EMERGENCY NURSING PEDIATRIC
COURSE (ENPC) Practice Exam Question
and Answers Latest Updates 2026 Graded
A+
The **ENPC** is a certification course provided by the Emergency
Nurses Association (ENA). It focuses on evidence-based pediatric
emergency care, including assessment, interventions, and management
of acutely ill or injured children.
1. A 15-month-old presents with high fever for 5 days, followed by a
diffuse maculopapular rash as the fever resolves. What is the most
likely diagnosis?
- **Answer**: Roseola infantum (HHV-6).
*Rationale*: Classic "fever then rash" pattern; benign, supportive
care.
2. A 7-year-old presents with limp, fever, and refusal to bear weight
on the left leg. What is the most concerning diagnosis until ruled out?
- **Answer**: Septic arthritis of the hip.
*Rationale*: Orthopedic emergency; requires urgent aspiration,
antibiotics, and possible surgical drainage.
, 3. A child presents with acute abdominal pain, rebound tenderness,
and guarding in the right lower quadrant. What is the
priority preparation?
- **Answer**: NPO, IV fluids, antibiotics, and surgical consult for
appendectomy.
*Rationale*: Suspected acute appendicitis; prevent perforation.
4. In a child with suspected bacterial meningitis (fever, nuchal rigidity,
altered mental status), what is the sequence of initial interventions?
- **Answer**: Administer antibiotics and dexamethasone
immediately after blood cultures (before or without waiting for LP if
delayed).
*Rationale*: Time-sensitive; empiric treatment reduces mortality.
5. A 10-year-old presents with suicidal ideation after a family
argument. What is the priority nursing action?
- **Answer**: Ensure 1:1 observation/safety, conduct risk
assessment, and involve mental health specialist.
*Rationale*: Immediate safety; mandatory reporting and crisis
intervention.
, 6. A toddler falls from a second-story window onto
concrete. Vital signs stable, but deformity of the forearm noted. What is
the most likely associated injury to assess for?
- **Answer**: Head or spinal injury (and supracondylar fracture of
humerus common in falls on outstretched hand).
*Rationale*: High-energy mechanism; full trauma survey required.
7. Which vaccine-preventable illness presents with paroxysmal
coughing, whoop, and post-tussive emesis?
- **Answer**: Pertussis (whooping cough).
*Rationale*: Droplet precautions; treat with azithromycin,
supportive care.
8. A child with von Willebrand disease presents with prolonged
bleeding after a dental extraction. What is the initial treatment?
- **Answer**: Desmopressin (DDAVP) if type 1, or factor replacement.
*Rationale*: Enhances vWF release; avoid NSAIDs.
9. In assessing shock progression, which stage is
characterized by hypotension, profound altered mental status, and
organ failure?
- **Answer**: Decompensated (progressive/irreversible) shock.
, *Rationale*: Late stage; aggressive resuscitation needed.
10. A 3-year-old presents with stridor at rest, drooling, and leaning
forward after putting a toy in mouth. What is the
immediate management?
- **Answer**: Allow position of comfort, prepare for emergent airway
(intubation or cricothyrotomy if needed); suspected foreign body.
*Rationale*: Do not examine throat; risk complete obstruction
11. A 6-week-old infant presents with poor feeding, listlessness, fever,
HR 160, RR 52, hypothermia (rectal temp
96°F/35.5°C), bulging fontanel, and capillary refill 4 seconds. What
diagnostic test should the nurse anticipate?
- **Answer**: Lumbar puncture.
*Rationale*: Signs suggest sepsis/meningitis in a neonate; LP is
priority for CSF analysis.
COURSE (ENPC) Practice Exam Question
and Answers Latest Updates 2026 Graded
A+
The **ENPC** is a certification course provided by the Emergency
Nurses Association (ENA). It focuses on evidence-based pediatric
emergency care, including assessment, interventions, and management
of acutely ill or injured children.
1. A 15-month-old presents with high fever for 5 days, followed by a
diffuse maculopapular rash as the fever resolves. What is the most
likely diagnosis?
- **Answer**: Roseola infantum (HHV-6).
*Rationale*: Classic "fever then rash" pattern; benign, supportive
care.
2. A 7-year-old presents with limp, fever, and refusal to bear weight
on the left leg. What is the most concerning diagnosis until ruled out?
- **Answer**: Septic arthritis of the hip.
*Rationale*: Orthopedic emergency; requires urgent aspiration,
antibiotics, and possible surgical drainage.
, 3. A child presents with acute abdominal pain, rebound tenderness,
and guarding in the right lower quadrant. What is the
priority preparation?
- **Answer**: NPO, IV fluids, antibiotics, and surgical consult for
appendectomy.
*Rationale*: Suspected acute appendicitis; prevent perforation.
4. In a child with suspected bacterial meningitis (fever, nuchal rigidity,
altered mental status), what is the sequence of initial interventions?
- **Answer**: Administer antibiotics and dexamethasone
immediately after blood cultures (before or without waiting for LP if
delayed).
*Rationale*: Time-sensitive; empiric treatment reduces mortality.
5. A 10-year-old presents with suicidal ideation after a family
argument. What is the priority nursing action?
- **Answer**: Ensure 1:1 observation/safety, conduct risk
assessment, and involve mental health specialist.
*Rationale*: Immediate safety; mandatory reporting and crisis
intervention.
, 6. A toddler falls from a second-story window onto
concrete. Vital signs stable, but deformity of the forearm noted. What is
the most likely associated injury to assess for?
- **Answer**: Head or spinal injury (and supracondylar fracture of
humerus common in falls on outstretched hand).
*Rationale*: High-energy mechanism; full trauma survey required.
7. Which vaccine-preventable illness presents with paroxysmal
coughing, whoop, and post-tussive emesis?
- **Answer**: Pertussis (whooping cough).
*Rationale*: Droplet precautions; treat with azithromycin,
supportive care.
8. A child with von Willebrand disease presents with prolonged
bleeding after a dental extraction. What is the initial treatment?
- **Answer**: Desmopressin (DDAVP) if type 1, or factor replacement.
*Rationale*: Enhances vWF release; avoid NSAIDs.
9. In assessing shock progression, which stage is
characterized by hypotension, profound altered mental status, and
organ failure?
- **Answer**: Decompensated (progressive/irreversible) shock.
, *Rationale*: Late stage; aggressive resuscitation needed.
10. A 3-year-old presents with stridor at rest, drooling, and leaning
forward after putting a toy in mouth. What is the
immediate management?
- **Answer**: Allow position of comfort, prepare for emergent airway
(intubation or cricothyrotomy if needed); suspected foreign body.
*Rationale*: Do not examine throat; risk complete obstruction
11. A 6-week-old infant presents with poor feeding, listlessness, fever,
HR 160, RR 52, hypothermia (rectal temp
96°F/35.5°C), bulging fontanel, and capillary refill 4 seconds. What
diagnostic test should the nurse anticipate?
- **Answer**: Lumbar puncture.
*Rationale*: Signs suggest sepsis/meningitis in a neonate; LP is
priority for CSF analysis.
