ENPC 6th Edition Course Exam Solved
Parents report their 3-year-old child has developed noisy breathing. On assessment, high-
pitched wheezes are audible and auscultated on inspiration and expiration. What
medication would be appropriate to administer first? - Initial medication intervention
includes an inhaled short-acting beta agonist.
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of
70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory values
would be most expected in this child? - Expected laboratory values would reveal an acidotic
state with a pH level below 7.3, an elevated serum bIcarbonate level, and an elevated blood
glucose level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on
auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The
white blood cell count is elevated and the patient noted to be tachypneic, tachycardic,
agitated, and has an increased respiratory effort. At the time of the event, the patient was
started on antibiotics with subsequent increasing manifestations instead of improvement.
Which of the following would be considered to be definitive treatment for the suspected
diagnosis? - The definitive treatment would be a bronchoscopy in order to retrieve the
suspected foreign body instead of diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations
with a bag-mask device. Once return of spontaneous circulation has been confirmed, which
of the following would be the priority intervention? - Establishing a secure airway
A 6-week-old is brought to the emergency department by the caregivers for poor feeding,
listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52
breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel.
Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test
the nurse should anticipate? - Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
following intravenous medication orders should the nurse question? - Ketorolac is an
appropriate medication for moderate to severe pain, however, it should not be used pre-
operatively due to its potential to increase the bleeding risk.
A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and
having vaginal bleeding. The patient is unsure of the gestational age and has not had any
prenatal treatment. The patient is quiet and lets her boyfriend answer most of the
questions. Which of the following is the most appropriate action for the nurse to take at
this point? - Have the boyfriend leave the room during the pelvic exam.
, A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
several attempts, your team has been unsuccessful at establishing vascular access. Of the
following, which is the next best option for establishing access quickly? - Intraosseous in
the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of
specimen samples would provide visual information regarding a potential complication of
this injury? - Electrical injuries, though they may appear to be small, can produce large
amounts of damage internally, including muscle damage. Myoglobin is excreted in the urine
and is evidenced by dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and
invasive procedures appear to be distressed and withdrawn. Which of the following
interventions would best ensure a sense of comfort and control for these parents? -
Providing frequent updates and re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following
preparations for topical anesthesia would be the best choice for this procedure? - LET
(lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for an
acetaminophen overdose? - A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is
noted: hypotension, tachycardia, absent breath sounds from the left chest with an
increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the
urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry of
86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow Coma
Score of 7. Which of the following orders will prompt the nurse to have a discussion with
the provider before initiating? - Urinary catheters are contraindicated for placement if
pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal
discolorations with edema to the areas is also a contraindication for this adjunct.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-
smelling urine. The child is hypotensive and tachycardic. Which of the following methods
for obtaining a urine sample is most appropriate in this circumstance? - Urinary
catherization
A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - Performing a suicide risk assessment
Parents report their 3-year-old child has developed noisy breathing. On assessment, high-
pitched wheezes are audible and auscultated on inspiration and expiration. What
medication would be appropriate to administer first? - Initial medication intervention
includes an inhaled short-acting beta agonist.
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of
70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory values
would be most expected in this child? - Expected laboratory values would reveal an acidotic
state with a pH level below 7.3, an elevated serum bIcarbonate level, and an elevated blood
glucose level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on
auscultation in the right upper lobe of the lung field after a choking event 4 days ago. The
white blood cell count is elevated and the patient noted to be tachypneic, tachycardic,
agitated, and has an increased respiratory effort. At the time of the event, the patient was
started on antibiotics with subsequent increasing manifestations instead of improvement.
Which of the following would be considered to be definitive treatment for the suspected
diagnosis? - The definitive treatment would be a bronchoscopy in order to retrieve the
suspected foreign body instead of diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations
with a bag-mask device. Once return of spontaneous circulation has been confirmed, which
of the following would be the priority intervention? - Establishing a secure airway
A 6-week-old is brought to the emergency department by the caregivers for poor feeding,
listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52
breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel.
Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test
the nurse should anticipate? - Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the
following intravenous medication orders should the nurse question? - Ketorolac is an
appropriate medication for moderate to severe pain, however, it should not be used pre-
operatively due to its potential to increase the bleeding risk.
A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and
having vaginal bleeding. The patient is unsure of the gestational age and has not had any
prenatal treatment. The patient is quiet and lets her boyfriend answer most of the
questions. Which of the following is the most appropriate action for the nurse to take at
this point? - Have the boyfriend leave the room during the pelvic exam.
, A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
several attempts, your team has been unsuccessful at establishing vascular access. Of the
following, which is the next best option for establishing access quickly? - Intraosseous in
the patient's medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of
specimen samples would provide visual information regarding a potential complication of
this injury? - Electrical injuries, though they may appear to be small, can produce large
amounts of damage internally, including muscle damage. Myoglobin is excreted in the urine
and is evidenced by dark, red-tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and
invasive procedures appear to be distressed and withdrawn. Which of the following
interventions would best ensure a sense of comfort and control for these parents? -
Providing frequent updates and re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -
Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following
preparations for topical anesthesia would be the best choice for this procedure? - LET
(lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for an
acetaminophen overdose? - A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is
noted: hypotension, tachycardia, absent breath sounds from the left chest with an
increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the
urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry of
86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow Coma
Score of 7. Which of the following orders will prompt the nurse to have a discussion with
the provider before initiating? - Urinary catheters are contraindicated for placement if
pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal
discolorations with edema to the areas is also a contraindication for this adjunct.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-
smelling urine. The child is hypotensive and tachycardic. Which of the following methods
for obtaining a urine sample is most appropriate in this circumstance? - Urinary
catherization
A child with bipolar disorder is brought to the emergency department for increasing
irritability, agitation, pressured speech, and a decreased need for sleep. What should be
included in the plan of care for this child? - Performing a suicide risk assessment
