ENPC EXAM 6TH ED QUESTIONS WITH CORRECT DETAILED ANSWERS

A 5-year-old child presents with hives, swelling of the lips and face, and stridor that developed about an hour after eating lunch. The child has no known allergies. Which of the following is the priority intervention? A. Administer intramuscular epinephrine B. Auscultate bilateral breath sounds C. Insert an intravenous catheter D. Administer inhaled albuterol - A. Administer intramuscular epinephrine An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing? A. SpO2 of 94 % on room air B. Widened pulse pressure C. Extreme lethargy D. Flash capillary refill - A. SpO2 of 94 % on room air A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child? A. Delivery of humidified oxygen by nasal cannula B. Administration of nebulized epinephrine C. Suctioning secretions from the oropharynx D. Administration of albuterol with a spacer - B. Administration of nebulized epinephrine A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the ED. Which of the following should be included in the discharge instructions? A. Practice yawning three to four times a day B. Resume eating a regular diet later today C. Apply hot packs to the joint area for pain control D. Use a nonsteroidal anti-inflammatory for pain control - D. Use a nonsteroidal anti-inflammatory for pain control Which of the following parameters would indicate that appropriate post resuscitation interventions were successfully carried out in the pediatric patient? A. Pulse oximetry reading of 96% B. Temperature of 99.8°F (37.6°C) C. Capillary refill of 1 second D. Capnography reading of 60 mm Hg - A. Pulse oximetry reading of 96% An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms? A. Anaphylaxis B. Renal colic C. Crohn's Disease D. Menarche - A. Anaphylaxis An 8-year-old trauma patient suddenly develops increased respiratory distress with a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt hypotensive event. Distention of the jugular veins is noted. Which of the following emergent interventions should be anticipated first? A. High flow oxygen B. Drug assisted intubation C. Chest tube insertion D. Needle decompression - D. Needle decompression A 4-week-old infant born prematurely is brought to the emergency department due to the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on these findings, what condition should the nurse suspect? A. Necrotizing enterocolitis B. Pyloric stenosis C. Megacolon D. Congenital diaphragmatic hernia - A. Necrotizing enterocolitis 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? A. Hypoglycemia B. Severe anemia C. Low pH level D. Elevated serum bicarbonate - C. Low pH level Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis? A. Hypernatremia B. Constipation C. Obesity D. Epiglottitis - B. Constipation Which of the following is the highest priority intervention for a wellappearing 2-month-old with a fever? A. Lumbar puncture B. Urine culture C. Intravenous fluid bolus D. Chest radiograph - B. Urine culture The caregivers of a 6-year-old report the child developed a cough with nasal congestion and "pink-eye" that started two days ago. Today they noticed a raised, red rash on the face, and grey papules in the mouth. Which of the following is the priority intervention for this patient? A. Obtain a nasopharyngeal swab B. Place in airborne isolation C. Place in contact isolation D. Obtain a fingerstick glucose - C. Place in contact isolation A 14-year-old patient with Down syndrome presents with an abnormal gait, head tilted to the left, decreased sensation to the extremities, and urinary incontinence. The patient has no history of trauma. Which of the following diagnostics is the priority for this patient? A. Lumbar spine magnetic resonance imaging B. Complete neurologic exam C. Urinalysis by straight catheterization D. Cervical spine radiographs - D. Cervical spine radiographs A 7-year-old is being seen for new onset of headaches. Which of the following manifestations would most likely rule out the potential of a primary etiology? A. Presence of ataxia B. Pulsating, unilateral pain C. Occurrence of photophobia D. Nausea, vomiting - A. Presence of ataxia A 3-week old is brought to the emergency department with a history of fussiness, spitting up, crying, and watery stools. Assessment reveals an alert child with moist mucous membranes. Which of the following should be the priority? A. Medicate with ondansetron for emesis B. Identify the type of formula the caregiver uses C. Obtain a stool specimen for culture D. Initiate intravenous access with 0.9% sodium chloride - B. Identify the type of formula the caregiver uses 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? A. EMLA (lidocaine 2.5% and prilocaine 2.5%) B. LET (lidocaine/epinephrine/tetracaine) C. LMX (lidocaine 4%) D. Tetracaine 4% - B. LET (lidocaine/epinephrine/tetracaine) A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic event. Assessment findings include a patient who is active and alert, in the 10th percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture of the left femur. Which of the following is the most likely cause? A. Osteomyelitis B. Physical maltreatment C. Ehlers-Danlos syndrome D. Osteogenesis imperfecta - D. Osteogenesis imperfecta A 3 year-old patient presents following frequent emesis and diarrhea over the past 12 hours. Which of the following assessment findings indicate that the patient' body is compensating for the fluid loss? A. Increased diastolic blood pressure B. Bounding peripheral pulses C. Prolonged capillary refill D. Increased urine output - A. Increased diastolic blood pressure