ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - CORRECT ANSWER B
The presence of bilious emesis is especially concerning because it may be indicative of an
immediately life-threatening bowel obstruction. A dislodged gastrostomy tube should be
reinserted within 4-6 hours to prevent stoma closure. Vomiting following a handlebar injury may
be indicative of many possible injuries, but does not take precedence unless other symptoms are
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
present. Infantile colic is described as inconsolable crying in infants, 2 weeks to 4 months old,
for up to 3 hours per day, more than 3 days per week, and lasting for more than 3 weeks.
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help prevent further
seizures. Contacting child protective services and other authorities can wait. The patient is post-
ictal so does not require lorazepam medication at this time. Pain medication can and should be
considered with significant burns, but is not a priority.
What is the priority intervention for symptomatic bradycardia in a four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - CORRECT ANSWER C
\
Identifying and treating other causes, chest compressions, and epinephrine are interventions for
pediatric bradycardia with signs of poor perfusion that are not improved by adequate
oxygenation and ventilation. Atropine and pacing may be considered if there is no response to
the other interventions.
A 5-year-old child presents to the emergency department after being hit by a car. The patient
complains of left upper quadrant pain, and the focused assessment with sonography for trauma
(FAST) exam shows fluid around her spleen. Which of the following findings would be an early
indication of ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - CORRECT ANSWER D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The nurse
may note a strong central pulse but weaker peripheral pulses, indicating the child is
compensating by shunting blood to their core.
inconsolable crying - CORRECT ANSWER rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than three weeks
A three-year-old is rescued after being submerged in a pool for several minutes. On arrival the
patient is responsive to painful stimuli with shallow respirations, diminished breath sounds, and
an occasional cough. Which of the following interventions is the initial management priority?
A.Initiation of abdominal thrusts to remove fluid from the lungs
B.Insertion of orogastric to remove of water and debris from stomach
C.Endotracheal intubation to provide positive pressure ventilation
D.Removal of wet clothing to prevent hypothermia - CORRECT ANSWER C
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
The primary survey assessment and treatment of deficits are the priority. Airway control and
positive pressure ventilation while preparing for intubation of a child who meets intubation
criteria (GCS < 8) should be performed while also maintaining cervical spine stabilization. The
child is responsive only to painful stimuli, has shallow respirations, and diminished breath
sounds. All of these are breathing problems and must be addressed immediately. Removing wet
clothing is necessary, but is not the main priority initially. With intubation an orogastric tube will
be placed and abdominal thrusts are not necessary to remove fluid from the abdomen.
A 3-month-old is brought to the emergency department with new onset of fever. You note the
child to be pale, tachypneic, and tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
A.Administer an appropriate dose of an antipyretic
B.Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C.Prepare a broad spectrum antibiotic infusion
D.Administer a vasoactive medication - CORRECT ANSWER B
This patient most likely has septic shock. An immediate goal is to reverse shock and restore
tissue perfusion with fluids. An antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and vasoactive medications may not
be needed if fluid resuscitation is successfu
A 6-month-old is seen for a recurrent respiratory infection. During the assessment, the mother
adds that the patient's stools seem to be fatty or "greasy". Which of the following disease
processes would be a primary concern for this child?
A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - CORRECT ANSWER A
In patients with cystic fibrosis, thick mucus inhibits the release of pancreatic enzymes necessary
for digestion. This results in impaired absorption and the inability to utilize ingested fats. These
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
fats are excreted in the stools and can present as "fatty" or "greasy". Combined with the recurrent
upper respiratory infections for an infant, cystic fibrosis should be ruled out. The other three
disease processes frequently present with respiratory issues but fatty stools would not normally
be seen.
A 14-year-old patient sustained a displaced fracture of the radius and ulna after falling from a
bicycle. Which of the following pain control interventions is most likely to result in
improvement in symptoms related to pain?
A.Applying a topical lidocaine-based cream
B.Elevating the extremity to the level of the heart
C.Placing warm compresses on the affected extremity
D.Applying a splint to the affected extremity - CORRECT ANSWER D
Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures.
This will also help to minimize complications. Topical creams and elevation of the extremity
will not help with pain control. The application of ice in an appropriate manner can help, but not
warmth which would be contraindicated in the early stages of the injury.
Which of the following is a known cause of pediatric seizures?
A.Benzodiazepine overdose
B.Supraventricular tachycardia
C.Overdiluted formula
D.Congenital heart disease - CORRECT ANSWER C
Water overload is a well-documented etiology of hyponatremia in infants, which can be caused
by excess dilution of formula. Hyponatremia is a known cause of seizures. Benzodiazepine
overdose is more likely to result is respiratory depression and coma. CHD and SVT are not
readily known to cause seizures.
For the infant, what duration of time is consider apneic?
A.10 seconds
B.20 seconds
C.5 seconds
D.15 seconds - CORRECT ANSWER B
The respiratory rate, depth, and regularity all continue to change the first year of life, making
respiratory assessments different than those of older children. Infants breathe faster and less
regularly, with apnea not considered as such until 20 seconds without a breath or associated with
other physiologic effects such as bradycardia.
An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated
prior to arrival. Which of the following is the priority assessment or intervention?
A. Assess the oropharynx
B. Assess endotracheal tube placement
C. Insert an orogastric tube
D. Insert a second intravenous access - CORRECT ANSWER B
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
Which of the following patients should be evaluated first?
A.A 3-year-old with a dislodged gastrostomy tube
B.An 18-month-old with bilious emesis
C.A 12-year-old with vomiting after a handlebar injury
D.A 3-month-old with periods of inconsolable crying - CORRECT ANSWER B
The presence of bilious emesis is especially concerning because it may be indicative of an
immediately life-threatening bowel obstruction. A dislodged gastrostomy tube should be
reinserted within 4-6 hours to prevent stoma closure. Vomiting following a handlebar injury may
be indicative of many possible injuries, but does not take precedence unless other symptoms are
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
present. Infantile colic is described as inconsolable crying in infants, 2 weeks to 4 months old,
for up to 3 hours per day, more than 3 days per week, and lasting for more than 3 weeks.
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte
imbalances. Early identification and treatment of electrolyte imbalances can help prevent further
seizures. Contacting child protective services and other authorities can wait. The patient is post-
ictal so does not require lorazepam medication at this time. Pain medication can and should be
considered with significant burns, but is not a priority.
What is the priority intervention for symptomatic bradycardia in a four-year-old child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - CORRECT ANSWER C
\
Identifying and treating other causes, chest compressions, and epinephrine are interventions for
pediatric bradycardia with signs of poor perfusion that are not improved by adequate
oxygenation and ventilation. Atropine and pacing may be considered if there is no response to
the other interventions.
A 5-year-old child presents to the emergency department after being hit by a car. The patient
complains of left upper quadrant pain, and the focused assessment with sonography for trauma
(FAST) exam shows fluid around her spleen. Which of the following findings would be an early
indication of ongoing blood loss?
A.Widening pulse pressure
B.Bradycardia
C.Decreasing diastolic blood pressure
D.Weak peripheral pulses - CORRECT ANSWER D
Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The nurse
may note a strong central pulse but weaker peripheral pulses, indicating the child is
compensating by shunting blood to their core.
inconsolable crying - CORRECT ANSWER rule of 3s:
crying more than 3 hours per day, more than three days per week, for longer than three weeks
A three-year-old is rescued after being submerged in a pool for several minutes. On arrival the
patient is responsive to painful stimuli with shallow respirations, diminished breath sounds, and
an occasional cough. Which of the following interventions is the initial management priority?
A.Initiation of abdominal thrusts to remove fluid from the lungs
B.Insertion of orogastric to remove of water and debris from stomach
C.Endotracheal intubation to provide positive pressure ventilation
D.Removal of wet clothing to prevent hypothermia - CORRECT ANSWER C
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
The primary survey assessment and treatment of deficits are the priority. Airway control and
positive pressure ventilation while preparing for intubation of a child who meets intubation
criteria (GCS < 8) should be performed while also maintaining cervical spine stabilization. The
child is responsive only to painful stimuli, has shallow respirations, and diminished breath
sounds. All of these are breathing problems and must be addressed immediately. Removing wet
clothing is necessary, but is not the main priority initially. With intubation an orogastric tube will
be placed and abdominal thrusts are not necessary to remove fluid from the abdomen.
A 3-month-old is brought to the emergency department with new onset of fever. You note the
child to be pale, tachypneic, and tachycardic, with weak distal pulses. Which intervention is the
priority for this patient?
A.Administer an appropriate dose of an antipyretic
B.Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid
C.Prepare a broad spectrum antibiotic infusion
D.Administer a vasoactive medication - CORRECT ANSWER B
This patient most likely has septic shock. An immediate goal is to reverse shock and restore
tissue perfusion with fluids. An antipyretic may be needed based on the temperature and patient
symptoms. An antibiotic should be started within an hour, and vasoactive medications may not
be needed if fluid resuscitation is successfu
A 6-month-old is seen for a recurrent respiratory infection. During the assessment, the mother
adds that the patient's stools seem to be fatty or "greasy". Which of the following disease
processes would be a primary concern for this child?
A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - CORRECT ANSWER A
In patients with cystic fibrosis, thick mucus inhibits the release of pancreatic enzymes necessary
for digestion. This results in impaired absorption and the inability to utilize ingested fats. These
, ENPC 6 EDITION QUESTIONS AND CORRECT
ANSWERS REAL EXAM WITH TESTED
QUESTIONS AND RATIONALE
ALREADY GRADED A FOR GUARANTEED
PASSLATEST UPDATE 2025.
fats are excreted in the stools and can present as "fatty" or "greasy". Combined with the recurrent
upper respiratory infections for an infant, cystic fibrosis should be ruled out. The other three
disease processes frequently present with respiratory issues but fatty stools would not normally
be seen.
A 14-year-old patient sustained a displaced fracture of the radius and ulna after falling from a
bicycle. Which of the following pain control interventions is most likely to result in
improvement in symptoms related to pain?
A.Applying a topical lidocaine-based cream
B.Elevating the extremity to the level of the heart
C.Placing warm compresses on the affected extremity
D.Applying a splint to the affected extremity - CORRECT ANSWER D
Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures.
This will also help to minimize complications. Topical creams and elevation of the extremity
will not help with pain control. The application of ice in an appropriate manner can help, but not
warmth which would be contraindicated in the early stages of the injury.
Which of the following is a known cause of pediatric seizures?
A.Benzodiazepine overdose
B.Supraventricular tachycardia
C.Overdiluted formula
D.Congenital heart disease - CORRECT ANSWER C
Water overload is a well-documented etiology of hyponatremia in infants, which can be caused
by excess dilution of formula. Hyponatremia is a known cause of seizures. Benzodiazepine
overdose is more likely to result is respiratory depression and coma. CHD and SVT are not
readily known to cause seizures.
For the infant, what duration of time is consider apneic?
A.10 seconds
B.20 seconds
C.5 seconds
D.15 seconds - CORRECT ANSWER B
The respiratory rate, depth, and regularity all continue to change the first year of life, making
respiratory assessments different than those of older children. Infants breathe faster and less
regularly, with apnea not considered as such until 20 seconds without a breath or associated with
other physiologic effects such as bradycardia.
An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated
prior to arrival. Which of the following is the priority assessment or intervention?
A. Assess the oropharynx
B. Assess endotracheal tube placement
C. Insert an orogastric tube
D. Insert a second intravenous access - CORRECT ANSWER B
