ULTIMATE ENPC EXAM LATEST 2023-2024 ACTUAL EXAM
150 QUESTIONS WITH CORRECT DETAILED ANSWERS
(RANKED) ALREADY GRADED A+
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?
Hypoglycemia (wrong)
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.
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?
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?
Establishing a secure airway
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?
initial medication intervention includes an inhaled short-acting beta agonist.
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?
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?
Ketorolac
Remediation feedback:
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?
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?
, 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?
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?
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?
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?
LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for
an acetaminophen overdose?
A bolus infusion of 150 mg/kg NAC should be administered.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence
of foul-smelling urine. The child is hypotensive and tachycardic. Which of the
following methods for obtaining a urine sample is most appropriate in this
circumstance?
Urinary catherization
You are discharging a patient home who has a history of depression. Discharge
teaching should include which of the following?
Ensuring all firearms in the home are locked up with no access available by the patient.
A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has
a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34
breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a
150 QUESTIONS WITH CORRECT DETAILED ANSWERS
(RANKED) ALREADY GRADED A+
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?
Hypoglycemia (wrong)
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.
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?
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?
Establishing a secure airway
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?
initial medication intervention includes an inhaled short-acting beta agonist.
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?
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?
Ketorolac
Remediation feedback:
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?
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?
, 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?
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?
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?
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?
LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for
an acetaminophen overdose?
A bolus infusion of 150 mg/kg NAC should be administered.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence
of foul-smelling urine. The child is hypotensive and tachycardic. Which of the
following methods for obtaining a urine sample is most appropriate in this
circumstance?
Urinary catherization
You are discharging a patient home who has a history of depression. Discharge
teaching should include which of the following?
Ensuring all firearms in the home are locked up with no access available by the patient.
A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has
a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34
breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a
