyhasybeenyconfirmed,ywhichyofytheyfollowingy
wouldybeytheypriorityyintervention?
Establishingyaysecureyairway
Parentsyreportytheiry3-year-oldychildyhasydevelopedynoisyybreathing.yOnyassessment,yhigh-
pitchedywheezesyareyaudibleyandyauscultatedyonyinspirationyandyexpiration.yWhatymedicationywou
ldybeyappropriateytoyadministeryfirst?
Humidifiedyoxygeny(wrong)
Remediationyfeedback:
Wheezingyisymostyoftenyidentifiedywithyasthmayinytheypediatricypopulation.yInitialymedicatio
nyinterventionyincludesyanyinhaledyshort-actingybetayagonist.
Ay6-week-
oldyisybroughtytoytheyemergencyydepartmentybyytheycaregiversyforypooryfeeding,ylistlessness,yandyf
ever.yAssessmentyrevealsyaycryingyinfant,yHRy160ybeats/minute,yRRy52ybreaths/
minute,yrectalytemperatureyofy96.0yFy(35.5yC),yandyaybulgingyanterioryfontanel.yCapillaryyrefillyisy4
,yseconds.yBasedyonytheseyfindingsywhatyisytheymostylikelyydiagnosticytestytheynurseyshouldyanticipa
te?
Lumbarypuncture
Ay12-year-
oldyisybeingypreppedyforysurgicalyinterventionyofyacuteyappendicitis.yWhichyofytheyfollowingyintrav
enousymedicationyordersyshouldytheynurseyquestion?
Hydromorphoney(wrong)
Remediationyfeedback:
Ketorolacyisyanyappropriateymedicationyforymoderateytoysevereypain,yhowever,yityshouldynoty
beyusedypre-operativelyydueytoyitsypotentialytoyincreaseytheybleedingyrisk.
Ay17-year-
oldyfemaleyarrivesyinytheyEDywithyheryboyfriendywhoystatesysheyisypregnantyandyhavingyvaginalyble
eding.yTheypatientyisyunsureyofytheygestationalyageyandyhasynotyhadyanyyprenatalytreatment.yTheypa
tientyisyquietyandyletsyheryboyfriendyanswerymostyofytheyquestions.yWhichyofytheyfollowingyisythey
mostyappropriateyactionyforytheynurseytoytakeyatythisypoint?
Haveytheyboyfriendyleaveytheyroomyduringytheypelvicyexam.
Ay2-year-
oldyarrivesyatytheyEDyinyhypovolemicyshockyandyneedsyfluidsyimmediately.yAfteryseveralyattempts,
yyouryteamyhasybeenyunsuccessfulyatyestablishingyvascularyaccess.yOfytheyfollowing,ywhichyisytheyn
extybestyoptionyforyestablishingyaccessyquickly?
Intraosseousyinytheypatient'symedialytibia.
, Aychildywithyanyelectricalyinjuryyisyseeny1yhourypostyevent.yWhichyofytheyfollowingytypesyofyspeci
menysamplesywouldyprovideyvisualyinformationyregardingyaypotentialycomplicationyofythisyinjury?
Sputumy(wrong)
Remediationyfeedback:
Electricalyinjuries,ythoughytheyymayyappearytoybeysmall,ycanyproduceylargeyamountsyofydam
ageyinternally,yincludingymuscleydamage.yMyoglobinyisyexcretedyinytheyurineyandyisyevidence
dybyydark,yred-tingedyurine.
Parentsywithyanyinfantyrequiringymultipleylaboratoryytests,yradiographicystudies,yandyinvasiveyproc
eduresyappearytoybeydistressedyandywithdrawn.yWhichyofytheyfollowingyinterventionsywouldybestye
nsureyaysenseyofycomfortyandycontrolyforytheseyparents?
Providingyfrequentyupdatesyandyre-educatingythemyonytheycareythatyisybeingyprovided
Whenytakingyvitalysignsyonyaystableyinfant,ywhichyofytheyfollowingyshouldybeydoneyfirst?
Respiratoryyrate
Aylacerationyonyaytoddler'syarmyisypreparedyforysuturing.yWhichyofytheyfollowingypreparationsyforyt
opicalyanesthesiaywouldybeytheybestychoiceyforythisyprocedure?
LETy(lidocaine/epinephrine/tetracaine)
WhichyofytheyfollowingyisyappropriateyadministrationyofyN-
acetylcysteiney(NAC)yforyanyacetaminophenyoverdose?
Aybolusyinfusionyofy150ymg/kgyNACyshouldybeyadministered.
