ENPC UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS COMPREHENSIVE
STUDY GUIDE
●● Assessment of the fontanelle provides the most useful information
for which two components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure
Answer: A
A sunken fontanelle is a red flag for circulation assessment in pediatric
triage and may indicate dehydration . A bulging fontanel is a red flag for
disability assessment in pediatric triage and can indicate increased
intracranial pressure.
●● Which of the following indicates the need for additional caregiver
education regarding a urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication.
,Answer: C
●● A nurse providing trauma informed care to the family of a seriously
ill child should be doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family
Answer: D
Caregivers experiencing the crisis of a critically ill child have low
attentiveness and increased stress so would benefit from having a
member of the healthcare team to stay with them as much as possible
and communicate updates on the plan of care. Caregivers should be
allowed to stay with their child as much as possible and not placed in a
secluded room away for them.
●● The caregiver of a 7-year old reports witnessing a seizure at home,
but no seizure history. 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 caregiver states the burns accidentally
occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of
interventions are the priority for this patient?
,A.Call police and child welfare authorities and have security detain the
caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid
bolus
D.Administer lorazepam and a fluid bolus and place on seizure
precautions
Answer: C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia
and electrolyte imbalances. Early identification and treatment of
electrolyte imbalances can help prevent further seizures. Contacting
child protective services and other authorities can wait. The patient is
post-ictal so does not require lorazepam medication at this time. Pain
medication can and should be considered with significant burns, but is
not a priority.
●● What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing
Answer: C
\
, Identifying and treating other causes, chest compressions, and
epinephrine are interventions for pediatric bradycardia with signs of
poor perfusion that are not improved by adequate oxygenation and
ventilation. Atropine and pacing may be considered if there is no
response to the other interventions.
●● A 5-year-old child presents to the emergency department after being
hit by a car. The patient 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?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses
Answer: D
Early signs of hypovolemic shock include tachycardia and delayed
capillary refill. The nurse may note a strong central pulse but weaker
peripheral pulses, indicating the child is compensating by shunting blood
to their core.
●● Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
CORRECT ANSWERS COMPREHENSIVE
STUDY GUIDE
●● Assessment of the fontanelle provides the most useful information
for which two components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure
Answer: A
A sunken fontanelle is a red flag for circulation assessment in pediatric
triage and may indicate dehydration . A bulging fontanel is a red flag for
disability assessment in pediatric triage and can indicate increased
intracranial pressure.
●● Which of the following indicates the need for additional caregiver
education regarding a urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication.
,Answer: C
●● A nurse providing trauma informed care to the family of a seriously
ill child should be doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family
Answer: D
Caregivers experiencing the crisis of a critically ill child have low
attentiveness and increased stress so would benefit from having a
member of the healthcare team to stay with them as much as possible
and communicate updates on the plan of care. Caregivers should be
allowed to stay with their child as much as possible and not placed in a
secluded room away for them.
●● The caregiver of a 7-year old reports witnessing a seizure at home,
but no seizure history. 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 caregiver states the burns accidentally
occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of
interventions are the priority for this patient?
,A.Call police and child welfare authorities and have security detain the
caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid
bolus
D.Administer lorazepam and a fluid bolus and place on seizure
precautions
Answer: C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia
and electrolyte imbalances. Early identification and treatment of
electrolyte imbalances can help prevent further seizures. Contacting
child protective services and other authorities can wait. The patient is
post-ictal so does not require lorazepam medication at this time. Pain
medication can and should be considered with significant burns, but is
not a priority.
●● What is the priority intervention for symptomatic bradycardia in a
four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing
Answer: C
\
, Identifying and treating other causes, chest compressions, and
epinephrine are interventions for pediatric bradycardia with signs of
poor perfusion that are not improved by adequate oxygenation and
ventilation. Atropine and pacing may be considered if there is no
response to the other interventions.
●● A 5-year-old child presents to the emergency department after being
hit by a car. The patient 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?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses
Answer: D
Early signs of hypovolemic shock include tachycardia and delayed
capillary refill. The nurse may note a strong central pulse but weaker
peripheral pulses, indicating the child is compensating by shunting blood
to their core.
●● Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
