ENPC FINAL EXAM LATEST 2023- n n n n
2024 REAL EXAM 150 QUESTIONS AND CORRECT AN
n n n n n n n
SWERS (VERIFIED ANSWERS)|AGRADE n n
When a poison has been ingested by a child, the parents should be instructed to do whi
n n n n n n n n n n n n n n n n
ch of the following first?
n n n n
a) Induce vomiting. n
b) Call the local poison control center.
n n n n n
c) Administer an emetic. n n
d) Get to an emergency facility. - ANSWER-
n n n n n n
Call the local poison control center. Correct
n n n n n n n
RATIONALE:
Not all poisons should be vomited. Strong acids, for example, could cause as much de
n n n n n n n n n n n n n n
struction of tissue being vomited as being swallowed. The poison control center will
n n n n n n n n n n n n n
provide the most accurate information on the next steps for the patient.
n n n n n n n n n n n
Assessment of a child reveals a tension pneumothorax. The nurse would prepare the
n n n n n n n n n n n n n
child for which of the following?
n n n n n
a) Needle thoracotomy n
b) Suctioning
c) Intubation
d) Defibrillation - ANSWER- n n
Needle thoracotomy Correct
n n n
RATIONALE:
A needle thoracotomy is indicated for tension pneumothorax to relieve the air collect
n n n n n n n n n n n n
ed in the space. Intubation is indicated for apnea and in situations in which the airway
n n n n n n n n n n n n n n n
cannot be maintained. Suctioning would be indicated for excessive airway secretions
n n n n n n n n n n n
that influence airway patency. Defibrillation is used to stimulate or alter the heart's el
n n n n n n n n n n n n n n
ectrical rhythm. n
A 6-year-
n
old girl who is being treated for shock is pulseless with an irregular heart rate of 32 BP
n n n n n n n n n n n n n n n n n
M. Choose the priority intervention:
n n n n
,a) Administer doses defibrillator shocks in a row n n n n n n
b) Initiate cardiac compressions n n
c) Give three doses of epinephrine n n n n
d) Defibrillate once followed by three cycles of cardiopulmonary resuscitation (
n n n n n n n n n
CPR) - ANSWER- Initiate cardiac compressions
n n n n n
Correct
RATIONALE:
The American Heart Association (AHA) emphasizes the importance of cardiac comp
n n n n n n n n n n
ressions in pulseless clients with arrhythmias, making this the priority intervention in
n n n n n n n n n n n n
this situation. Current AHA recommendations are for defibrillation to be administere
n n n n n n n n n n
d once followed by five cycles of CPR. The AHA now recommends against using mu
n n n n n n n n n n n n n n
ltiple doses of epinephrine because they have not been shown to be helpful and may a
n n n n n n n n n n n n n n n
ctually cause harm to the child. n n n n n
A 3-year-old girl had a near-
n n n n n
drowning incident when she fell into a wading pool. Which intervention would be of t
n n n n n n n n n n n n n n
he highest priority?
n n
a) Inserting a nasogastric tube to decompress stomach n n n n n n
b) Assuring the child stays still during an X-ray n n n n n n n
c) Suctioning the upper airway to ensure airway patency n n n n n n n
d) Covering the child with warming blankets - ANSWER- n n n n n n n
nSuctioning the upper airway to ensure airway patency n n n n n n n
Correct
RATIONALE:
Due to the potentially devastating effects of drowning-
n n n n n n n
related hypoxia on a child's brain, airway interventions must be initiated immediatel
n n n n n n n n n n n
y. The child's airway should be suctioned to ensure patency. Other interventions suc
n n n n n n n n n n n n
h as covering the child with blankets, inserting a nasogastric tube, and assuring that t
n n n n n n n n n n n n n n
he child remains still during X-
n n n n n
ray are interventions that are appropriate once airway patency is achieved and maint
n n n n n n n n n n n n
ained.
The nurse is preparing an in-
n n n n n
service program on pediatric cardiopulmonary resuscitation. The nurse would includ
n n n n n n n n n
e a discussion that cardiopulmonary arrest in infants and children is most likely the re
n n n n n n n n n n n n n n
sult of which of the following?
n n n n n
a) Underlying heart disease n n
b) Respiratory failure n
c) Neurologic trauma n
d) Lethal arrhythmia - ANSWER- Respiratory failure
n n n n n
,Correct
RATIONALE:
Cardiopulmonary arrest in infants and children typically results from disorders that l n n n n n n n n n n n
ead to respiratory failure and shock. In adults, the most common causes of cardiopul
n n n n n n n n n n n n n
monary arrest are lethal arrhythmias secondary to heart disease. Although neurologic
n n n n n n n n n n
trauma can lead to respiratory failure, it alone is not the most likely factor.
n n n n n n n n n n n n n n
A 13-year-
n
old girl suffered a serious fall while hiking with friends and injured her head. She is n
n n n n n n n n n n n n n n n n
ow being evaluated by a nurse in the emergency room. The nurse notices clear fluid fl
n n n n n n n n n n n n n n n
owing from the girl's nose. The girl's friend said that she had been suffering from poll
n n n n n n n n n n n n n n n
en allergy recently. Which of the following interventions should the nurse implement
n n n n n n n n n n n
to determine whether the fluid is cerebrospinal fluid (CSF) or rhinitis from an allergy
n n n n n n n n n n n n n n
?
a) Evaluate the client's level of consciousness n n n n n
b) Assess the client's blood pressure n n n n
c) Perform a skull x-ray n n n
d) Test the fluid with a glucose reagent strip - ANSWER-
n n n n n n n n n
nTest the fluid with a glucose reagent strip
n n n n n n n
Correct
RATIONALE:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear, respectively) may b
n n n n n n n n n n n n n
e noticeable. The fluid is cerebrospinal fluid (CSF) and is a serious finding because it
n n n n n n n n n n n n n n n
means that the child's central nervous system is open to infection. If it's not clear if the
n n n n n n n n n n n n n n n n
nfluid is CSF or rhinitis from an allergy, test the fluid with a glucose reagent strip. CS
n n n n n n n n n n n n n n n n
F will test positive for glucose, whereas the clear, watery drainage from an upper resp
n n n n n n n n n n n n n n
iratory tract infection or allergy will not. The other interventions would not help deter
n n n n n n n n n n n n n
mine whether the fluid was CSF or rhinitis.
n n n n n n n
Which medication is used for symptomatic bradycardia unresponsive to ventilation a
n n n n n n n n n n
nd oxygenation?
n
a) Atropine
b) Naloxone
c) Sodium bicarbonate n
d) Calcium carbonate - ANSWER- n n n
Atropine Correct
n n
RATIONALE:
, Atropine is used for symptomatic bradycardia unresponsive to ventilation and oxyg
n n n n n n n n n n
enation. Sodium bicarbonate is used for metabolic acidosis. Naloxone reverses the e
n n n n n n n n n n n
ffect of opioids. Calcium carbonate is used for documented or suspected hypocalce
n n n n n n n n n n n
mia, hyperkalemia, hypermagnesemia, and calcium channel blocker overdose.
n n n n n n n
The nurse must calculate the adolescent's cardiac output. The child's heart rate is 7
n n n n n n n n n n n n n
6 beats per minute and the stroke volume is 75 mL. Calculate the child's cardiac out
n n n n n n n n n n n n n n n
put. - ANSWER- 5700 n n n
RATIONALE:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke volume (SV).
n n n n n n n n n n n n n n
That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
n n n n n n n n n n n n n n n
A 4-year-
n
old girl has been admitted to the emergency department after accidently ingesting a cl
n n n n n n n n n n n n n
eaning product. Which of the following treatments is most likely appropriate in the i
n n n n n n n n n n n n n
mmediate treatment of the girl's poisoning? n n n n n
a) Intravenous rehydration n
b) Administration of activated charcoal n n n
c) Gastric lavage n
d) Inducing vomiting - ANSWER- Administration of activated charcoal
n n n n n n n
RATIONALE:
Explanation:
Activated charcoal is the most common treatment for many poisonings and is more ef
n n n n n n n n n n n n n
fective and safe than induced vomiting or gastric lavage. Rehydration is likely necess
n n n n n n n n n n n n
ary, but this does not actively treat the girl's poisoning.
n n n n n n n n n
The child's ability to perfuse well is poor due to inadequate circulation. The physician
n n n n n n n n n n n n n
nwrites an order for the child to receive 20 mL of normal saline for each kilogram of bo
n n n n n n n n n n n n n n n n n
dy weight. The child will receive the normal saline as a bolus through a central intrav
n n n n n n n n n n n n n n n
enous line. The child weighs 78 pounds. Calculate
n n n n n n n
the amount of normal saline the nurse should administer as a bolus. Round to the near
n n n n n n n n n n n n n n n
est whole number.
n n
mL - ANSWER- 709 n n n
RATIONALE:
78 pounds x 1 kg/2.2 pounds = 35.455 kg x 20 mL/kg = 709.1 mL. When rounded to t
n n n n n n n n n n n n n n n n n n
he nearest whole number = 709 mL
n n n n n n
2024 REAL EXAM 150 QUESTIONS AND CORRECT AN
n n n n n n n
SWERS (VERIFIED ANSWERS)|AGRADE n n
When a poison has been ingested by a child, the parents should be instructed to do whi
n n n n n n n n n n n n n n n n
ch of the following first?
n n n n
a) Induce vomiting. n
b) Call the local poison control center.
n n n n n
c) Administer an emetic. n n
d) Get to an emergency facility. - ANSWER-
n n n n n n
Call the local poison control center. Correct
n n n n n n n
RATIONALE:
Not all poisons should be vomited. Strong acids, for example, could cause as much de
n n n n n n n n n n n n n n
struction of tissue being vomited as being swallowed. The poison control center will
n n n n n n n n n n n n n
provide the most accurate information on the next steps for the patient.
n n n n n n n n n n n
Assessment of a child reveals a tension pneumothorax. The nurse would prepare the
n n n n n n n n n n n n n
child for which of the following?
n n n n n
a) Needle thoracotomy n
b) Suctioning
c) Intubation
d) Defibrillation - ANSWER- n n
Needle thoracotomy Correct
n n n
RATIONALE:
A needle thoracotomy is indicated for tension pneumothorax to relieve the air collect
n n n n n n n n n n n n
ed in the space. Intubation is indicated for apnea and in situations in which the airway
n n n n n n n n n n n n n n n
cannot be maintained. Suctioning would be indicated for excessive airway secretions
n n n n n n n n n n n
that influence airway patency. Defibrillation is used to stimulate or alter the heart's el
n n n n n n n n n n n n n n
ectrical rhythm. n
A 6-year-
n
old girl who is being treated for shock is pulseless with an irregular heart rate of 32 BP
n n n n n n n n n n n n n n n n n
M. Choose the priority intervention:
n n n n
,a) Administer doses defibrillator shocks in a row n n n n n n
b) Initiate cardiac compressions n n
c) Give three doses of epinephrine n n n n
d) Defibrillate once followed by three cycles of cardiopulmonary resuscitation (
n n n n n n n n n
CPR) - ANSWER- Initiate cardiac compressions
n n n n n
Correct
RATIONALE:
The American Heart Association (AHA) emphasizes the importance of cardiac comp
n n n n n n n n n n
ressions in pulseless clients with arrhythmias, making this the priority intervention in
n n n n n n n n n n n n
this situation. Current AHA recommendations are for defibrillation to be administere
n n n n n n n n n n
d once followed by five cycles of CPR. The AHA now recommends against using mu
n n n n n n n n n n n n n n
ltiple doses of epinephrine because they have not been shown to be helpful and may a
n n n n n n n n n n n n n n n
ctually cause harm to the child. n n n n n
A 3-year-old girl had a near-
n n n n n
drowning incident when she fell into a wading pool. Which intervention would be of t
n n n n n n n n n n n n n n
he highest priority?
n n
a) Inserting a nasogastric tube to decompress stomach n n n n n n
b) Assuring the child stays still during an X-ray n n n n n n n
c) Suctioning the upper airway to ensure airway patency n n n n n n n
d) Covering the child with warming blankets - ANSWER- n n n n n n n
nSuctioning the upper airway to ensure airway patency n n n n n n n
Correct
RATIONALE:
Due to the potentially devastating effects of drowning-
n n n n n n n
related hypoxia on a child's brain, airway interventions must be initiated immediatel
n n n n n n n n n n n
y. The child's airway should be suctioned to ensure patency. Other interventions suc
n n n n n n n n n n n n
h as covering the child with blankets, inserting a nasogastric tube, and assuring that t
n n n n n n n n n n n n n n
he child remains still during X-
n n n n n
ray are interventions that are appropriate once airway patency is achieved and maint
n n n n n n n n n n n n
ained.
The nurse is preparing an in-
n n n n n
service program on pediatric cardiopulmonary resuscitation. The nurse would includ
n n n n n n n n n
e a discussion that cardiopulmonary arrest in infants and children is most likely the re
n n n n n n n n n n n n n n
sult of which of the following?
n n n n n
a) Underlying heart disease n n
b) Respiratory failure n
c) Neurologic trauma n
d) Lethal arrhythmia - ANSWER- Respiratory failure
n n n n n
,Correct
RATIONALE:
Cardiopulmonary arrest in infants and children typically results from disorders that l n n n n n n n n n n n
ead to respiratory failure and shock. In adults, the most common causes of cardiopul
n n n n n n n n n n n n n
monary arrest are lethal arrhythmias secondary to heart disease. Although neurologic
n n n n n n n n n n
trauma can lead to respiratory failure, it alone is not the most likely factor.
n n n n n n n n n n n n n n
A 13-year-
n
old girl suffered a serious fall while hiking with friends and injured her head. She is n
n n n n n n n n n n n n n n n n
ow being evaluated by a nurse in the emergency room. The nurse notices clear fluid fl
n n n n n n n n n n n n n n n
owing from the girl's nose. The girl's friend said that she had been suffering from poll
n n n n n n n n n n n n n n n
en allergy recently. Which of the following interventions should the nurse implement
n n n n n n n n n n n
to determine whether the fluid is cerebrospinal fluid (CSF) or rhinitis from an allergy
n n n n n n n n n n n n n n
?
a) Evaluate the client's level of consciousness n n n n n
b) Assess the client's blood pressure n n n n
c) Perform a skull x-ray n n n
d) Test the fluid with a glucose reagent strip - ANSWER-
n n n n n n n n n
nTest the fluid with a glucose reagent strip
n n n n n n n
Correct
RATIONALE:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear, respectively) may b
n n n n n n n n n n n n n
e noticeable. The fluid is cerebrospinal fluid (CSF) and is a serious finding because it
n n n n n n n n n n n n n n n
means that the child's central nervous system is open to infection. If it's not clear if the
n n n n n n n n n n n n n n n n
nfluid is CSF or rhinitis from an allergy, test the fluid with a glucose reagent strip. CS
n n n n n n n n n n n n n n n n
F will test positive for glucose, whereas the clear, watery drainage from an upper resp
n n n n n n n n n n n n n n
iratory tract infection or allergy will not. The other interventions would not help deter
n n n n n n n n n n n n n
mine whether the fluid was CSF or rhinitis.
n n n n n n n
Which medication is used for symptomatic bradycardia unresponsive to ventilation a
n n n n n n n n n n
nd oxygenation?
n
a) Atropine
b) Naloxone
c) Sodium bicarbonate n
d) Calcium carbonate - ANSWER- n n n
Atropine Correct
n n
RATIONALE:
, Atropine is used for symptomatic bradycardia unresponsive to ventilation and oxyg
n n n n n n n n n n
enation. Sodium bicarbonate is used for metabolic acidosis. Naloxone reverses the e
n n n n n n n n n n n
ffect of opioids. Calcium carbonate is used for documented or suspected hypocalce
n n n n n n n n n n n
mia, hyperkalemia, hypermagnesemia, and calcium channel blocker overdose.
n n n n n n n
The nurse must calculate the adolescent's cardiac output. The child's heart rate is 7
n n n n n n n n n n n n n
6 beats per minute and the stroke volume is 75 mL. Calculate the child's cardiac out
n n n n n n n n n n n n n n n
put. - ANSWER- 5700 n n n
RATIONALE:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke volume (SV).
n n n n n n n n n n n n n n
That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
n n n n n n n n n n n n n n n
A 4-year-
n
old girl has been admitted to the emergency department after accidently ingesting a cl
n n n n n n n n n n n n n
eaning product. Which of the following treatments is most likely appropriate in the i
n n n n n n n n n n n n n
mmediate treatment of the girl's poisoning? n n n n n
a) Intravenous rehydration n
b) Administration of activated charcoal n n n
c) Gastric lavage n
d) Inducing vomiting - ANSWER- Administration of activated charcoal
n n n n n n n
RATIONALE:
Explanation:
Activated charcoal is the most common treatment for many poisonings and is more ef
n n n n n n n n n n n n n
fective and safe than induced vomiting or gastric lavage. Rehydration is likely necess
n n n n n n n n n n n n
ary, but this does not actively treat the girl's poisoning.
n n n n n n n n n
The child's ability to perfuse well is poor due to inadequate circulation. The physician
n n n n n n n n n n n n n
nwrites an order for the child to receive 20 mL of normal saline for each kilogram of bo
n n n n n n n n n n n n n n n n n
dy weight. The child will receive the normal saline as a bolus through a central intrav
n n n n n n n n n n n n n n n
enous line. The child weighs 78 pounds. Calculate
n n n n n n n
the amount of normal saline the nurse should administer as a bolus. Round to the near
n n n n n n n n n n n n n n n
est whole number.
n n
mL - ANSWER- 709 n n n
RATIONALE:
78 pounds x 1 kg/2.2 pounds = 35.455 kg x 20 mL/kg = 709.1 mL. When rounded to t
n n n n n n n n n n n n n n n n n n
he nearest whole number = 709 mL
n n n n n n
