ENPC Exam TestBank 2022 (All Answers are Correct)

1. Which of the following would be an abnormal finding in a patient with glomerulonephritis? Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be con centrated and dark brown/tea-colored. Decreased energy Hypertension Nausea, vomiting 2. A 3-year-old is brought to the emergency department with a 2-day history of a runny nose, lowgrade fever, and a "barky" cough at night. The caregiver tells the emergency department nurse the coughing is getting worse. The child is awake and alert, with stridor. The nurse should anticipate which of the following? Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. Delivery of humidified oxygen Bag-valve-mask ventilations Suctioning secretions from the oropharynx 3. The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? Allow the extended to family members to serve as interpreters during the procedure. Dedicate a healthcare team member to be with the family during the procedure. Allowing caregivers to remain with the pediatric patient is more supportive in this situation. Allow family members to serve as interpreters during the procedure Provide access to nondenominational clergy in a quiet area 4. Which of the following patient presentations should increase suspicion of potential child maltreatment? Right radial spiral fracture in a 10-year-old practicing martial arts Bruising to the left ear of a newborn from sleeping on his side Any bruise in a nonexploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse. Closed greenstick wrist fracture in a 4 year old who fell off his bicycle Bruises in various stages of healing to the lower extremities of a 2-year-old 5. A 14-year-old high school student who was pitching for his baseball team was hit in the chest by the ball and had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest? Aortic Dissection Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey. Pericardial Tamponade Blunt Aortic Injury 6. 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? Ecstasy overdose Neuroleptic malignant syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare reaction to antipsychotic medications. Serotonin syndrome Nicotine overdose 7. Which of the following patients should be evaluated first? A 3-year-old with a dislodged gastrostomy tube A 12-year-old with left shoulder pain after a handlebar injury 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. A 3-month-old with periods of inconsolable crying 8. Which of the following tasks can the nurse do to decrease adverse medication events? Obtain the patient's weight in kilograms This is the preferred measurement for medication calculations for pediatric and adult patients. Verifying the patient dose during shift report at nursing station Dual confirmation of a hard to read order Confirming patient's attending provider 9. Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases? Mononucleosis Hemophilia Sickle cell anemia These are all complications of sickle cell anemia. Acute rheumatic fever 10. 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? Empowerment, voice and choice 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. Peer support Trustworthiness and transparency 11. 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? Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis. Bronchopulmonary Dysplasia Pneumonitis Reactive Airway Disease 12. 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? Ondansetron Midzaolam Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided. Vancomycin 13. 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? Administer lorazepam and a fluid bolus and place on seizure precautions 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. Administer intravenous analgesics, a fluid bolus, and obtain a point of care glucose Call police and child welfare authorities and have security detain parent 14. In which of the following primary survey components can assessment of the fontanel provide the most useful information? Circulation and disability A sunken fontanel may indicate dehydration; a bulging fontanel can indicate increased intracranial pressure. Breathing and circulation Disability and exposure Circulation and exposure 15. 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? Decreasing preload Decreasing contractility Increasing afterload Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. 16. A toddler has a chemical eye injury. Which of the following is the priority intervention? Consult with ophthalmology within 24 hours Copious eye irrigation with an isotonic solution Normal saline or Ringer's lactate solution are both acceptable for irrigation. Irrigate until the pH of the eye returns to normal. The pH of Ringer's lactate is closer to that of human tears and may be more comfortable than normal saline. Elevate the head of the bed to 30 to 45 degrees. Administration of an ocular antibiotic 17. 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? Discharge to home with follow-up instructions to contact their primary care physician 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. Consult cardiology for appropriate follow-up Repeat a head-to-toe exam to identify any missed traumatic injuries 18. Which of the following is the most appropriate intervention for a child experiencing a seizure? Prepare to administer intranasal midazolam Midazolam has gained favor because of its ease of use and quick onset of action. Place the child in a prone position Prepare to administer rectal diazepam Place the child in a supine position 19. 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? Reposition the endotracheal tube 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. Insert an orogastric tube Assess the oropharynx 20. 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? Initiation of abdominal thrusts for removal of fluid from the lungs Insertion of orogastric or nasogastric tube for removal of water and debris from stomach Removal of wet clothing to prevent hypothermia Endotracheal intubation with positive pressure ventilation Airway control and positive pressure ventilation are the priority interventions for this patient. 21. 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? Referring to their child as "the patient". Appointing one staff member to communicate with them. This will help create a solid patientstaff bond and facilitate communication. Placing the family in a secluded room. Telling the family how they should feel. 22. You are discharging a patient to home with a history of depression. Discharge teaching should include which of the following?