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ENPC 6th Edition Study Guide 2025 | Emergency Nursing Pediatric
Course Practice Test, Scenarios, and Answer Key
Master the ENPC 6th Edition with this 2025 updated study guide. Covers pediatric assessment,
trauma, shock, respiratory and cardiac emergencies, pharmacology, and family-centered care.
Includes ENPC-style practice questions, case studies, and detailed answer rationales aligned with
the Emergency Nurses Association (ENA) guidelines.
• ENPC 6th Edition 2025
• ENPC study guide PDF
• Emergency Nursing Pediatric Course 6th Edition
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 - 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?
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A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - 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 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 - 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.
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 - ANSWER-D
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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.
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 - 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 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.
inconsolable crying - 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 - ANSWER-C
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
ENPC 6th Edition Study Guide 2025 | Emergency Nursing Pediatric
Course Practice Test, Scenarios, and Answer Key
Master the ENPC 6th Edition with this 2025 updated study guide. Covers pediatric assessment,
trauma, shock, respiratory and cardiac emergencies, pharmacology, and family-centered care.
Includes ENPC-style practice questions, case studies, and detailed answer rationales aligned with
the Emergency Nurses Association (ENA) guidelines.
• ENPC 6th Edition 2025
• ENPC study guide PDF
• Emergency Nursing Pediatric Course 6th Edition
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 - 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?
,2|Page
A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - 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 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 - 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.
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 - ANSWER-D
, 3|Page
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.
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 - 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 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.
inconsolable crying - 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 - ANSWER-C
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
