ENPC 6th EDITION
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? - Answer- A.Increased diastolic blood pressure
B.Bounding peripheral pulses
C.Prolonged capillary refill
D.Increased urine output
You are discharging a patient home who has a history of depression. Discharge teaching should
include which of the following? - Answer- A.Discussing the importance of stopping all current
psychiatric medications.
B.Providing the family a list of behavioral health facilities to call for follow-up.
C.Explaining that the family should not call authorities for escalations in the patient's behavior.
D.Ensuring all firearms in the home are locked up with no access available by the patient.
A child with an electrical injury is seen 1 hour post event. Which of the following specimen
samples would provide visual information regarding a potential complication of this injury? -
Answer- A.Serum
B.Urine
C.Stool
D.Sputum
A 4-year-old patient is being assessed for a foreign body in the nose. The child is awake and alert
and watching a video on the caregivers phone. Vitals include HR of 110 beats/minute, RR of 26
breaths per minute, BP of 138/90 mm Hg, and T of 37.3oC (99.3oF) orally. Which of the following
interventions should the nurse perform next? - Answer- A.Check the size of the blood pressure
cuff
B.Recheck the temperature rectally
C.Recheck the blood pressure on the other arm
D.Place the patient on cardiac and respiratory monitors
A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of
consciousness with no pulses. Which of the following is the priority intervention? - Answer-
A.Utilize AED/defibrillator
B.Prepare for needle decompression
C.Administer intravenous epinephrine
D.Intubate with endotracheal tube
The triage nurse is assessing a 14 year old male who was brought in by ambulance. The patient
reports he was playing his video games at home when he had a sudden onset of groin pain that
was so severe he became nauseated and vomited. Further assessment reveals a swollen
scrotum. What is the priority intervention for this patient? - Answer- A.Obtaining a sterile urine
sample
B.Initiating intravenous access
C.Preparing the patient for ultrasound
D.Scanning the patient's bladder
,A caregiver reports their one-month-old has had a yellowish color to their eyes and skin over the
last two weeks. If left untreated, which body system can this affect? - Answer- A.Integumentary
B.Renal
C.Gastrointestinal
D.Neurological
An infant presents to the emergency department with difficulty breathing. The patient is pale and
respirations appear rapid and shallow. Which location on the torso is the most effective site for
assessing bilateral breath sounds? - Answer- A.Bilateral posterior back
B.Over the epigastrium
C.Bilateral midaxillary
D.Bilateral anterior chest
A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and
hypotension after eating lunch. Which of the following is the priority intervention? - Answer-
A.Intramuscular epinephrine
B.Inhaled albuterol
C.Oral diphenhydramine
D.Intravenous ondansetron
A 3-year-old is assessed for the presence of increasing amounts of serosanguineous drainage
from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely
etiology? - Answer- A.Magnet
B.Button battery
C.Dried bean
D.Fishing weight
Caregivers state an 18-month-old child had a harsh, barky cough, low-grade fever, and irritability
throughout the night. On assessment this morning, the child appears alert, is interactive, their
present cough is quiet, and their temperature is 98.8°F (37.1°C) axillary. Which of the following
diagnoses is the highest probablity for this child? - Answer- A.Asthma
B.Croup
C.Epiglottitis
D.Pneumonia
A 12-year-old female patient arrives awake and alert with an acute onset of abdominal pain on the
right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right
side and there is tenderness to the breasts. Which of the following laboratory tests is the priority
for this patient? - Answer- A.Human chorionic gonadotropin
B.Complete blood count
C.Vaginal cultures
D.Bedside glucose level
A fertilizer silo exploded during a school tour of a working farm. The children are able to manage
their own secretions but all are incontinent and salivating, with excess tearing. Which of the
following is the priority intervention? - Answer- A.Removal of clothing and decontamination
B.Establishing patient identification
C.Rapid administration of atropine
D.Providing supportive treatment
, A caregiver states their 3-year-old child ate some marijuana gummies approximately 3 hours prior
to arrival. The PAT reveals the child is pink, difficult to arouse, and work of breathing is normal.
What is your initial intervention? - Answer- A.Administer activated charcoal
B.Check the child's blood glucose
C.Initiate intravenous access
D.Obtain a full set of vital signs
A 14-year-old patient presents to the emergency department with her aunt after being assaulted.
The patient has multiple bruises inconsistent with the assault history and seems guarded with her
answers. A urine test is positive for pregnancy, although the patient denies being sexually active.
The aunt repeatedly asks when they will be discharged. The ED nurse recognizes these finding as
red flags for which of the following? - Answer- A.Labor trafficking
B.Sex trafficking
C.Psychological abuse
D.Physical abuse
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have
hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a
splenic rupture is suspected. Which of the following diagnoses should be suspected as a
companion injury with these findings and associated mechanism of injury? - Answer- A.Lumbar
fracture
B.Pneumothorax
C.Subdural hematoma
D.Cardiac tamponade
Which patient reflects an EMTALA compliant transfer? - Answer- A.An actively seizing toddler
being transferred to a pediatric-specific facility. That facility is checking on inpatient bed
availability.
B.A post-ictal patient with status epilepticus being transferred to a higher level of care with an
accepting physician. All records are copied.
C.A teenager with abdominal trauma and critical labs being transferred to a pediatric trauma
center for surgery. The facility has not accepted the transfer yet.
D.An infant with respiratory difficulties being transferred to another hospital with the same level of
pediatric care. Parents are not present, and records are copied.
After an explosion at a school, you are helping triage patients. In your field triage room you find a
5-year-old patient who is not breathing. What is the appropriate initial intervention? - Answer-
A.Assign the patient as black/expectant.
B.Open the airway and assess for breathing. - -
C.Check for capillary refill of < 2 seconds
D.Initiate cardiopulmonary resuscitation
Return of spontaneous circulation has been confirmed in a 5-year-old following cardiopulmonary
arrest after a 5-day history of vomiting and diarrhea. Vital signs are BP 72/60 mm Hg, HR 140
beats/minute, RR assisted at 30 breaths/minute via definitive airway, SpO2 97%, and T 36.8°C
(98.4°F) rectally. Which of the following would be the priority intervention at this time? - Answer-
A.Obtain a 12-lead electrocardiogram
B.Administer maintenance fluids
C.Obtain a chest radiograph
D.Administer an isotonic crystalloid bolus
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? - Answer- A.Increased diastolic blood pressure
B.Bounding peripheral pulses
C.Prolonged capillary refill
D.Increased urine output
You are discharging a patient home who has a history of depression. Discharge teaching should
include which of the following? - Answer- A.Discussing the importance of stopping all current
psychiatric medications.
B.Providing the family a list of behavioral health facilities to call for follow-up.
C.Explaining that the family should not call authorities for escalations in the patient's behavior.
D.Ensuring all firearms in the home are locked up with no access available by the patient.
A child with an electrical injury is seen 1 hour post event. Which of the following specimen
samples would provide visual information regarding a potential complication of this injury? -
Answer- A.Serum
B.Urine
C.Stool
D.Sputum
A 4-year-old patient is being assessed for a foreign body in the nose. The child is awake and alert
and watching a video on the caregivers phone. Vitals include HR of 110 beats/minute, RR of 26
breaths per minute, BP of 138/90 mm Hg, and T of 37.3oC (99.3oF) orally. Which of the following
interventions should the nurse perform next? - Answer- A.Check the size of the blood pressure
cuff
B.Recheck the temperature rectally
C.Recheck the blood pressure on the other arm
D.Place the patient on cardiac and respiratory monitors
A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of
consciousness with no pulses. Which of the following is the priority intervention? - Answer-
A.Utilize AED/defibrillator
B.Prepare for needle decompression
C.Administer intravenous epinephrine
D.Intubate with endotracheal tube
The triage nurse is assessing a 14 year old male who was brought in by ambulance. The patient
reports he was playing his video games at home when he had a sudden onset of groin pain that
was so severe he became nauseated and vomited. Further assessment reveals a swollen
scrotum. What is the priority intervention for this patient? - Answer- A.Obtaining a sterile urine
sample
B.Initiating intravenous access
C.Preparing the patient for ultrasound
D.Scanning the patient's bladder
,A caregiver reports their one-month-old has had a yellowish color to their eyes and skin over the
last two weeks. If left untreated, which body system can this affect? - Answer- A.Integumentary
B.Renal
C.Gastrointestinal
D.Neurological
An infant presents to the emergency department with difficulty breathing. The patient is pale and
respirations appear rapid and shallow. Which location on the torso is the most effective site for
assessing bilateral breath sounds? - Answer- A.Bilateral posterior back
B.Over the epigastrium
C.Bilateral midaxillary
D.Bilateral anterior chest
A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and
hypotension after eating lunch. Which of the following is the priority intervention? - Answer-
A.Intramuscular epinephrine
B.Inhaled albuterol
C.Oral diphenhydramine
D.Intravenous ondansetron
A 3-year-old is assessed for the presence of increasing amounts of serosanguineous drainage
from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely
etiology? - Answer- A.Magnet
B.Button battery
C.Dried bean
D.Fishing weight
Caregivers state an 18-month-old child had a harsh, barky cough, low-grade fever, and irritability
throughout the night. On assessment this morning, the child appears alert, is interactive, their
present cough is quiet, and their temperature is 98.8°F (37.1°C) axillary. Which of the following
diagnoses is the highest probablity for this child? - Answer- A.Asthma
B.Croup
C.Epiglottitis
D.Pneumonia
A 12-year-old female patient arrives awake and alert with an acute onset of abdominal pain on the
right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right
side and there is tenderness to the breasts. Which of the following laboratory tests is the priority
for this patient? - Answer- A.Human chorionic gonadotropin
B.Complete blood count
C.Vaginal cultures
D.Bedside glucose level
A fertilizer silo exploded during a school tour of a working farm. The children are able to manage
their own secretions but all are incontinent and salivating, with excess tearing. Which of the
following is the priority intervention? - Answer- A.Removal of clothing and decontamination
B.Establishing patient identification
C.Rapid administration of atropine
D.Providing supportive treatment
, A caregiver states their 3-year-old child ate some marijuana gummies approximately 3 hours prior
to arrival. The PAT reveals the child is pink, difficult to arouse, and work of breathing is normal.
What is your initial intervention? - Answer- A.Administer activated charcoal
B.Check the child's blood glucose
C.Initiate intravenous access
D.Obtain a full set of vital signs
A 14-year-old patient presents to the emergency department with her aunt after being assaulted.
The patient has multiple bruises inconsistent with the assault history and seems guarded with her
answers. A urine test is positive for pregnancy, although the patient denies being sexually active.
The aunt repeatedly asks when they will be discharged. The ED nurse recognizes these finding as
red flags for which of the following? - Answer- A.Labor trafficking
B.Sex trafficking
C.Psychological abuse
D.Physical abuse
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have
hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a
splenic rupture is suspected. Which of the following diagnoses should be suspected as a
companion injury with these findings and associated mechanism of injury? - Answer- A.Lumbar
fracture
B.Pneumothorax
C.Subdural hematoma
D.Cardiac tamponade
Which patient reflects an EMTALA compliant transfer? - Answer- A.An actively seizing toddler
being transferred to a pediatric-specific facility. That facility is checking on inpatient bed
availability.
B.A post-ictal patient with status epilepticus being transferred to a higher level of care with an
accepting physician. All records are copied.
C.A teenager with abdominal trauma and critical labs being transferred to a pediatric trauma
center for surgery. The facility has not accepted the transfer yet.
D.An infant with respiratory difficulties being transferred to another hospital with the same level of
pediatric care. Parents are not present, and records are copied.
After an explosion at a school, you are helping triage patients. In your field triage room you find a
5-year-old patient who is not breathing. What is the appropriate initial intervention? - Answer-
A.Assign the patient as black/expectant.
B.Open the airway and assess for breathing. - -
C.Check for capillary refill of < 2 seconds
D.Initiate cardiopulmonary resuscitation
Return of spontaneous circulation has been confirmed in a 5-year-old following cardiopulmonary
arrest after a 5-day history of vomiting and diarrhea. Vital signs are BP 72/60 mm Hg, HR 140
beats/minute, RR assisted at 30 breaths/minute via definitive airway, SpO2 97%, and T 36.8°C
(98.4°F) rectally. Which of the following would be the priority intervention at this time? - Answer-
A.Obtain a 12-lead electrocardiogram
B.Administer maintenance fluids
C.Obtain a chest radiograph
D.Administer an isotonic crystalloid bolus
