ENPC 6th Edition Course Exam Answers RATED A+
2023\2024 UPDATE
1. 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?
o Answer: Hypoglycemia (wrong)
o 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.
2. 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?
o Answer: Computed tomography (wrong)
, o 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.
3. 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?
o Answer: Establishing a secure airway.
4. 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?
o Answer: Humidified oxygen (wrong)
o Remediation feedback: Wheezing is most often identified with asthma in the
pediatric population. Initial medication intervention includes an inhaled short-
acting beta agonist.
5. 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
2023\2024 UPDATE
1. 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?
o Answer: Hypoglycemia (wrong)
o 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.
2. 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?
o Answer: Computed tomography (wrong)
, o 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.
3. 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?
o Answer: Establishing a secure airway.
4. 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?
o Answer: Humidified oxygen (wrong)
o Remediation feedback: Wheezing is most often identified with asthma in the
pediatric population. Initial medication intervention includes an inhaled short-
acting beta agonist.
5. 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
