2026 ENPC TEST PAPER SET QUESTIONS AND
ANSWERS SURE A+
✔✔A fertilizer silo exploded during a school tour of a working farm. The children are
able to manage their own secretions but all are incontinent and salivating, with excess
tearing. Which of the following is the priority intervention? - ✔✔A.Removal of clothing
and decontamination
B.Establishing patient identification
C.Rapid administration of atropine
D.Providing supportive treatment
✔✔A caregiver states their 3-year-old child ate some marijuana gummies approximately
3 hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of
breathing is normal. What is your initial intervention? - ✔✔A.Administer activated
charcoal
B.Check the child's blood glucose
C.Initiate intravenous access
D.Obtain a full set of vital signs
✔✔A 14-year-old patient presents to the emergency department with her aunt after
being assaulted. The patient has multiple bruises inconsistent with the assault history
and seems guarded with her answers. A urine test is positive for pregnancy, although
the patient denies being sexually active. The aunt repeatedly asks when they will be
,discharged. The ED nurse recognizes these finding as red flags for which of the
following? - ✔✔A.Labor trafficking
B.Sex trafficking
C.Psychological abuse
D.Physical abuse
✔✔A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is
noted to have hypotension, tachycardia, and contusions and discoloration across the
lap area. On exam a splenic rupture is suspected. Which of the following diagnoses
should be suspected as a companion injury with these findings and associated
mechanism of injury? - ✔✔A.Lumbar fracture
B.Pneumothorax
C.Subdural hematoma
D.Cardiac tamponade
✔✔Which patient reflects an EMTALA compliant transfer? - ✔✔A.An actively seizing
toddler being transferred to a pediatric-specific facility. That facility is checking on
inpatient bed availability.
B.A post-ictal patient with status epilepticus being transferred to a higher level of care
with an accepting physician. All records are copied.
C.A teenager with abdominal trauma and critical labs being transferred to a pediatric
trauma center for surgery. The facility has not accepted the transfer yet.
D.An infant with respiratory difficulties being transferred to another hospital with the
same level of pediatric care. Parents are not present, and records are copied.
✔✔After an explosion at a school, you are helping triage patients. In your field triage
room you find a 5-year-old patient who is not breathing. What is the appropriate initial
intervention? - ✔✔A.Assign the patient as black/expectant.
B.Open the airway and assess for breathing. - -
C.Check for capillary refill of < 2 seconds
D.Initiate cardiopulmonary resuscitation
✔✔Return of spontaneous circulation has been confirmed in a 5-year-old following
cardiopulmonary arrest after a 5-day history of vomiting and diarrhea. Vital signs are BP
72/60 mm Hg, HR 140 beats/minute, RR assisted at 30 breaths/minute via definitive
airway, SpO2 97%, and T 36.8°C (98.4°F) rectally. Which of the following would be the
priority intervention at this time? - ✔✔A.Obtain a 12-lead electrocardiogram
B.Administer maintenance fluids
C.Obtain a chest radiograph
D.Administer an isotonic crystalloid bolus
✔✔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? - ✔✔A.Initiating
targeted temperature management
, B.Performing a capillary glucose level
C.Establishing a secure airway
D.Administering maintenance IV fluids
✔✔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? - ✔✔A.Limiting caregiver presence in the
room
B.Providing distraction using loud video games
C.Performing a suicide risk assessment
D.Allowing unrestricted movement throughout the department.
✔✔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? - ✔✔A.Increased heart rate
B.Decreased preload
C.Increased afterload
D.Decreased contractility
✔✔An 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-
bilious vomiting, and a low grade fever. On assessment the child is intermittently
inconsolable followed by periods of normal activity. A sausage-shaped mass is noted
during palpation of the abdomen. The nurse should prepare for which of the following? -
✔✔A.Gastric tube insertion
B.Enema with air
C.Surgical intervention
D.Computerized tomography
✔✔What is the first step in the care of the newly born infant? - ✔✔A.Suction the nose
and mouth
B.Measure pulse oximetry
C.Calculate an APGAR score
D.Warm, dry, and stimulate
✔✔A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a
fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute,
and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5
seconds. Which of the following would be most indicative of the need for intravenous
rehydration therapy for this patient? - ✔✔A.Capillary refill
B.Blood pressure
C.Pulse rate
D.Respiratory rate
✔✔Which of the following is a family-centered care concept ? - ✔✔A.Information is
shared with family only when medical decisions are made by the provider.
ANSWERS SURE A+
✔✔A fertilizer silo exploded during a school tour of a working farm. The children are
able to manage their own secretions but all are incontinent and salivating, with excess
tearing. Which of the following is the priority intervention? - ✔✔A.Removal of clothing
and decontamination
B.Establishing patient identification
C.Rapid administration of atropine
D.Providing supportive treatment
✔✔A caregiver states their 3-year-old child ate some marijuana gummies approximately
3 hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of
breathing is normal. What is your initial intervention? - ✔✔A.Administer activated
charcoal
B.Check the child's blood glucose
C.Initiate intravenous access
D.Obtain a full set of vital signs
✔✔A 14-year-old patient presents to the emergency department with her aunt after
being assaulted. The patient has multiple bruises inconsistent with the assault history
and seems guarded with her answers. A urine test is positive for pregnancy, although
the patient denies being sexually active. The aunt repeatedly asks when they will be
,discharged. The ED nurse recognizes these finding as red flags for which of the
following? - ✔✔A.Labor trafficking
B.Sex trafficking
C.Psychological abuse
D.Physical abuse
✔✔A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is
noted to have hypotension, tachycardia, and contusions and discoloration across the
lap area. On exam a splenic rupture is suspected. Which of the following diagnoses
should be suspected as a companion injury with these findings and associated
mechanism of injury? - ✔✔A.Lumbar fracture
B.Pneumothorax
C.Subdural hematoma
D.Cardiac tamponade
✔✔Which patient reflects an EMTALA compliant transfer? - ✔✔A.An actively seizing
toddler being transferred to a pediatric-specific facility. That facility is checking on
inpatient bed availability.
B.A post-ictal patient with status epilepticus being transferred to a higher level of care
with an accepting physician. All records are copied.
C.A teenager with abdominal trauma and critical labs being transferred to a pediatric
trauma center for surgery. The facility has not accepted the transfer yet.
D.An infant with respiratory difficulties being transferred to another hospital with the
same level of pediatric care. Parents are not present, and records are copied.
✔✔After an explosion at a school, you are helping triage patients. In your field triage
room you find a 5-year-old patient who is not breathing. What is the appropriate initial
intervention? - ✔✔A.Assign the patient as black/expectant.
B.Open the airway and assess for breathing. - -
C.Check for capillary refill of < 2 seconds
D.Initiate cardiopulmonary resuscitation
✔✔Return of spontaneous circulation has been confirmed in a 5-year-old following
cardiopulmonary arrest after a 5-day history of vomiting and diarrhea. Vital signs are BP
72/60 mm Hg, HR 140 beats/minute, RR assisted at 30 breaths/minute via definitive
airway, SpO2 97%, and T 36.8°C (98.4°F) rectally. Which of the following would be the
priority intervention at this time? - ✔✔A.Obtain a 12-lead electrocardiogram
B.Administer maintenance fluids
C.Obtain a chest radiograph
D.Administer an isotonic crystalloid bolus
✔✔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? - ✔✔A.Initiating
targeted temperature management
, B.Performing a capillary glucose level
C.Establishing a secure airway
D.Administering maintenance IV fluids
✔✔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? - ✔✔A.Limiting caregiver presence in the
room
B.Providing distraction using loud video games
C.Performing a suicide risk assessment
D.Allowing unrestricted movement throughout the department.
✔✔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? - ✔✔A.Increased heart rate
B.Decreased preload
C.Increased afterload
D.Decreased contractility
✔✔An 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-
bilious vomiting, and a low grade fever. On assessment the child is intermittently
inconsolable followed by periods of normal activity. A sausage-shaped mass is noted
during palpation of the abdomen. The nurse should prepare for which of the following? -
✔✔A.Gastric tube insertion
B.Enema with air
C.Surgical intervention
D.Computerized tomography
✔✔What is the first step in the care of the newly born infant? - ✔✔A.Suction the nose
and mouth
B.Measure pulse oximetry
C.Calculate an APGAR score
D.Warm, dry, and stimulate
✔✔A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a
fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute,
and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5
seconds. Which of the following would be most indicative of the need for intravenous
rehydration therapy for this patient? - ✔✔A.Capillary refill
B.Blood pressure
C.Pulse rate
D.Respiratory rate
✔✔Which of the following is a family-centered care concept ? - ✔✔A.Information is
shared with family only when medical decisions are made by the provider.
