ENPC EXAM SCRIPT TESTED QUESTIONS
AND SOLUTIONS 100 PERCENT CORRECT
◉ A 5 year-old with no health problems presents to the Emergency
Department with a sudden onset of chest pain and shortness of breath.
Parents state that the family was involved in a bad car crash one week
ago. A thorough assessment and workup has not revealed any
abnormalities. Which of the following steps is the best next step to
take? Answer: Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical
complaints. Assess for other behavioral symptoms to facilitate
appropriate care and follow-up.
◉ 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
AND SOLUTIONS 100 PERCENT CORRECT
◉ A 5 year-old with no health problems presents to the Emergency
Department with a sudden onset of chest pain and shortness of breath.
Parents state that the family was involved in a bad car crash one week
ago. A thorough assessment and workup has not revealed any
abnormalities. Which of the following steps is the best next step to
take? Answer: Ask about any new bed-wetting or sleep disturbances
Pediatric patients with anxiety and PTSD may present with physical
complaints. Assess for other behavioral symptoms to facilitate
appropriate care and follow-up.
◉ 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
