ENPC 6th Edition Course Exam
2024
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 ANS-Initial medication intervention includes an inhaled short-
acting beta agonist.
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 ANS-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 ANS-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 ANS-Establishing a secure airway
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 ANS-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 ANS-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 ANS-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 ANS-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
ANS-Electrical injuries, though they may appear to be small, can produce large amounts of damage
internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-
tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures
appear to be distressed and withdrawn. Which of the following interventions would best ensure a sense
of comfort and control for these parents? -CORRECT ANS-Providing frequent updates and re-educating
them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -CORRECT ANS-
Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations for topical
anesthesia would be the best choice for this procedure? -CORRECT ANS-LET
(lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acetaminophen
overdose? -CORRECT ANS-A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is noted:
hypotension, tachycardia, absent breath sounds from the left chest with an increased respiratory rate,
pain on palpation of the pelvis, tinge of blood noted at the urinary meatus, moderate active bleeding
from a laceration to left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left
upper leg, and a Glasgow Coma Score of 7. Which of the following orders will prompt the nurse to have
2024
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 ANS-Initial medication intervention includes an inhaled short-
acting beta agonist.
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 ANS-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 ANS-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 ANS-Establishing a secure airway
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 ANS-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 ANS-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 ANS-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 ANS-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
ANS-Electrical injuries, though they may appear to be small, can produce large amounts of damage
internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-
tinged urine.
Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures
appear to be distressed and withdrawn. Which of the following interventions would best ensure a sense
of comfort and control for these parents? -CORRECT ANS-Providing frequent updates and re-educating
them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first? -CORRECT ANS-
Respiratory rate
A laceration on a toddler's arm is prepared for suturing. Which of the following preparations for topical
anesthesia would be the best choice for this procedure? -CORRECT ANS-LET
(lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acetaminophen
overdose? -CORRECT ANS-A bolus infusion of 150 mg/kg NAC should be administered.
A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is noted:
hypotension, tachycardia, absent breath sounds from the left chest with an increased respiratory rate,
pain on palpation of the pelvis, tinge of blood noted at the urinary meatus, moderate active bleeding
from a laceration to left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left
upper leg, and a Glasgow Coma Score of 7. Which of the following orders will prompt the nurse to have
