ENPC 5th edition Questions with correct
Answers
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. - Answer- 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?
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. - Answer- You are discharging a patient to home
with a history of depression. Discharge teaching should include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions. - Answer- 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?
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. -
Answer- 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?
, ventilation to address hypoxia is the priority intervention. - Answer- What is the priority
intervention for symptomatic bradycardia in a four-year-old child?
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." - Answer- 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?
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 - Answer- 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate
by increasing heart rate - Answer- 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?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children
younger than 4
Pg 11Any bruising in a child younger than 4 months. - Answer- Which of the following
patient presentations should increase suspicion of potential child maltreatment?
Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease. - Answer- All of
the vaccine administrations listed are appropriate EXCEPT for which of the following?
Answers
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. - Answer- 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?
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. - Answer- You are discharging a patient to home
with a history of depression. Discharge teaching should include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions. - Answer- 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?
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. -
Answer- 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?
, ventilation to address hypoxia is the priority intervention. - Answer- What is the priority
intervention for symptomatic bradycardia in a four-year-old child?
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." - Answer- 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?
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 - Answer- 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate
by increasing heart rate - Answer- 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?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children
younger than 4
Pg 11Any bruising in a child younger than 4 months. - Answer- Which of the following
patient presentations should increase suspicion of potential child maltreatment?
Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease. - Answer- All of
the vaccine administrations listed are appropriate EXCEPT for which of the following?
