ENPC EXAM 2023-2024 ENPC UPDATE
QUESTIONS AND CORRECT ANSWERS
RATED A+
Components in the prioritization of pediatric emergency care (4) -
ANSWER-PAT, Focused Assessment (objective information), Focused
pediatric Hx(subjective information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components - ANSWER-Appearance.
Work of Breathing. Circulation to the skin. This forms the "general
impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
Pediatric Assessment Triangle : Appearance - ANSWER-Most important.
Reflects adequacy of ventilation, oxygenation, brain perfusion, and central
nervous system function.
Assess for : tone, interactiveness, consolability, look/gaze, and speech/cry.
Pediatric Assessment Triangle : Work of Breathing - ANSWER-Breathing
easy, even, and unlabored or tripod position, nasal flaring, retractions,
supraclavicular retractions
Pediatric Assessment Triangle : Circulation to the skin - ANSWER-Mottling
or PWD
PQRST for Pain - ANSWER-(pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
Verbal Report for pain - ANSWER-(pg86)
Self-report is the most reliable indicatior of pain; however not all pediatric pt
are capable or wiling to verbalize their discomfort.
,What age is the respiratory system considered fully developed? -
ANSWER-8 years old
Most ______ age __to____, are concrete thinkers and interpret words
literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers.
They often confuse coincidence with causation, and have difficulty
distinguising fantasy from reality. - ANSWER-(pg36)
Most Toddlers age 1yo to 3yo , are concrete thinkers and interpret words
literally.
Where as, most Preschoolers age 3yo to 5yo, are magical and illogical
thinkers. They often confuse coincidence with causation, and have difficulty
distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____
sign and may indicate a loss of ___% to ___% of their circulating blood
volume. - ANSWER-(pg262)
Late sign.
20% to 25% of circulating blood volume
6P's Assessment for Musculoskeletal Trauma - ANSWER-(pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - ANSWER-1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate
tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the
greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care
for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
, If live interpreter not available for 15mins use ________ - ANSWER-
Language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________ -
ANSWER-suction nose
Opiod antidote - ANSWER-Narcan
Benzo antidote - ANSWER-Romazicon
Neutropenic pt with a temperature - ANSWER-Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern - ANSWER-Meningocoxcemia
Petiachia/Purpura
Bicycle accident concerns - ANSWER-Did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal Urine Output for child - ANSWER-1 to 2ml / Kg / Hr
Differences of child vs adult : BSA, blood volume, glycogen storage,
metabolic rate - ANSWER-Children have : increased BSA(predispose to
temp dysregulation), decreased circulation blood volume(predispose to
hypovolemia), decreased glycogen storage(predisoposed to
hypoglycemia), Increased metabolic rate.
Oral Rehydration for 9month old with mild dehydration. - ANSWER-
Glucose and sodium solution, every 2 to 5min with 5 to 10ml
6week old infant, no medical hx. eating poorly, vomiting, "hard to wake up",
responsive to pain. Anterior fontanel bulging, tachypnic. Diagnostic
evaluation expected? - ANSWER-Skeletal survey
Possible shaken baby syndrome
Minimal Acceptable BP's - ANSWER-Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)
QUESTIONS AND CORRECT ANSWERS
RATED A+
Components in the prioritization of pediatric emergency care (4) -
ANSWER-PAT, Focused Assessment (objective information), Focused
pediatric Hx(subjective information), assignment of an acuity rating decision
Pediatric Assessment Triangle : (3) components - ANSWER-Appearance.
Work of Breathing. Circulation to the skin. This forms the "general
impression".
If there is an acute disruption in 1 component, child is "sicker".
If there is an acute disruption in 2+ components the child is "sickest"
Pediatric Assessment Triangle : Appearance - ANSWER-Most important.
Reflects adequacy of ventilation, oxygenation, brain perfusion, and central
nervous system function.
Assess for : tone, interactiveness, consolability, look/gaze, and speech/cry.
Pediatric Assessment Triangle : Work of Breathing - ANSWER-Breathing
easy, even, and unlabored or tripod position, nasal flaring, retractions,
supraclavicular retractions
Pediatric Assessment Triangle : Circulation to the skin - ANSWER-Mottling
or PWD
PQRST for Pain - ANSWER-(pg86)
Precipitating and palliating factors
Quality
Radiation
Severity, symptoms, and site
Time or triggering factors
Verbal Report for pain - ANSWER-(pg86)
Self-report is the most reliable indicatior of pain; however not all pediatric pt
are capable or wiling to verbalize their discomfort.
,What age is the respiratory system considered fully developed? -
ANSWER-8 years old
Most ______ age __to____, are concrete thinkers and interpret words
literally.
Where as, most _____ age ___ to ___, are magical and illogical thinkers.
They often confuse coincidence with causation, and have difficulty
distinguising fantasy from reality. - ANSWER-(pg36)
Most Toddlers age 1yo to 3yo , are concrete thinkers and interpret words
literally.
Where as, most Preschoolers age 3yo to 5yo, are magical and illogical
thinkers. They often confuse coincidence with causation, and have difficulty
distinguising fantasy from reality.
Hypotension related to hypovolemia in pediatric trauma patients is a _____
sign and may indicate a loss of ___% to ___% of their circulating blood
volume. - ANSWER-(pg262)
Late sign.
20% to 25% of circulating blood volume
6P's Assessment for Musculoskeletal Trauma - ANSWER-(pg 283)
Pallor : color different from uninjured
Pain
Pulselessness
Parasthesia
Paralysis
Poikilothermia
Burn Transfer Criteria - ANSWER-1. Partial thickness >10% of BSA
2. Face, hands, feet, genetalia, perineum or major joints
3. Third degree burns in any age group.
4. Electrical burns, including lightning injury, and chemical burns.
5. Inhalation injury.
6. Burn injury in pt with preexisting medical disorders that could complicate
tx.
7. Concomitant trauma (such as fx) in which the burn injury poses the
greatest risk of morbidity or mortality.
8. Burned children in hospital wo qualified equipment or personnel to care
for them
9. Pt who will require special social, emotional, or rehabilitative intervention.
, If live interpreter not available for 15mins use ________ - ANSWER-
Language line interpreter
Infants are obligate nose breathers. If nose is obstructed ___________ -
ANSWER-suction nose
Opiod antidote - ANSWER-Narcan
Benzo antidote - ANSWER-Romazicon
Neutropenic pt with a temperature - ANSWER-Don't take rectal temp.
No invasive procedures if not necessary.
Nonblanchable Rashes of concern - ANSWER-Meningocoxcemia
Petiachia/Purpura
Bicycle accident concerns - ANSWER-Did pt strike handle bars?
Possible abdominal injury
Ribs are more horizontal and provide less protection.
Normal Urine Output for child - ANSWER-1 to 2ml / Kg / Hr
Differences of child vs adult : BSA, blood volume, glycogen storage,
metabolic rate - ANSWER-Children have : increased BSA(predispose to
temp dysregulation), decreased circulation blood volume(predispose to
hypovolemia), decreased glycogen storage(predisoposed to
hypoglycemia), Increased metabolic rate.
Oral Rehydration for 9month old with mild dehydration. - ANSWER-
Glucose and sodium solution, every 2 to 5min with 5 to 10ml
6week old infant, no medical hx. eating poorly, vomiting, "hard to wake up",
responsive to pain. Anterior fontanel bulging, tachypnic. Diagnostic
evaluation expected? - ANSWER-Skeletal survey
Possible shaken baby syndrome
Minimal Acceptable BP's - ANSWER-Newborn = 60
Infant = 70
Child = 70 + (2 x age in yrs)