ENPC 6th Edition Exam (2025/2026) – Questions and Answers
with Explanations
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? - CORRECT ANSWER >>>>>Hypoglycemia
(wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic
ketoacidosis. Manifestations include signs of dehydration (
dry mucous membranes, hypotension, tachycardia),
incontinence (polyuria), vomiting, abdominal pain,
Kussmaul respirations (to counter the acidosis), polydipsia,
anorexia, and weight loss. 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? - CORRECT
ANSWER >>>>>Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a
choking incident with subsequent failure to improve on
antibiotics. Wheezing or decreased lung sounds in one area
of the pulmonary system is a high indicator for a foreign
body along with signs of hypoxia such as cyanosis,
tachypnea, tachycardia, increased respiratory effort,
agitation or lethargy, and elevated white blood cell counts
indicating an infectious process. 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? - CORRECT ANSWER >>>>>Establishing a
secure airway
,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? -
CORRECT ANSWER >>>>>Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the
pediatric population. Initial medication intervention
includes an inhaled short-acting beta agonist.
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? - CORRECT ANSWER
>>>>>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? - CORRECT
ANSWER >>>>>Hydromorphone (wrong)
Remediation feedback:
, 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? - CORRECT ANSWER >>>>>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? - CORRECT ANSWER >>>>>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? - CORRECT ANSWER
>>>>>Sputum (wrong)
with Explanations
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? - CORRECT ANSWER >>>>>Hypoglycemia
(wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic
ketoacidosis. Manifestations include signs of dehydration (
dry mucous membranes, hypotension, tachycardia),
incontinence (polyuria), vomiting, abdominal pain,
Kussmaul respirations (to counter the acidosis), polydipsia,
anorexia, and weight loss. 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? - CORRECT
ANSWER >>>>>Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a
choking incident with subsequent failure to improve on
antibiotics. Wheezing or decreased lung sounds in one area
of the pulmonary system is a high indicator for a foreign
body along with signs of hypoxia such as cyanosis,
tachypnea, tachycardia, increased respiratory effort,
agitation or lethargy, and elevated white blood cell counts
indicating an infectious process. 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? - CORRECT ANSWER >>>>>Establishing a
secure airway
,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? -
CORRECT ANSWER >>>>>Humidified oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the
pediatric population. Initial medication intervention
includes an inhaled short-acting beta agonist.
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? - CORRECT ANSWER
>>>>>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? - CORRECT
ANSWER >>>>>Hydromorphone (wrong)
Remediation feedback:
, 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? - CORRECT ANSWER >>>>>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? - CORRECT ANSWER >>>>>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? - CORRECT ANSWER
>>>>>Sputum (wrong)
