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ENPC (Emergency Nursing Pediatric Course) 6th
Edition|| ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
|ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||LATEST EXAM!!!||
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
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
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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.
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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 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,
, 4|Page
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?
A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - ANSWER-A
ENPC (Emergency Nursing Pediatric Course) 6th
Edition|| ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
|ALREADY GRADED A+| ||PROFESSOR VERIFIED||
||LATEST EXAM!!!||
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
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
,2|Page
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.
,3|Page
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 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,
, 4|Page
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?
A.Cystic fibrosis
B.Bronchopulmonary dysplasia
C.Pneumonitis
D.Down syndrome - ANSWER-A
