ENPC EXAM SCRIPT VERIFIED QUESTIONS
AND SOLUTIONS COMPLETE REVIEW
MATERIAL
●● An 18-month-old is seen for fever, slight circumoral cyanosis, and
wheezing noted on auscultation in the right upper lobe of the lung field
after a choking event 4 days ago. The white blood cell count is elevated
and the patient noted to be tachypneic, tachycardic, agitated, and has an
increased respiratory effort. At the time of the event, the patient was
started on antibiotics with subsequent increasing manifestations instead
of improvement. Which of the following would be considered to be
definitive treatment for the suspected diagnosis?
Answer: The definitive treatment would be a bronchoscopy in order to
retrieve the suspected foreign body instead of diagnostic tests to locate
the foreign body itself.
●● 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?
Answer: Establishing a secure airway
●● Parents report their 3-year-old child has developed noisy breathing.
On assessment, high-pitched wheezes are audible and auscultated on
inspiration and expiration. What medication would be appropriate to
administer first?
,Answer: initial medication intervention includes an inhaled short-acting
beta agonist.
●● A 6-week-old is brought to the emergency department by the
caregivers for poor feeding, listlessness, and fever. Assessment reveals a
crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal
temperature of 96.0 F (35.5 C), and a bulging anterior fontanel.
Capillary refill is 4 seconds. Based on these findings what is the most
likely diagnostic test the nurse should anticipate?
Answer: Lumbar puncture
●● A 12-year-old is being prepped for surgical intervention of acute
appendicitis. Which of the following intravenous medication orders
should the nurse question?
Answer: Ketorolac
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
●● A 17-year-old female arrives in the ED with her boyfriend who states
she is pregnant and having vaginal bleeding. The patient is unsure of the
gestational age and has not had any prenatal treatment. The patient is
quiet and lets her boyfriend answer most of the questions. Which of the
,following is the most appropriate action for the nurse to take at this
point?
Answer: Have the boyfriend leave the room during the pelvic exam.
●● A 2-year-old arrives at the ED in hypovolemic shock and needs
fluids immediately. After several attempts, your team has been
unsuccessful at establishing vascular access. Of the following, which is
the next best option for establishing access quickly?
Answer: Intraosseous in the patient's medial tibia.
●● 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?
Answer: 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?
Answer: 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?
, Answer: 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?
Answer: LET (lidocaine/epinephrine/tetracaine)
●● Which of the following is appropriate administration of N-
acetylcysteine (NAC) for an acetaminophen overdose?
Answer: 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?
Answer: Urinary catherization
●● You are discharging a patient home who has a history of depression.
Discharge teaching should include which of the following?
Answer: 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
AND SOLUTIONS COMPLETE REVIEW
MATERIAL
●● An 18-month-old is seen for fever, slight circumoral cyanosis, and
wheezing noted on auscultation in the right upper lobe of the lung field
after a choking event 4 days ago. The white blood cell count is elevated
and the patient noted to be tachypneic, tachycardic, agitated, and has an
increased respiratory effort. At the time of the event, the patient was
started on antibiotics with subsequent increasing manifestations instead
of improvement. Which of the following would be considered to be
definitive treatment for the suspected diagnosis?
Answer: The definitive treatment would be a bronchoscopy in order to
retrieve the suspected foreign body instead of diagnostic tests to locate
the foreign body itself.
●● 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?
Answer: Establishing a secure airway
●● Parents report their 3-year-old child has developed noisy breathing.
On assessment, high-pitched wheezes are audible and auscultated on
inspiration and expiration. What medication would be appropriate to
administer first?
,Answer: initial medication intervention includes an inhaled short-acting
beta agonist.
●● A 6-week-old is brought to the emergency department by the
caregivers for poor feeding, listlessness, and fever. Assessment reveals a
crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal
temperature of 96.0 F (35.5 C), and a bulging anterior fontanel.
Capillary refill is 4 seconds. Based on these findings what is the most
likely diagnostic test the nurse should anticipate?
Answer: Lumbar puncture
●● A 12-year-old is being prepped for surgical intervention of acute
appendicitis. Which of the following intravenous medication orders
should the nurse question?
Answer: Ketorolac
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain,
however, it should not be used pre-operatively due to its potential to
increase the bleeding risk.
●● A 17-year-old female arrives in the ED with her boyfriend who states
she is pregnant and having vaginal bleeding. The patient is unsure of the
gestational age and has not had any prenatal treatment. The patient is
quiet and lets her boyfriend answer most of the questions. Which of the
,following is the most appropriate action for the nurse to take at this
point?
Answer: Have the boyfriend leave the room during the pelvic exam.
●● A 2-year-old arrives at the ED in hypovolemic shock and needs
fluids immediately. After several attempts, your team has been
unsuccessful at establishing vascular access. Of the following, which is
the next best option for establishing access quickly?
Answer: Intraosseous in the patient's medial tibia.
●● 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?
Answer: 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?
Answer: 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?
, Answer: 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?
Answer: LET (lidocaine/epinephrine/tetracaine)
●● Which of the following is appropriate administration of N-
acetylcysteine (NAC) for an acetaminophen overdose?
Answer: 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?
Answer: Urinary catherization
●● You are discharging a patient home who has a history of depression.
Discharge teaching should include which of the following?
Answer: 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
