ENPC – EMERGENCY NURSING PEDIATRIC COURSE EXAM
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 4-year-old child is brought to the ED after a fall from a tree. The child is crying
but can move all limbs. Vital signs: HR 120, RR 28, BP 95/60, SpO₂ 97%. Which
action is the priority?
A. Obtain X-rays of all limbs
B. Perform a primary survey (ABCs)
C. Administer pain medication
D. Start an IV line
Answer: B – Perform a primary survey (ABCs)
Rationale: The primary survey (Airway, Breathing, Circulation, Disability,
Exposure) is always the first step in emergency care to identify life-threatening
conditions, even if the child appears stable.
Question 2
A 2-year-old presents with fever, drooling, stridor, and sitting in the tripod
position. What is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Asthma exacerbation
D. Bronchiolitis
Answer: B – Epiglottitis
Rationale: Sudden onset fever, drooling, stridor, and tripod positioning are classic
signs of epiglottitis. Immediate airway management is critical; do not attempt to
visualize the throat.
,Question 3
A child with suspected dehydration is lethargic and has dry mucous membranes.
The nurse should first:
A. Start oral rehydration solution
B. Assess the child’s airway and vital signs
C. Obtain a blood sample for electrolytes
D. Insert a nasogastric tube
Answer: B – Assess the child’s airway and vital signs
Rationale: In emergency situations, assessing ABCs comes first, especially in
lethargic children who may be at risk of rapid deterioration.
Question 4
Which is the most appropriate pain assessment tool for a 3-year-old child?
A. Numeric Rating Scale (0–10)
B. Wong-Baker FACES Pain Rating Scale
C. Visual Analog Scale (VAS)
D. FLACC Scale
Answer: D – FLACC Scale
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is
appropriate for children ages 2 months to 7 years who cannot reliably self-report
pain.
Question 5
A 7-year-old ingested a household cleaner. Which is the first nursing action?
A. Induce vomiting
B. Call Poison Control
C. Administer activated charcoal
D. Start IV fluids
Answer: B – Call Poison Control
,Rationale: Immediate consultation with Poison Control is crucial to guide
appropriate, safe management. Vomiting may worsen injury depending on the
substance.
Question 6
A child in shock has a weak, thready pulse, hypotension, and cool extremities. The
nurse recognizes this as:
A. Compensated shock
B. Decompensated shock
C. Cardiogenic shock
D. Distributive shock
Answer: B – Decompensated shock
Rationale: Hypotension in children is a late sign. Weak pulse, hypotension, and
cool extremities indicate decompensated shock requiring immediate intervention.
Question 7
A child with asthma presents with wheezing and intercostal retractions. Which is
the first-line intervention?
A. IV corticosteroids
B. Nebulized short-acting beta-agonist
C. Oxygen via non-rebreather mask
D. Chest physiotherapy
Answer: B – Nebulized short-acting beta-agonist
Rationale: Rapid bronchodilation with a short-acting beta-agonist (e.g., albuterol)
is first-line therapy for acute asthma exacerbations.
, Question 8
A 5-year-old presents with a sudden seizure at home. The parent reports it lasted 3
minutes. The child is postictal. What is the priority?
A. Place the child in a safe position
B. Administer anticonvulsants immediately
C. Insert an IV line
D. Perform a head CT
Answer: A – Place the child in a safe position
Rationale: Safety during and immediately after a seizure is priority. Most seizures
lasting <5 minutes stop spontaneously; further interventions may follow if seizures
persist.
Question 9
A toddler presents with a temperature of 40°C, irritability, and petechiae. The
nurse’s immediate action should be:
A. Administer antipyretics
B. Obtain a complete blood count
C. Initiate sepsis protocol and notify the physician
D. Apply a cooling blanket
Answer: C – Initiate sepsis protocol and notify the physician
Rationale: High fever with petechiae suggests possible meningococcemia or
sepsis; prompt recognition and rapid treatment are critical.
Question 10
A child with suspected appendicitis complains of RLQ pain. Which finding is most
concerning?
A. Low-grade fever
B. Rebound tenderness
C. Nausea and vomiting
D. Mild anorexia
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 4-year-old child is brought to the ED after a fall from a tree. The child is crying
but can move all limbs. Vital signs: HR 120, RR 28, BP 95/60, SpO₂ 97%. Which
action is the priority?
A. Obtain X-rays of all limbs
B. Perform a primary survey (ABCs)
C. Administer pain medication
D. Start an IV line
Answer: B – Perform a primary survey (ABCs)
Rationale: The primary survey (Airway, Breathing, Circulation, Disability,
Exposure) is always the first step in emergency care to identify life-threatening
conditions, even if the child appears stable.
Question 2
A 2-year-old presents with fever, drooling, stridor, and sitting in the tripod
position. What is the most likely diagnosis?
A. Croup
B. Epiglottitis
C. Asthma exacerbation
D. Bronchiolitis
Answer: B – Epiglottitis
Rationale: Sudden onset fever, drooling, stridor, and tripod positioning are classic
signs of epiglottitis. Immediate airway management is critical; do not attempt to
visualize the throat.
,Question 3
A child with suspected dehydration is lethargic and has dry mucous membranes.
The nurse should first:
A. Start oral rehydration solution
B. Assess the child’s airway and vital signs
C. Obtain a blood sample for electrolytes
D. Insert a nasogastric tube
Answer: B – Assess the child’s airway and vital signs
Rationale: In emergency situations, assessing ABCs comes first, especially in
lethargic children who may be at risk of rapid deterioration.
Question 4
Which is the most appropriate pain assessment tool for a 3-year-old child?
A. Numeric Rating Scale (0–10)
B. Wong-Baker FACES Pain Rating Scale
C. Visual Analog Scale (VAS)
D. FLACC Scale
Answer: D – FLACC Scale
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is
appropriate for children ages 2 months to 7 years who cannot reliably self-report
pain.
Question 5
A 7-year-old ingested a household cleaner. Which is the first nursing action?
A. Induce vomiting
B. Call Poison Control
C. Administer activated charcoal
D. Start IV fluids
Answer: B – Call Poison Control
,Rationale: Immediate consultation with Poison Control is crucial to guide
appropriate, safe management. Vomiting may worsen injury depending on the
substance.
Question 6
A child in shock has a weak, thready pulse, hypotension, and cool extremities. The
nurse recognizes this as:
A. Compensated shock
B. Decompensated shock
C. Cardiogenic shock
D. Distributive shock
Answer: B – Decompensated shock
Rationale: Hypotension in children is a late sign. Weak pulse, hypotension, and
cool extremities indicate decompensated shock requiring immediate intervention.
Question 7
A child with asthma presents with wheezing and intercostal retractions. Which is
the first-line intervention?
A. IV corticosteroids
B. Nebulized short-acting beta-agonist
C. Oxygen via non-rebreather mask
D. Chest physiotherapy
Answer: B – Nebulized short-acting beta-agonist
Rationale: Rapid bronchodilation with a short-acting beta-agonist (e.g., albuterol)
is first-line therapy for acute asthma exacerbations.
, Question 8
A 5-year-old presents with a sudden seizure at home. The parent reports it lasted 3
minutes. The child is postictal. What is the priority?
A. Place the child in a safe position
B. Administer anticonvulsants immediately
C. Insert an IV line
D. Perform a head CT
Answer: A – Place the child in a safe position
Rationale: Safety during and immediately after a seizure is priority. Most seizures
lasting <5 minutes stop spontaneously; further interventions may follow if seizures
persist.
Question 9
A toddler presents with a temperature of 40°C, irritability, and petechiae. The
nurse’s immediate action should be:
A. Administer antipyretics
B. Obtain a complete blood count
C. Initiate sepsis protocol and notify the physician
D. Apply a cooling blanket
Answer: C – Initiate sepsis protocol and notify the physician
Rationale: High fever with petechiae suggests possible meningococcemia or
sepsis; prompt recognition and rapid treatment are critical.
Question 10
A child with suspected appendicitis complains of RLQ pain. Which finding is most
concerning?
A. Low-grade fever
B. Rebound tenderness
C. Nausea and vomiting
D. Mild anorexia
