ENPC EXAM 6TH UNIT QUESTIONS WITH CORRECT i i i i i i
i DETAILED ANSWERS i
1. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss,and dry mucous membranes.Vital
ii ii ii ii ii ii ii ii ii i ii ii ii i
signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
the following laboratory values would be most expected in this child?
ii ii ii ii ii ii ii ii ii ii ii
..ANSWER>> Hypoglycemia (wrong)Remediation feedback: ii ii ii
Children can present with new onset diabetes in diabetic ketoacidosis.Manifesta-
ii ii ii ii ii ii ii ii ii i
tionsincludesignsofdehydration(drymucousmembranes,hypotension,tachycar- dia), incontinence (polyuria), vomiting,
ii i i i i i i i i i i ii ii ii ii
abdominal pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia, and weight loss. Expected laboratory
ii ii ii ii ii ii ii ii ii ii ii ii ii i ii
values would reveal an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate level, and an elevated blood
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
glucose level > 200 mg.dL.
ii ii ii ii ii
2. An18-month-oldisseenforfever,slightcircumoralcyanosis,andwheezing noted on auscultation in the right upper
i i i i i i i i i i ii ii ii ii ii ii ii
lobe of the lung field after a choking event4daysago.Thewhitebloodcellcountiselevatedandthepatientnoted to be
ii ii ii ii ii ii ii ii ii i i i i i i i i i i i i i i ii ii
tachypneic, tachycardic, agitated, and has an increased respiratory effort. At the time of the event, the patient was
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
started on antibiotics with subsequent increasing manifestations instead of improvement.Which of the following
ii ii ii ii ii ii ii ii ii ii i ii ii ii
would be considered to be definitive treatment for the suspected diagnosis?
ii ii ii ii ii ii ii ii ii ii ii
..ANSWER>> Computed tomography (wrong)Remediation feedback:
i i ii ii ii ii
Manifestationsofalowerairwayforeignbodyincludeachokingincidentwithsubse- quent failure to improve on i i i i i i i i i i i i ii ii ii ii ii
antibiotics.Wheezing or decreased lung sounds in one area of the pulmonarysystem is a high indicator for aforeign bodyalong
ii i ii ii ii ii ii ii ii ii i i ii i i i i i i i ii ii
with signs of hypoxia such as cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and
ii i ii ii ii ii ii ii ii ii ii ii ii ii ii ii
elevated white blood cell counts indicating an infectious process.The definitive treatment would be a bronchoscopy in order
ii ii ii ii ii ii ii ii ii i ii ii ii ii ii ii ii ii
to retrieve the suspected foreign body instead of diagnostic tests to locate the foreign body itself.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
3. A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a bag-mask
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii device. Once return of spontaneous circulation has been confirmed,which of the following would be the priority
ii ii ii ii ii ii ii ii i ii ii ii ii ii ii ii
ii intervention?
ii ..ANSWER>> Establishing a secure airway i ii ii ii
4. Parents report their 3-year-old child has developed noisy breathing. On assessment,high-pitchedwheezesare
ii ii ii ii ii ii ii ii ii ii i i i
audibleandauscultatedoninspiration and expiration.What medication would be appropriate to administer
i i i i i ii ii i ii ii ii ii ii ii
..ANSWER>> first?: - Humidified oxygen (wrong)
i ii i ii ii ii
1|P a g
i i
,Remediation feedback: ii
Wheezing is most often identified with asthma in the pediatric population.Initial medication intervention includes an inhaled
ii ii ii ii ii ii ii ii ii ii i ii ii ii ii ii
short-acting beta agonist.
ii ii ii
5. A 6-week-old is brought to the emergency department by the caregivers for poorfeeding,listlessness,and
ii ii ii ii ii ii ii ii ii ii ii ii ii i i
fever.Assessment reveals a crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F
ii i ii ii ii i ii ii ii ii ii ii ii ii ii ii ii
(35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings what is the most likely
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
diagnostic test the nurse should anticipate?
ii ii ii ii ii ii
..ANSWER>> Lumbar puncture
i ii ii
6. A12-year-oldisbeingpreppedforsurgicalinterventionofacuteappendici- tis.Which of the following intravenous
i i i i i i i i i i ii i ii ii ii ii
ii medication orders should the nurse question? ii ii ii ii ii
i ..ANSWER>> Hydromorphone (wrong) ii ii
Remediation feedback: ii
Ketorolac is an appropriate medication for moderate to severe pain, however, it shouldnotbeusedpre-operativelyduetoits
ii ii ii ii ii ii ii ii ii ii ii ii i i i i i i i
potentialtoincreasethebleedingrisk.
i i i i i i
7. A 17-year-old female arrives in the ED with her boyfriend who states she is
ii ii ii ii ii ii ii ii ii ii ii ii ii
pregnantandhavingvaginalbleeding.Thepatientisunsureofthegestational age and has not had any prenatal
ii i i i i i i i i i i i ii ii ii ii ii ii ii
treatment.The patient is quiet and lets her boyfriend answer most of the questions.Which of the following is the most
ii i ii ii ii ii ii ii ii ii ii ii ii ii i ii ii ii ii ii ii
appropriateactionforthenursetotakeatthispoint?
ii i i i i i i i i i
..ANSWER>> Havetheboyfriendleave the room during the pelvic exam.
i i i i i ii ii ii ii ii ii
8. A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After several attempts, your
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii team has been unsuccessful at establishing vascular access.Of the following,which is the next best option for
ii ii ii ii ii ii ii i ii ii i ii ii ii ii ii ii
ii establishing access quickly? ii ii
i ..ANSWER>> Intraosseous in the patient's medial tibia. ii ii ii ii ii ii
9. A child with an electrical injury is seen 1 hour post event. Which of the fol-
i ii ii ii ii ii ii ii ii ii ii i ii ii ii
ii lowingtypesofspecimensampleswouldprovidevisualinformationregarding a potential complication of this injury?
i i i i i i i i i ii ii ii ii ii ii
i ..ANSWER>> Sputum (wrong) i ii ii
Remediation feedback: ii
Electrical injuries,though theymayappear tobesmall, canproducelargeamounts of damage internally, including muscle
i i i i i i i i i i i i ii ii ii ii ii
damage.Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine.
ii i ii ii ii ii ii ii ii ii ii ii ii ii
10. Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures appear
ii ii ii ii ii ii ii ii ii ii ii ii ii
to be distressed and withdrawn. Whichofthefollowinginterventionswouldbestensureasenseofcomfortand controlfor
ii ii ii ii ii ii i i i i i i i i i i i i ii i
theseparents?
i i
..ANSWER>> Providingfrequent updatesandre-educatingthemon the care that is being provided
i ii i i i i i i ii ii ii ii ii ii
2|P a g
i i
i DETAILED ANSWERS i
1. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss,and dry mucous membranes.Vital
ii ii ii ii ii ii ii ii ii i ii ii ii i
signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
the following laboratory values would be most expected in this child?
ii ii ii ii ii ii ii ii ii ii ii
..ANSWER>> Hypoglycemia (wrong)Remediation feedback: ii ii ii
Children can present with new onset diabetes in diabetic ketoacidosis.Manifesta-
ii ii ii ii ii ii ii ii ii i
tionsincludesignsofdehydration(drymucousmembranes,hypotension,tachycar- dia), incontinence (polyuria), vomiting,
ii i i i i i i i i i i ii ii ii ii
abdominal pain, Kussmaul respirations (to counter the acidosis), polydipsia, anorexia, and weight loss. Expected laboratory
ii ii ii ii ii ii ii ii ii ii ii ii ii i ii
values would reveal an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate level, and an elevated blood
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
glucose level > 200 mg.dL.
ii ii ii ii ii
2. An18-month-oldisseenforfever,slightcircumoralcyanosis,andwheezing noted on auscultation in the right upper
i i i i i i i i i i ii ii ii ii ii ii ii
lobe of the lung field after a choking event4daysago.Thewhitebloodcellcountiselevatedandthepatientnoted to be
ii ii ii ii ii ii ii ii ii i i i i i i i i i i i i i i ii ii
tachypneic, tachycardic, agitated, and has an increased respiratory effort. At the time of the event, the patient was
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
started on antibiotics with subsequent increasing manifestations instead of improvement.Which of the following
ii ii ii ii ii ii ii ii ii ii i ii ii ii
would be considered to be definitive treatment for the suspected diagnosis?
ii ii ii ii ii ii ii ii ii ii ii
..ANSWER>> Computed tomography (wrong)Remediation feedback:
i i ii ii ii ii
Manifestationsofalowerairwayforeignbodyincludeachokingincidentwithsubse- quent failure to improve on i i i i i i i i i i i i ii ii ii ii ii
antibiotics.Wheezing or decreased lung sounds in one area of the pulmonarysystem is a high indicator for aforeign bodyalong
ii i ii ii ii ii ii ii ii ii i i ii i i i i i i i ii ii
with signs of hypoxia such as cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and
ii i ii ii ii ii ii ii ii ii ii ii ii ii ii ii
elevated white blood cell counts indicating an infectious process.The definitive treatment would be a bronchoscopy in order
ii ii ii ii ii ii ii ii ii i ii ii ii ii ii ii ii ii
to retrieve the suspected foreign body instead of diagnostic tests to locate the foreign body itself.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
3. A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a bag-mask
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii device. Once return of spontaneous circulation has been confirmed,which of the following would be the priority
ii ii ii ii ii ii ii ii i ii ii ii ii ii ii ii
ii intervention?
ii ..ANSWER>> Establishing a secure airway i ii ii ii
4. Parents report their 3-year-old child has developed noisy breathing. On assessment,high-pitchedwheezesare
ii ii ii ii ii ii ii ii ii ii i i i
audibleandauscultatedoninspiration and expiration.What medication would be appropriate to administer
i i i i i ii ii i ii ii ii ii ii ii
..ANSWER>> first?: - Humidified oxygen (wrong)
i ii i ii ii ii
1|P a g
i i
,Remediation feedback: ii
Wheezing is most often identified with asthma in the pediatric population.Initial medication intervention includes an inhaled
ii ii ii ii ii ii ii ii ii ii i ii ii ii ii ii
short-acting beta agonist.
ii ii ii
5. A 6-week-old is brought to the emergency department by the caregivers for poorfeeding,listlessness,and
ii ii ii ii ii ii ii ii ii ii ii ii ii i i
fever.Assessment reveals a crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F
ii i ii ii ii i ii ii ii ii ii ii ii ii ii ii ii
(35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings what is the most likely
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
diagnostic test the nurse should anticipate?
ii ii ii ii ii ii
..ANSWER>> Lumbar puncture
i ii ii
6. A12-year-oldisbeingpreppedforsurgicalinterventionofacuteappendici- tis.Which of the following intravenous
i i i i i i i i i i ii i ii ii ii ii
ii medication orders should the nurse question? ii ii ii ii ii
i ..ANSWER>> Hydromorphone (wrong) ii ii
Remediation feedback: ii
Ketorolac is an appropriate medication for moderate to severe pain, however, it shouldnotbeusedpre-operativelyduetoits
ii ii ii ii ii ii ii ii ii ii ii ii i i i i i i i
potentialtoincreasethebleedingrisk.
i i i i i i
7. A 17-year-old female arrives in the ED with her boyfriend who states she is
ii ii ii ii ii ii ii ii ii ii ii ii ii
pregnantandhavingvaginalbleeding.Thepatientisunsureofthegestational age and has not had any prenatal
ii i i i i i i i i i i i ii ii ii ii ii ii ii
treatment.The patient is quiet and lets her boyfriend answer most of the questions.Which of the following is the most
ii i ii ii ii ii ii ii ii ii ii ii ii ii i ii ii ii ii ii ii
appropriateactionforthenursetotakeatthispoint?
ii i i i i i i i i i
..ANSWER>> Havetheboyfriendleave the room during the pelvic exam.
i i i i i ii ii ii ii ii ii
8. A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After several attempts, your
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
ii team has been unsuccessful at establishing vascular access.Of the following,which is the next best option for
ii ii ii ii ii ii ii i ii ii i ii ii ii ii ii ii
ii establishing access quickly? ii ii
i ..ANSWER>> Intraosseous in the patient's medial tibia. ii ii ii ii ii ii
9. A child with an electrical injury is seen 1 hour post event. Which of the fol-
i ii ii ii ii ii ii ii ii ii ii i ii ii ii
ii lowingtypesofspecimensampleswouldprovidevisualinformationregarding a potential complication of this injury?
i i i i i i i i i ii ii ii ii ii ii
i ..ANSWER>> Sputum (wrong) i ii ii
Remediation feedback: ii
Electrical injuries,though theymayappear tobesmall, canproducelargeamounts of damage internally, including muscle
i i i i i i i i i i i i ii ii ii ii ii
damage.Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine.
ii i ii ii ii ii ii ii ii ii ii ii ii ii
10. Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures appear
ii ii ii ii ii ii ii ii ii ii ii ii ii
to be distressed and withdrawn. Whichofthefollowinginterventionswouldbestensureasenseofcomfortand controlfor
ii ii ii ii ii ii i i i i i i i i i i i i ii i
theseparents?
i i
..ANSWER>> Providingfrequent updatesandre-educatingthemon the care that is being provided
i ii i i i i i i ii ii ii ii ii ii
2|P a g
i i
