2026 ENPC COMPREHENSIVE UPDATED
QUESTIONS AND ANSWERS SURE A+
✔✔A child with an electrical injury is seen 1 hour post event. Which of the following
types of specimen samples would provide visual information regarding a potential
complication of this injury? - ✔✔Myoglobin is excreted in the urine and is evidenced by
dark, red-tinged urine.
✔✔Parents with an infant requiring multiple laboratory tests, radiographic studies, and
invasive procedures appear to be distressed and withdrawn. Which of the following
interventions would best ensure a sense of comfort and control for these parents? -
✔✔Providing frequent updates and re-educating them on the care that is being provided
✔✔When taking vital signs on a stable infant, which of the following should be done
first? - ✔✔Respiratory rate
✔✔A laceration on a toddler's arm is prepared for suturing. Which of the following
preparations for topical anesthesia would be the best choice for this procedure? -
✔✔LET (lidocaine/epinephrine/tetracaine)
,✔✔Which of the following is appropriate administration of N-acetylcysteine (NAC) for an
acetaminophen overdose? - ✔✔A bolus infusion of 150 mg/kg NAC should be
administered.
✔✔A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of
foul-smelling urine. The child is hypotensive and tachycardic. Which of the following
methods for obtaining a urine sample is most appropriate in this circumstance? -
✔✔Urinary catherization
✔✔You are discharging a patient home who has a history of depression. Discharge
teaching should include which of the following? - ✔✔Ensuring all firearms in the home
are locked up with no access available by the patient.
✔✔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? - ✔✔Capillary refill
✔✔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? -
✔✔Enema with air
✔✔A 13-year -old male presents to the triage desk complaining of nausea and vomiting.
The patient looks distressed and pale. He complains of spasming pain in his right
scrotum which has now become constant and more severe. Which of the following
assessment findings would the nurse expect with this patient? - ✔✔Elevated right
testicle
✔✔An 8-year-old trauma patient suddenly develops increased respiratory distress with
a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt
hypotensive event. Distention of the jugular veins is noted. Which of the following
emergent interventions should be anticipated first? - ✔✔Needle decompression is
emergently necessary to release the air and allow expansion of the lung again.
✔✔An 8-year-old pedestrian is thrown onto the hood of a moving vehicle striking the
windshield. On arrival to the ED. the patient is minimally responsive with active bleeding
from the nose and mouth. The patient is vomiting. Which of the following interventions
would most likely be considered? - ✔✔Endotracheal intubation
, ✔✔The nurse is reevaluating the effectiveness of interventions for a 4-year-old child
with a suspected tension pneumothorax. Which assessment finding indicates the
interventions were effective? - ✔✔Bilateral chest wall rise with assisted ventilations.
✔✔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? - ✔✔Osteogenesis
imperfecta
✔✔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? - ✔✔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? -
✔✔The presence of a purpuric rash necessitates the infant to be placed in isolation
immediately as this is a symptom of possible meningitis.
QUESTIONS AND ANSWERS SURE A+
✔✔A child with an electrical injury is seen 1 hour post event. Which of the following
types of specimen samples would provide visual information regarding a potential
complication of this injury? - ✔✔Myoglobin is excreted in the urine and is evidenced by
dark, red-tinged urine.
✔✔Parents with an infant requiring multiple laboratory tests, radiographic studies, and
invasive procedures appear to be distressed and withdrawn. Which of the following
interventions would best ensure a sense of comfort and control for these parents? -
✔✔Providing frequent updates and re-educating them on the care that is being provided
✔✔When taking vital signs on a stable infant, which of the following should be done
first? - ✔✔Respiratory rate
✔✔A laceration on a toddler's arm is prepared for suturing. Which of the following
preparations for topical anesthesia would be the best choice for this procedure? -
✔✔LET (lidocaine/epinephrine/tetracaine)
,✔✔Which of the following is appropriate administration of N-acetylcysteine (NAC) for an
acetaminophen overdose? - ✔✔A bolus infusion of 150 mg/kg NAC should be
administered.
✔✔A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of
foul-smelling urine. The child is hypotensive and tachycardic. Which of the following
methods for obtaining a urine sample is most appropriate in this circumstance? -
✔✔Urinary catherization
✔✔You are discharging a patient home who has a history of depression. Discharge
teaching should include which of the following? - ✔✔Ensuring all firearms in the home
are locked up with no access available by the patient.
✔✔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? - ✔✔Capillary refill
✔✔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? -
✔✔Enema with air
✔✔A 13-year -old male presents to the triage desk complaining of nausea and vomiting.
The patient looks distressed and pale. He complains of spasming pain in his right
scrotum which has now become constant and more severe. Which of the following
assessment findings would the nurse expect with this patient? - ✔✔Elevated right
testicle
✔✔An 8-year-old trauma patient suddenly develops increased respiratory distress with
a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt
hypotensive event. Distention of the jugular veins is noted. Which of the following
emergent interventions should be anticipated first? - ✔✔Needle decompression is
emergently necessary to release the air and allow expansion of the lung again.
✔✔An 8-year-old pedestrian is thrown onto the hood of a moving vehicle striking the
windshield. On arrival to the ED. the patient is minimally responsive with active bleeding
from the nose and mouth. The patient is vomiting. Which of the following interventions
would most likely be considered? - ✔✔Endotracheal intubation
, ✔✔The nurse is reevaluating the effectiveness of interventions for a 4-year-old child
with a suspected tension pneumothorax. Which assessment finding indicates the
interventions were effective? - ✔✔Bilateral chest wall rise with assisted ventilations.
✔✔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? - ✔✔Osteogenesis
imperfecta
✔✔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? - ✔✔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? -
✔✔The presence of a purpuric rash necessitates the infant to be placed in isolation
immediately as this is a symptom of possible meningitis.
