Page 1 of 38
ENPC EXAM LATEST 2023-2024 ACTUAL EXAM
2 VERSIONS 100 QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A+
A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is
brought to the emergency department with severe muscle rigidity and hyperthermia. These
symptoms are most likely caused by which of the following? - ANSWER-Neuroleptic malignant
syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare
reaction to antipsychotic medications.
Which of the following patients should be evaluated first - ANSWER-An 18-month-old with
bilious emesis Bilious emesis in an 18-month-old is always considered an emergent symptom
indicative of a life-threatening bowel obstruction.
1. Which of the following tasks can the nurse do to decrease adverse medication events? -
ANSWER-Obtain the patient's weight in kilograms This is the preferred measurement for
medication calculations for pediatric and adult patients
Acute chest syndrome, stroke, and splenic sequestration are complications of which of the
following diseases? - ANSWER-Sickle cell anemia These are all complications of sickle cell
anemia.
During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential
sex trafficking victim. The trauma informed approach to care emphasizes certain principles in
caring for these types of patients. Which of the following care principles has the highest priority?
- ANSWER-Physical and psychological safety Create an environment where patients feel safe,
both physically and psychologically. Increase awareness of the patient's interpersonal
interactions with others to screen for risk of harm. Prioritize the patient being in a safe location
1
,Page 2 of 38
A 6-month-old is brought to the emergency department for a recurrent respiratory infection.
When gathering a history from the caregiver, the emergency nurse learns that, in addition to the
respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned
about which of the following disease processes? - ANSWER-Cystic Fibrosis Pancreatic
insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis.
The emergency nurse is caring for a patient with significant facial trauma and a suspected globe
rupture. Which of the following medication orders would the nurse question? - ANSWER-
Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided.
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? - ANSWER-Draw and send a metabolic panel, administer a fluid bolus, and
obtain a point of care glucose Significant burns can cause electrolyte imbalances. Electrolyte
imbalances may be the cause of the patient's seizure. Electrolyte imbalances need to be identified
and treated.
In which of the following primary survey components can assessment of the fontanel provide the
most useful information? - ANSWER-Circulation and disability A sunken fontanel may indicate
dehydration; a bulging fontanel can indicate increased intracranial pressure.
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? - ANSWER-Increasing heart rate In pediatric patients, tachycardia is the
primary compensatory mechanism to increase cardiac output.
2
,Page 3 of 38
A toddler has a chemical eye injury. Which of the following is the priority intervention? -
ANSWER-Increasing heart rate In pediatric patients, tachycardia is the primary compensatory
mechanism to increase cardiac output.
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? - ANSWER-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.
Which of the following is the most appropriate intervention for a child experiencing a seizure? -
ANSWER-Prepare to administer intranasal midazolam Midazolam has gained favor because of
its ease of use and quick onset of action.
An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated
prior to arrival. Which of the following is the priority assessment or intervention? - ANSWER-
Assess the endotracheal tube placement and patency If a patient arrives with an artificial airway
(endotracheal tube or tracheostomy) in place, assess its placement, tube patency, and the oral
airway (in that order) before moving to the next step of the primary survey.
A three-year-old is rescued after being submerged in a residential pool for several minutes. On
arrival at the Emergency Department he is responsive to painful stimuli, has shallow respirations
with diminished breath sounds throughout, and has an occasional cough. What is the initial
management priority? - ANSWER-Endotracheal intubation with positive pressure ventilation
Airway control and positive pressure ventilation are the priority interventions for this patient.
A nurse providing crisis intervention to the family of a seriously ill child can best keep the
family informed of the child's condition by doing which of the following? - ANSWER-
Appointing one staff member to communicate with them. This will help create a solid patient-
staff bond and facilitate communication.
3
, Page 4 of 38
You are discharging a patient to home with a history of depression. Discharge teaching should
include which of the following? - ANSWER-Ensuring all firearms in the home are locked in a
safe place with no access by the patient. Promote 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.
A 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department,
the child has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale
skin. Vital signs are HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The
child is most likely in which of the following shock states? - ANSWER-Hypovolemic shock The
mechanism and presentation lead to a suspicion of blood loss.
Which of the following is the priority intervention for a pediatric patient with diabetic
ketoacidosis? - ANSWER-Insulin infusion A continuous infusion of insulin at 0.05-0.1
unit/kg/hr should be used to decrease blood glucose.
Which of the following describes a neonate's normal position? - ANSWER-Flexion with
extremities close to the body A neonate's normal position is flexion with extremities close to the
body.
The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the
radius and ulna after falling from a bicycle. Which of the following pain interventions is most
likely to result in improvement in symptoms? - ANSWER-Application of a splint to the affected
extremity Splinting is an effective non-pharmacologic intervention to reduce pain associated
with fractures.
The type of vascular access is appropriate in all of the patient situations given EXCEPT for
which of the following? - ANSWER-Peripherally inserted central catheter line for one time fluid
bolus This vascular access is most appropriate for long term medication administration and
multiple blood draws.
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
4
ENPC EXAM LATEST 2023-2024 ACTUAL EXAM
2 VERSIONS 100 QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A+
A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is
brought to the emergency department with severe muscle rigidity and hyperthermia. These
symptoms are most likely caused by which of the following? - ANSWER-Neuroleptic malignant
syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare
reaction to antipsychotic medications.
Which of the following patients should be evaluated first - ANSWER-An 18-month-old with
bilious emesis Bilious emesis in an 18-month-old is always considered an emergent symptom
indicative of a life-threatening bowel obstruction.
1. Which of the following tasks can the nurse do to decrease adverse medication events? -
ANSWER-Obtain the patient's weight in kilograms This is the preferred measurement for
medication calculations for pediatric and adult patients
Acute chest syndrome, stroke, and splenic sequestration are complications of which of the
following diseases? - ANSWER-Sickle cell anemia These are all complications of sickle cell
anemia.
During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential
sex trafficking victim. The trauma informed approach to care emphasizes certain principles in
caring for these types of patients. Which of the following care principles has the highest priority?
- ANSWER-Physical and psychological safety Create an environment where patients feel safe,
both physically and psychologically. Increase awareness of the patient's interpersonal
interactions with others to screen for risk of harm. Prioritize the patient being in a safe location
1
,Page 2 of 38
A 6-month-old is brought to the emergency department for a recurrent respiratory infection.
When gathering a history from the caregiver, the emergency nurse learns that, in addition to the
respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned
about which of the following disease processes? - ANSWER-Cystic Fibrosis Pancreatic
insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis.
The emergency nurse is caring for a patient with significant facial trauma and a suspected globe
rupture. Which of the following medication orders would the nurse question? - ANSWER-
Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided.
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? - ANSWER-Draw and send a metabolic panel, administer a fluid bolus, and
obtain a point of care glucose Significant burns can cause electrolyte imbalances. Electrolyte
imbalances may be the cause of the patient's seizure. Electrolyte imbalances need to be identified
and treated.
In which of the following primary survey components can assessment of the fontanel provide the
most useful information? - ANSWER-Circulation and disability A sunken fontanel may indicate
dehydration; a bulging fontanel can indicate increased intracranial pressure.
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? - ANSWER-Increasing heart rate In pediatric patients, tachycardia is the
primary compensatory mechanism to increase cardiac output.
2
,Page 3 of 38
A toddler has a chemical eye injury. Which of the following is the priority intervention? -
ANSWER-Increasing heart rate In pediatric patients, tachycardia is the primary compensatory
mechanism to increase cardiac output.
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? - ANSWER-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.
Which of the following is the most appropriate intervention for a child experiencing a seizure? -
ANSWER-Prepare to administer intranasal midazolam Midazolam has gained favor because of
its ease of use and quick onset of action.
An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated
prior to arrival. Which of the following is the priority assessment or intervention? - ANSWER-
Assess the endotracheal tube placement and patency If a patient arrives with an artificial airway
(endotracheal tube or tracheostomy) in place, assess its placement, tube patency, and the oral
airway (in that order) before moving to the next step of the primary survey.
A three-year-old is rescued after being submerged in a residential pool for several minutes. On
arrival at the Emergency Department he is responsive to painful stimuli, has shallow respirations
with diminished breath sounds throughout, and has an occasional cough. What is the initial
management priority? - ANSWER-Endotracheal intubation with positive pressure ventilation
Airway control and positive pressure ventilation are the priority interventions for this patient.
A nurse providing crisis intervention to the family of a seriously ill child can best keep the
family informed of the child's condition by doing which of the following? - ANSWER-
Appointing one staff member to communicate with them. This will help create a solid patient-
staff bond and facilitate communication.
3
, Page 4 of 38
You are discharging a patient to home with a history of depression. Discharge teaching should
include which of the following? - ANSWER-Ensuring all firearms in the home are locked in a
safe place with no access by the patient. Promote 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.
A 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department,
the child has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale
skin. Vital signs are HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The
child is most likely in which of the following shock states? - ANSWER-Hypovolemic shock The
mechanism and presentation lead to a suspicion of blood loss.
Which of the following is the priority intervention for a pediatric patient with diabetic
ketoacidosis? - ANSWER-Insulin infusion A continuous infusion of insulin at 0.05-0.1
unit/kg/hr should be used to decrease blood glucose.
Which of the following describes a neonate's normal position? - ANSWER-Flexion with
extremities close to the body A neonate's normal position is flexion with extremities close to the
body.
The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the
radius and ulna after falling from a bicycle. Which of the following pain interventions is most
likely to result in improvement in symptoms? - ANSWER-Application of a splint to the affected
extremity Splinting is an effective non-pharmacologic intervention to reduce pain associated
with fractures.
The type of vascular access is appropriate in all of the patient situations given EXCEPT for
which of the following? - ANSWER-Peripherally inserted central catheter line for one time fluid
bolus This vascular access is most appropriate for long term medication administration and
multiple blood draws.
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
4
