VERSIONS) EACH WITH 50 QUESTIONS AND m m m m m m
CORRECT SOLUTIONS| ALREADY GRADED A| m m m m m
ACE YOUR GRADES. m m
Enpc 6th edition course exam vesrion 1
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A 4-year-
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old presents with vomiting, lethargy, frequent urination, weight loss, and dry mu
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cous membranes. Vital signs reveal deep respirations at 44 breaths per minute,
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bp of 70/44 mm hg, and hr of 144 beats per minute. Which of the following lab
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oratory values would be most expected in this child? - correct answer-
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hypoglycemia (wrong) m
Remediation feedback: m
Children can present with new onset diabetes in diabetic ketoacidosis. Manifest
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ations include signs of dehydration ( dry mucous membranes, hypotension, tach
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ycardia), incontinence (polyuria), vomiting, abdominal pain, kussmaul respiration
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s (to counter the acidosis), polydipsia, anorexia, and weight loss. Expected labora
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tory values would reveal an acidotic state with a ph level below 7.3, an elevated
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mserum bicarbonate level, and an elevated blood glucose level > 200 mg.dl.
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An 18-month-
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old is seen for fever, slight circumoral cyanosis, and wheezing noted on auscultat
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ion in the right upper lobe of the lung field after a choking event 4 days ago. Th
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e white blood cell count is elevated and the patient noted to be tachypneic, tac
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hycardic, agitated, and has an increased respiratory effort. At the time of the ev
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ent, the patient was started on antibiotics with subsequent
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,increasing manifestations instead of improvement. Which of the following woul
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d be considered to be definitive treatment for the suspected diagnosis? -
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mcorrect answer-computed tomography (wrong)
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Remediation feedback: m
Manifestations of a lower airway foreign body include a choking incident with s
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ubsequent failure to improve on antibiotics. Wheezing or decreased lung sounds
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min one area of the pulmonary system is a high indicator for a foreign body alon
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g with signs of hypoxia such as cyanosis, tachypnea, tachycardia, increased resp
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iratory effort, agitation or lethargy, and elevated white blood cell counts indicat
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ing an infectious process. The definitive treatment would be a bronchoscopy in
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order to retrieve the suspected foreign body instead of diagnostic tests to locat
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e the foreign body itself.
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A child in cardiopulmonary arrest is receiving chest compressions and manual ve
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ntilations with a bag- m m m
mask device. Once return of spontaneous circulation has been confirmed, which
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of the following would be the priority intervention? - correct answer-
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establishing a secure airway m m m
Parents report their 3-year-m m m
old child has developed noisy breathing. On assessment, high-
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pitched wheezes are audible and auscultated on inspiration and expiration. Wha
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t medication would be appropriate to administer first? - correct answer-
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humidified oxygen (wrong) m m
Remediation feedback: m
,Wheezing is most often identified with asthma in the pediatric population. Initial
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medication intervention includes an inhaled short-acting beta agonist.
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A 6-week-
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old is brought to the emergency department by the caregivers for poor feeding
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, listlessness, and fever. Assessment reveals a crying infant, hr 160 beats/minut
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e, rr 52 breaths/minute, rectal temperature of 96.0 f (35.5 c), and a bulging ant
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erior fontanel. Capillary refill is 4 seconds. Based on these findings what is the
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most likely diagnostic test the nurse should anticipate? - correct answer-
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lumbar puncture m
A 12-year-
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old is being prepped for surgical intervention of acute appendicitis. Which of the
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mfollowing intravenous medication orders should the nurse question?
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- correct answer-hydromorphone (wrong)
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Remediation feedback: m
Ketorolac is an appropriate medication for moderate to severe pain, however, it
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mshould not be used pre-m m m m
operatively due to its potential to increase the bleeding risk.
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A 17-year-
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old female arrives in the ed with her boyfriend who states she is pregnant and h
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aving vaginal bleeding. The patient is unsure of the gestational age and has not
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had any prenatal treatment. The patient is quiet and lets her boyfriend answer
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most of the questions. Which of the following is the most appropriate action for
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mthe nurse to take at this point? - correct answer-
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have the boyfriend leave the room during the pelvic exam.
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, A 2-year-
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old arrives at the ed in hypovolemic shock and needs fluids immediately. After s
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everal attempts, your team has been unsuccessful at establishing vascular acces
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s. Of the following, which is the next best option for establishing access quickly?
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- correct answer-intraosseous in the patient's medial tibia.
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A child with an electrical injury is seen 1 hour post event. Which of the followin
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g types of specimen samples would provide visual information regarding a poten
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tial complication of this injury? - correct answer-sputum (wrong)
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Remediation feedback: m
Electrical injuries, though they may appear to be small, can produce large amou
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nts of damage internally, including muscle damage. Myoglobin is excreted in the
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murine and is evidenced by dark, red-tinged urine.
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Parents with an infant requiring multiple laboratory tests, radiographic studies, a
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nd invasive procedures appear to be distressed and withdrawn. Which of the fol
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lowing interventions would best ensure a sense of comfort and control for these
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mparents? - correct answer-providing frequent updates and re-
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educating them on the care that is being provided
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When taking vital signs on a stable infant, which of the following should be done
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first? - correct answer-respiratory rate
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