ENPC Study Questions and Answers
A 4-day-old who is brought to the emergency department with the parental complaint of
"not acting right" is found to be hypoglycemic. What is the appropriate glucose
concentration to administer to this neonate?
A.Dextrose 5%
B.Dextrose 10%
C.Dextrose 25%
D.Dextrose 50% ✅B
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect
their fragile vasculature while providing needed glucose. Dextrose 5% is not used to
treat hypoglycemia in children. Dextrose 25% is used for children above the age of 5
years. Dextrose 50% is not recommended for use in pediatrics unless it is diluted.
Assessment of the fontanelle provides the most useful information for which two
components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure ✅A
A sunken fontanelle is a red flag for circulation assessment in pediatric triage and may
indicate dehydration . A bulging fontanel is a red flag for disability assessment in
pediatric triage and can indicate increased intracranial pressure.
Which of the following indicates the need for additional caregiver education regarding a
urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication. ✅C
A nurse providing trauma informed care to the family of a seriously ill child should be
doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family ✅D
Caregivers experiencing the crisis of a critically ill child have low attentiveness and
increased stress so would benefit from having a member of the healthcare team to stay
with them as much as possible and communicate updates on the plan of care.
, Caregivers should be allowed to stay with their child as much as possible and not
placed in a secluded room away for them.
The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. 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 caregiver states the burns
accidentally occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of interventions are
the priority for this patient?
A.Call police and child welfare authorities and have security detain the caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions ✅C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help
prevent further seizures. Contacting child protective services and other authorities can
wait. The patient is post-ictal so does not require lorazepam medication at this time.
Pain medication can and should be considered with significant burns, but is not a
priority.
What is the priority intervention for symptomatic bradycardia in a four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing ✅C
I am running a few minutes late; my previous meeting is running over.
Identifying and treating other causes, chest compressions, and epinephrine are
interventions for pediatric bradycardia with signs of poor perfusion that are not improved
by adequate oxygenation and ventilation. Atropine and pacing may be considered if
there is no response to the other interventions.
A 5-year-old child presents to the emergency department after being hit by a car. The
patient 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?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses ✅D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The
nurse may note a strong central pulse but weaker peripheral pulses, indicating the child
is compensating by shunting blood to their core.
A 4-day-old who is brought to the emergency department with the parental complaint of
"not acting right" is found to be hypoglycemic. What is the appropriate glucose
concentration to administer to this neonate?
A.Dextrose 5%
B.Dextrose 10%
C.Dextrose 25%
D.Dextrose 50% ✅B
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protect
their fragile vasculature while providing needed glucose. Dextrose 5% is not used to
treat hypoglycemia in children. Dextrose 25% is used for children above the age of 5
years. Dextrose 50% is not recommended for use in pediatrics unless it is diluted.
Assessment of the fontanelle provides the most useful information for which two
components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure ✅A
A sunken fontanelle is a red flag for circulation assessment in pediatric triage and may
indicate dehydration . A bulging fontanel is a red flag for disability assessment in
pediatric triage and can indicate increased intracranial pressure.
Which of the following indicates the need for additional caregiver education regarding a
urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication. ✅C
A nurse providing trauma informed care to the family of a seriously ill child should be
doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family ✅D
Caregivers experiencing the crisis of a critically ill child have low attentiveness and
increased stress so would benefit from having a member of the healthcare team to stay
with them as much as possible and communicate updates on the plan of care.
, Caregivers should be allowed to stay with their child as much as possible and not
placed in a secluded room away for them.
The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure
history. 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 caregiver states the burns
accidentally occurred three days ago, but was afraid to bring the patient in due to an
ongoing child welfare investigation.Which of the following groups of interventions are
the priority for this patient?
A.Call police and child welfare authorities and have security detain the caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions ✅C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help
prevent further seizures. Contacting child protective services and other authorities can
wait. The patient is post-ictal so does not require lorazepam medication at this time.
Pain medication can and should be considered with significant burns, but is not a
priority.
What is the priority intervention for symptomatic bradycardia in a four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing ✅C
I am running a few minutes late; my previous meeting is running over.
Identifying and treating other causes, chest compressions, and epinephrine are
interventions for pediatric bradycardia with signs of poor perfusion that are not improved
by adequate oxygenation and ventilation. Atropine and pacing may be considered if
there is no response to the other interventions.
A 5-year-old child presents to the emergency department after being hit by a car. The
patient 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?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses ✅D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The
nurse may note a strong central pulse but weaker peripheral pulses, indicating the child
is compensating by shunting blood to their core.
