ENPC 6 2026 ADVANCED PEDIATRIC TRIAGE
AND EMERGENCY INTERVENTION STUDY
MATERIALS
◉ 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.
AND EMERGENCY INTERVENTION STUDY
MATERIALS
◉ 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.
