ENPC 6TH EDITION COURSE PREP EXAM 150 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES 2026 LATEST VERSION
COVERING THE MOST TESTED QUESTIONS GRADED A+
1. What is the first priority when assessing a pediatric trauma patient?
A) Disability assessment
B) Airway with cervical spine protection
C) Exposure and temperature control
D) Circulation assessment
Rationale: The primary survey always begins with airway management while maintaining spinal
precautions.
2. Which finding best indicates adequate perfusion in a child?
A) Capillary refill > 4 seconds
B) Weak peripheral pulses
C) Warm extremities and brisk capillary refill
D) Cool mottled skin
Rationale: Warm skin and capillary refill under 2 seconds indicate effective perfusion.
3. What is the most appropriate initial intervention for an apneic child with a pulse?
A) Begin chest compressions
B) Provide bag-mask ventilations
C) Administer epinephrine
D) Obtain IV access
Rationale: Bag-mask ventilation supports oxygenation before compressions are needed.
4. A 2-year-old presents with inspiratory stridor and drooling. What condition should be
suspected?
A) Asthma
B) Bronchiolitis
C) Epiglottitis
D) Croup
Rationale: Stridor and drooling suggest epiglottitis, a true airway emergency.
5. Which is the best pain assessment tool for a nonverbal 1-year-old?
A) Numeric Rating Scale
, B) FLACC scale
C) Wong-Baker FACES scale
D) Visual Analog Scale
Rationale: The FLACC scale measures pain using behavioral cues in infants and nonverbal
children.
6. What is the most common cause of pediatric cardiac arrest?
A) Cardiac arrhythmia
B) Respiratory failure or shock
C) Toxin ingestion
D) Seizure activity
Rationale: Pediatric arrest is most often secondary to respiratory or circulatory failure.
7. What should be done immediately after defibrillating a pediatric patient in VFib?
A) Check the pulse
B) Resume CPR for 2 minutes
C) Administer epinephrine
D) Obtain a rhythm strip
Rationale: CPR is resumed immediately after shock to maximize perfusion.
8. Which of the following is a sign of compensated shock in children?
A) Tachycardia with normal blood pressure
B) Hypotension
C) Bradycardia
D) Decreased LOC
Rationale: Children maintain BP until late in shock; early signs include tachycardia.
9. A 4-year-old with severe burns is crying and fearful. What is the best nursing intervention?
A) Delay treatment until calm
B) Involve caregivers to provide comfort and reassurance
C) Apply dressings immediately without explanation
D) Offer candy
Rationale: Family-centered care and comfort reduce psychological trauma.
,10. What is the best indicator of neurological function in a child?
A) Pupillary response
B) Level of consciousness
C) Reflexes
D) Motor tone
Rationale: Changes in consciousness are the earliest sign of neurological deterioration.
11. Which statement reflects appropriate fluid resuscitation in pediatric shock?
A) Administer 40 mL/kg bolus
B) Administer 20 mL/kg isotonic fluid bolus
C) Start with maintenance fluids only
D) Delay fluids until labs return
Rationale: The standard pediatric bolus is 20 mL/kg isotonic fluid, repeated as needed.
12. What is the first sign of respiratory distress in a child?
A) Tachypnea
B) Bradycardia
C) Cyanosis
D) Grunting
Rationale: Increased respiratory rate is the earliest and most sensitive indicator.
13. Which finding in a 3-year-old indicates respiratory failure?
A) Mild retractions
B) Bradypnea and decreased LOC
C) Nasal flaring
D) Tachycardia
Rationale: Decreased rate and LOC signal fatigue and impending arrest.
14. The preferred site for intraosseous access in a child is:
A) Femur
B) Proximal tibia
C) Distal radius
D) Iliac crest
Rationale: The proximal tibia provides easy access to the marrow space for rapid infusion.
, 15. What is the best way to prevent hypothermia during trauma resuscitation?
A) Warm the environment and fluids
B) Use cold saline for lavage
C) Delay clothing removal
D) Administer vasodilators
Rationale: Warming prevents hypothermia, which worsens outcomes in trauma.
16. Which sign best indicates increased intracranial pressure in a 6-year-old?
A) Hyperactivity
B) Normal pupils
C) Vomiting without nausea
D) Low-pitched cry
Rationale: Projectile vomiting is an early sign of increased ICP.
17. Which of the following best describes “family-centered care”?
A) Partnering with caregivers in assessment and treatment decisions
B) Limiting family presence
C) Encouraging families to stay in waiting areas
D) Assigning family duties without discussion
Rationale: Family-centered care involves collaboration between caregivers and healthcare
providers.
18. A toddler with croup presents with barking cough. The nurse expects which intervention?
A) Intubation
B) Nebulized racemic epinephrine
C) Antibiotics
D) Chest compressions
Rationale: Racemic epinephrine reduces upper airway swelling in croup.
19. What is the normal systolic BP for a 5-year-old?
A) 50 mmHg
B) 90–110 mmHg
C) 120–130 mmHg
D) 70 mmHg
Rationale: Normal systolic pressure for school-age children is approximately 90–110 mmHg.
CORRECT ANSWERS WITH RATIONALES 2026 LATEST VERSION
COVERING THE MOST TESTED QUESTIONS GRADED A+
1. What is the first priority when assessing a pediatric trauma patient?
A) Disability assessment
B) Airway with cervical spine protection
C) Exposure and temperature control
D) Circulation assessment
Rationale: The primary survey always begins with airway management while maintaining spinal
precautions.
2. Which finding best indicates adequate perfusion in a child?
A) Capillary refill > 4 seconds
B) Weak peripheral pulses
C) Warm extremities and brisk capillary refill
D) Cool mottled skin
Rationale: Warm skin and capillary refill under 2 seconds indicate effective perfusion.
3. What is the most appropriate initial intervention for an apneic child with a pulse?
A) Begin chest compressions
B) Provide bag-mask ventilations
C) Administer epinephrine
D) Obtain IV access
Rationale: Bag-mask ventilation supports oxygenation before compressions are needed.
4. A 2-year-old presents with inspiratory stridor and drooling. What condition should be
suspected?
A) Asthma
B) Bronchiolitis
C) Epiglottitis
D) Croup
Rationale: Stridor and drooling suggest epiglottitis, a true airway emergency.
5. Which is the best pain assessment tool for a nonverbal 1-year-old?
A) Numeric Rating Scale
, B) FLACC scale
C) Wong-Baker FACES scale
D) Visual Analog Scale
Rationale: The FLACC scale measures pain using behavioral cues in infants and nonverbal
children.
6. What is the most common cause of pediatric cardiac arrest?
A) Cardiac arrhythmia
B) Respiratory failure or shock
C) Toxin ingestion
D) Seizure activity
Rationale: Pediatric arrest is most often secondary to respiratory or circulatory failure.
7. What should be done immediately after defibrillating a pediatric patient in VFib?
A) Check the pulse
B) Resume CPR for 2 minutes
C) Administer epinephrine
D) Obtain a rhythm strip
Rationale: CPR is resumed immediately after shock to maximize perfusion.
8. Which of the following is a sign of compensated shock in children?
A) Tachycardia with normal blood pressure
B) Hypotension
C) Bradycardia
D) Decreased LOC
Rationale: Children maintain BP until late in shock; early signs include tachycardia.
9. A 4-year-old with severe burns is crying and fearful. What is the best nursing intervention?
A) Delay treatment until calm
B) Involve caregivers to provide comfort and reassurance
C) Apply dressings immediately without explanation
D) Offer candy
Rationale: Family-centered care and comfort reduce psychological trauma.
,10. What is the best indicator of neurological function in a child?
A) Pupillary response
B) Level of consciousness
C) Reflexes
D) Motor tone
Rationale: Changes in consciousness are the earliest sign of neurological deterioration.
11. Which statement reflects appropriate fluid resuscitation in pediatric shock?
A) Administer 40 mL/kg bolus
B) Administer 20 mL/kg isotonic fluid bolus
C) Start with maintenance fluids only
D) Delay fluids until labs return
Rationale: The standard pediatric bolus is 20 mL/kg isotonic fluid, repeated as needed.
12. What is the first sign of respiratory distress in a child?
A) Tachypnea
B) Bradycardia
C) Cyanosis
D) Grunting
Rationale: Increased respiratory rate is the earliest and most sensitive indicator.
13. Which finding in a 3-year-old indicates respiratory failure?
A) Mild retractions
B) Bradypnea and decreased LOC
C) Nasal flaring
D) Tachycardia
Rationale: Decreased rate and LOC signal fatigue and impending arrest.
14. The preferred site for intraosseous access in a child is:
A) Femur
B) Proximal tibia
C) Distal radius
D) Iliac crest
Rationale: The proximal tibia provides easy access to the marrow space for rapid infusion.
, 15. What is the best way to prevent hypothermia during trauma resuscitation?
A) Warm the environment and fluids
B) Use cold saline for lavage
C) Delay clothing removal
D) Administer vasodilators
Rationale: Warming prevents hypothermia, which worsens outcomes in trauma.
16. Which sign best indicates increased intracranial pressure in a 6-year-old?
A) Hyperactivity
B) Normal pupils
C) Vomiting without nausea
D) Low-pitched cry
Rationale: Projectile vomiting is an early sign of increased ICP.
17. Which of the following best describes “family-centered care”?
A) Partnering with caregivers in assessment and treatment decisions
B) Limiting family presence
C) Encouraging families to stay in waiting areas
D) Assigning family duties without discussion
Rationale: Family-centered care involves collaboration between caregivers and healthcare
providers.
18. A toddler with croup presents with barking cough. The nurse expects which intervention?
A) Intubation
B) Nebulized racemic epinephrine
C) Antibiotics
D) Chest compressions
Rationale: Racemic epinephrine reduces upper airway swelling in croup.
19. What is the normal systolic BP for a 5-year-old?
A) 50 mmHg
B) 90–110 mmHg
C) 120–130 mmHg
D) 70 mmHg
Rationale: Normal systolic pressure for school-age children is approximately 90–110 mmHg.
