ENPC EXAM 2023 PRACTICE QUESTIONS AND ANSWERS
Pediatric triangle - Answer appearance
work of breathing
circulation to skin
General appearance considerations - Answer Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: - Answer Increased work of breathing evidenced by
tachypnea, stridor, grunting, retractions, accessory musles, nasal flaring, head
bobbing, abnormal positioning
Circulation to Skin - Answer Observe palor
mottling
cyanosis
Sick, Sicker, Sickest - Answer Sick: no disruption of any component of PAT but
caregivers are concerned
Sicker: one component of PAT is a concern
Sickest 2+ concerns of PAT
2 leading causes of altered mental status in kids - Answer hypoxia
hypoglycemia
Blood pressure norms - Answer Hypotension: Less than 70 + (2 x age in years)
Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
,Crying child - Answer Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: - Answer increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds
Respiratory failure signs - Answer fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions - Answer Allow child to stay in most comfortable
position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup - Answer 1-3 days of nasal congestion and fever with sudden onset of
barky cough
Treatment: dexamethasone and nebulized epi
Discharge Teaching: oral hydration, get child to cool air or steamy bathroom
Asthma interventions - Answer albuterol, duo neb and oral steroid
Bronchiolitis/RSV - Answer Assessment: 1-3 days nasal congestion fever, cough,
respiratory distress with wheezing and crackles. Dehydration and tachypnea
, interventions: nasla suctioning, fluids
sever: heated, high flow nasal cannula O2
Discharge: lasts 2-3 weeks; nasal suctioning; monitor hydration
treating hypoglycemia - Answer obtain glucose for anyone who is not awake and
alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? - Answer When the child is not awake and
alert or AMS is suspected
Preventing Secondary brain injury in TBI - Answer prevent hypotension and
hypoxia
cuffed vs uncuffed tube - Answer uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula - Answer infant: 10ml/kg
kid: 20ml/kg
normal vitals - Answer pg 52
blood glucose normal ages 5-11 - Answer 72-140
Cardiac Assessment - Answer Trend pulse and pulse pressure
palapate upper and lower extremity pulses
symptoms of CHF - Answer poor feeding, irritability, fatigue easily with rapid
resp rate, increased work of breathing
Ass and Interventions similar to adults
Myocarditis Assessment and treatment - Answer Assess: consider in anyone
with recent viral infection; SOB and crackles; dysrhthmias; heart failure;
syncope; elevated liver enzymes
Treat: diuretics; BP support; ECMO; transplant
Hypovolemic Shock - Answer Tachycardia, tacypnea; AMS; slight increaes in
diastolic pressure
Intervention: Stop bleed; give fluids and RBC; balanced therapy; offer pedialyte if
not NPO
Pediatric triangle - Answer appearance
work of breathing
circulation to skin
General appearance considerations - Answer Tone
Interactiveness: drawn to sounds or people. Wants to play
Consolability
Look/Gaze
Speech/cry
Work of breathing: - Answer Increased work of breathing evidenced by
tachypnea, stridor, grunting, retractions, accessory musles, nasal flaring, head
bobbing, abnormal positioning
Circulation to Skin - Answer Observe palor
mottling
cyanosis
Sick, Sicker, Sickest - Answer Sick: no disruption of any component of PAT but
caregivers are concerned
Sicker: one component of PAT is a concern
Sickest 2+ concerns of PAT
2 leading causes of altered mental status in kids - Answer hypoxia
hypoglycemia
Blood pressure norms - Answer Hypotension: Less than 70 + (2 x age in years)
Widening pulse pressure = increased ICP
Narrowing pulse pressure = hypovolemic shock
,Crying child - Answer Vigorous = good
weak = sick
high-pitched = increased ICP
"Fussiness" = red flag
Respiratory distress indicated by: - Answer increased heart rate
skin color changes
incrased work of breathing
wheezing
diaphoresis
abnormal airwa sounds
Respiratory failure signs - Answer fatigue and become lethargic
hypoxia
hypercarbia
General airway interventions - Answer Allow child to stay in most comfortable
position
Give O2 to maintain it above 92%
O2 does NOT measure ventilation
Croup - Answer 1-3 days of nasal congestion and fever with sudden onset of
barky cough
Treatment: dexamethasone and nebulized epi
Discharge Teaching: oral hydration, get child to cool air or steamy bathroom
Asthma interventions - Answer albuterol, duo neb and oral steroid
Bronchiolitis/RSV - Answer Assessment: 1-3 days nasal congestion fever, cough,
respiratory distress with wheezing and crackles. Dehydration and tachypnea
, interventions: nasla suctioning, fluids
sever: heated, high flow nasal cannula O2
Discharge: lasts 2-3 weeks; nasal suctioning; monitor hydration
treating hypoglycemia - Answer obtain glucose for anyone who is not awake and
alert
treat kids with 2-4ml/kg of D25W
When to perform blood glucose test? - Answer When the child is not awake and
alert or AMS is suspected
Preventing Secondary brain injury in TBI - Answer prevent hypotension and
hypoxia
cuffed vs uncuffed tube - Answer uncuffed= (age in years/4) + 4
cuffed= (age in years/4) + 3.5
fluid bolus formula - Answer infant: 10ml/kg
kid: 20ml/kg
normal vitals - Answer pg 52
blood glucose normal ages 5-11 - Answer 72-140
Cardiac Assessment - Answer Trend pulse and pulse pressure
palapate upper and lower extremity pulses
symptoms of CHF - Answer poor feeding, irritability, fatigue easily with rapid
resp rate, increased work of breathing
Ass and Interventions similar to adults
Myocarditis Assessment and treatment - Answer Assess: consider in anyone
with recent viral infection; SOB and crackles; dysrhthmias; heart failure;
syncope; elevated liver enzymes
Treat: diuretics; BP support; ECMO; transplant
Hypovolemic Shock - Answer Tachycardia, tacypnea; AMS; slight increaes in
diastolic pressure
Intervention: Stop bleed; give fluids and RBC; balanced therapy; offer pedialyte if
not NPO
