ENPC 6 2026 EMERGENCY PEDIATRIC
NURSING CORE CONCEPTS AND CLINICAL
SCENARIO REVIEW GUIDE
◉ 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
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying.
Answer: B
The presence of bilious emesis is especially concerning because it
may be indicative of an immediately life-threatening bowel
obstruction. A dislodged gastrostomy tube should be reinserted
within 4-6 hours to prevent stoma closure. Vomiting following a
handlebar injury may be indicative of many possible injuries, but
does not take precedence unless other symptoms are present.
,Infantile colic is described as inconsolable crying in infants, 2 weeks
to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
◉ inconsolable crying.
Answer: rule of 3s:
crying more than 3 hours per day, more than three days per week,
for longer than three weeks
◉ A three-year-old is rescued after being submerged in a pool for
several minutes. On arrival the patient is responsive to painful
stimuli with shallow respirations, diminished breath sounds, and an
occasional cough. Which of the following interventions is the initial
management priority?
A.Initiation of abdominal thrusts to remove fluid from the lungs
B.Insertion of orogastric to remove of water and debris from
stomach
C.Endotracheal intubation to provide positive pressure ventilation
D.Removal of wet clothing to prevent hypothermia.
Answer: C
The primary survey assessment and treatment of deficits are the
priority. Airway control and positive pressure ventilation while
, preparing for intubation of a child who meets intubation criteria
(GCS < 8) should be performed while also maintaining cervical spine
stabilization. The child is responsive only to painful stimuli, has
shallow respirations, and diminished breath sounds. All of these are
breathing problems and must be addressed immediately. Removing
wet clothing is necessary, but is not the main priority initially. With
intubation an orogastric tube will be placed and abdominal thrusts
are not necessary to remove fluid from the abdomen.
◉ A 3-month-old is brought to the emergency department with new
onset of fever. You note the child to be pale, tachypneic, and
tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
A.Administer an appropriate dose of an antipyretic
B.Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C.Prepare a broad spectrum antibiotic infusion
D.Administer a vasoactive medication.
Answer: B
This patient most likely has septic shock. An immediate goal is to
reverse shock and restore tissue perfusion with fluids. An
antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and
vasoactive medications may not be needed if fluid resuscitation is
successfu
NURSING CORE CONCEPTS AND CLINICAL
SCENARIO REVIEW GUIDE
◉ 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
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying.
Answer: B
The presence of bilious emesis is especially concerning because it
may be indicative of an immediately life-threatening bowel
obstruction. A dislodged gastrostomy tube should be reinserted
within 4-6 hours to prevent stoma closure. Vomiting following a
handlebar injury may be indicative of many possible injuries, but
does not take precedence unless other symptoms are present.
,Infantile colic is described as inconsolable crying in infants, 2 weeks
to 4 months old, for up to 3 hours per day, more than 3 days per
week, and lasting for more than 3 weeks.
◉ inconsolable crying.
Answer: rule of 3s:
crying more than 3 hours per day, more than three days per week,
for longer than three weeks
◉ A three-year-old is rescued after being submerged in a pool for
several minutes. On arrival the patient is responsive to painful
stimuli with shallow respirations, diminished breath sounds, and an
occasional cough. Which of the following interventions is the initial
management priority?
A.Initiation of abdominal thrusts to remove fluid from the lungs
B.Insertion of orogastric to remove of water and debris from
stomach
C.Endotracheal intubation to provide positive pressure ventilation
D.Removal of wet clothing to prevent hypothermia.
Answer: C
The primary survey assessment and treatment of deficits are the
priority. Airway control and positive pressure ventilation while
, preparing for intubation of a child who meets intubation criteria
(GCS < 8) should be performed while also maintaining cervical spine
stabilization. The child is responsive only to painful stimuli, has
shallow respirations, and diminished breath sounds. All of these are
breathing problems and must be addressed immediately. Removing
wet clothing is necessary, but is not the main priority initially. With
intubation an orogastric tube will be placed and abdominal thrusts
are not necessary to remove fluid from the abdomen.
◉ A 3-month-old is brought to the emergency department with new
onset of fever. You note the child to be pale, tachypneic, and
tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
A.Administer an appropriate dose of an antipyretic
B.Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C.Prepare a broad spectrum antibiotic infusion
D.Administer a vasoactive medication.
Answer: B
This patient most likely has septic shock. An immediate goal is to
reverse shock and restore tissue perfusion with fluids. An
antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and
vasoactive medications may not be needed if fluid resuscitation is
successfu
