ENPC COMPREHENSIVE EXAM PREP
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● You are discharging a patient to home with a history of depression.
Discharge teaching should include which of the following?
Answer: Ensuring all firearms in the home are locked in a safe place
with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of
depression or suicidal ideation by encouraging that all firearms and
medications are under lock to prevent overdoses or suicide attempt.
●● A 2-year old has uniformly demarcated burns to bilateral lower
extremities, approximately 30% of the childs total body surface area.
The father states he briefly left the room while the child was in the bath
and the child apparently played with the faucet. Which of the following
interventions has the highest priority?
Answer: Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority
interventions.
,●● A 7-year-old arrives via ambulance. The patient's mother reports
witnessing a seizure at home. The patient has no seizure history. Upon
examination, the patient is post-ictal with a heart rate of 142 beats per
minute, respiratory rate of 36 breaths per minute, and blood pressure of
86/72 mm Hg. Significant burns are noted to the patient's back and
lower extremities. The mother states the burns accidentally occurred 3
days ago, but she was afraid to bring patient in due to an ongoing child
welfare investigation. Which of the following are the MOST appropriate
immediate interventions?
Answer: Draw and send a metabolic panel and venous blood gas,
administer a fluid bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent
another seizure.
●● What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
Answer: ventilation to address hypoxia is the priority intervention.
●● A 14-year-old high school student who was pitching for his baseball
team was hit in the chest by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of the cardiac arrest?
Answer: Commotio cordis
, Comotio Cordis "occurs when chest is struck during the refractory
period of the cardiac conduction cycle. This type of injury usually occurs
in recreational sports such as baseball or ice hockey."
●● A 5-year-old child presents to the emergency department after being
hit by a car. She complains of left upper quadrant pain and the focused
assessment with sonography for trauma (FAST) exam shows fluid
around her spleen. Which of the following findings would be an early
indication of ongoing blood loss?
Answer: Focused Assessment: Vital Signs: "As the patient compensates
for altered tissue perfusion, the pulse pressure narrows and the heart rate
increases" - (need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse
pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign
●● A 5-year-old patient presents to the emergency department with
severe dehydration due to viral gastroenteritis. He has signs of shock due
to his hypovolemia. Which of the following physiologic responses to
shock has the greatest impact on improving cardiac output in the
pediatric patient?
Answer: Increasing heart rate
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● You are discharging a patient to home with a history of depression.
Discharge teaching should include which of the following?
Answer: Ensuring all firearms in the home are locked in a safe place
with no access by the patient.
Promoting injury prevention with caregivers of patients with a history of
depression or suicidal ideation by encouraging that all firearms and
medications are under lock to prevent overdoses or suicide attempt.
●● A 2-year old has uniformly demarcated burns to bilateral lower
extremities, approximately 30% of the childs total body surface area.
The father states he briefly left the room while the child was in the bath
and the child apparently played with the faucet. Which of the following
interventions has the highest priority?
Answer: Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority
interventions.
,●● A 7-year-old arrives via ambulance. The patient's mother reports
witnessing a seizure at home. The patient has no seizure history. Upon
examination, the patient is post-ictal with a heart rate of 142 beats per
minute, respiratory rate of 36 breaths per minute, and blood pressure of
86/72 mm Hg. Significant burns are noted to the patient's back and
lower extremities. The mother states the burns accidentally occurred 3
days ago, but she was afraid to bring patient in due to an ongoing child
welfare investigation. Which of the following are the MOST appropriate
immediate interventions?
Answer: Draw and send a metabolic panel and venous blood gas,
administer a fluid bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent
another seizure.
●● What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
Answer: ventilation to address hypoxia is the priority intervention.
●● A 14-year-old high school student who was pitching for his baseball
team was hit in the chest by the ball and had a sudden cardiac arrest. Of
the following, which is the most likely cause of the cardiac arrest?
Answer: Commotio cordis
, Comotio Cordis "occurs when chest is struck during the refractory
period of the cardiac conduction cycle. This type of injury usually occurs
in recreational sports such as baseball or ice hockey."
●● A 5-year-old child presents to the emergency department after being
hit by a car. She complains of left upper quadrant pain and the focused
assessment with sonography for trauma (FAST) exam shows fluid
around her spleen. Which of the following findings would be an early
indication of ongoing blood loss?
Answer: Focused Assessment: Vital Signs: "As the patient compensates
for altered tissue perfusion, the pulse pressure narrows and the heart rate
increases" - (need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse
pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign
●● A 5-year-old patient presents to the emergency department with
severe dehydration due to viral gastroenteritis. He has signs of shock due
to his hypovolemia. Which of the following physiologic responses to
shock has the greatest impact on improving cardiac output in the
pediatric patient?
Answer: Increasing heart rate
