ENPC 6th Edition Exam Questions With Correct Answers/updated/24/25, Exams of Nursing

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ENPC 6th Edition Exam Questions With Correct

Answers/updated/24/

1.A neonate presents to the emergency department with irritability, weak cry, and hypotonia. Which of the following is a priority intervention?: Serum blood glucose Head compterized tomography scan Prostaglandin infusion Toxin Screening 2.Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis?: Hypernatremia *Constipation Obesity Epiglottitis 3.A nurse begins making multiple errors in clinical decisions regarding the care of patients in the pediatric emergency department. The nurse has worked many consecutive shifts caring for severely ill and injured children and men- tioned to a co-worker that they are not sleeping and feel anxious

2 / about coming to work. What condition may this nurse be experiencing?: Nurse traumatization Pediatric Traumatization Direct Traumatization *Vicarious Traumatization 4.A 14-year-old patient with Down syndrome presents with an abnormal gait, head tilted to the left, decreased sensation to the extremities, and urinary incontinence. The patient has no history of trauma. Which of the following diagnostics is the priority for this patient?: Lumbar Spine MRI Complete Neurologic Exam Urinalysis by Straight Catheter *Cervical Spine Radiograph 5.The caregivers of a 6-year-old report the child developed a cough with nasal congestion and "pink-eye" that started two days ago. Today they noticed a raised, red rash on the face, and grey papules in the mouth. Which of the following is the priority intervention for this patient?: Obtain a

3 / nasopharyngeal swab *Airborne Isolation Contact Isolation Fingerstick Glucose 6.A 12-year-old is being prepped for surgical intervention of acute appendici- tis. Which of the following intravenous medication orders should the nurse question?: Morphine Acetaminophe n Hydromorphon e *Ketorolac 7.A child with an injury to the lower cervical spine with spinal cord involvment would most likely demonstrate which of the following findings during assess- ment?: Increased rectal tone Increased urinary outcomes

4 / Decreased end-tidal CO *Decreased Respiratory effort 8.An adolescent is awaiting ICU admission for pneumonia. During reassess- ment, which of the following findings would be most indicative that respiratory failure is developing?: SpO2 of 94 % on room air Widened Pulse Pressure *Extreme Lethargy Flash Capillary Refill

5 / 9.A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made?: Defer all questions to the provider Allow family member to hold the pt *Provide simple, Straight forward information Begin Memory making activities 10.Parents with an infant requiring multiple laboratory tests, radiographic studies, and invasive procedures appear to be distressed and withdrawn. Which of the following interventions would best ensure a sense of comfort and control for these parents?: *Providing frequent updates and re- educating them on the care that is being provided Taking the child to the radiographic studies while the parents rest in the room Ensuring adequate lighting and keeping the door closed to provide privacy Answering questions only when the parents ask them in order to reduce

6 / information overload 11.Return of spontaneous circulation has been confirmed in a 5-year-old fol- lowing cardiopulmonary arrest after a 5-day history of vomiting and diarrhea. Vital signs are BP 72/60 mm Hg, HR 140 beats/minute, RR assisted at 30 breaths/minute via definitive airway, SpO2 97%, and T 36.8°C (98.4°F) rectally. Which of the following would be the priority intervention at this time?: Obtain a 12-lead electrocardiogram Administer maintenance fluids Obtain a chest radiograph *Administer an isotonic crystalloid bolus 12.The triage nurse is assessing a 14 year old male who was brought in by ambulance. The patient reports he was playing his video games at home when he had a sudden onset of groin pain that was so severe he became nauseated and vomited. Further assessment reveals a swollen scrotum. What is the priority intervention for this patient?: Obtaining a sterile urine sample Initiating intravenous access *Preparing the patient for

7 / ultrasound Scanning the patient's bladder 13.A 15-year-old presents alone requesting care. Which of the following chief complaints would most likely be considered legal or appropriate to treat without parental consent?: Lower back pain Itching rash to arms *Possible Pregnancy Dental Pain 14.A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have hypotension, tachycardia, and contusions and discol- oration across the lap area. On exam a splenic rupture is suspected. Which of the following diagnoses should be suspected as a companion injury with these findings and associated mechanism of injury?: Lumbar Fracture Pneumothorax Subdural Hematoma Cardiac Tamponade 15.A 12-year-old female patient arrives awake and alert with an acute onset

8 / of abdominal pain on the right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right side and there is tenderness to the breasts. Which of the following laboratory tests is the priority for this patient?: *Human chorionic gonadotropin CBC Vaginal Cultures Bedside Glucose 16.An alteration in a child's interaction with their environment (appearance) can indicate a significant underlying problem. Which of the following mnemon- ics is most helpful in assessing the appearance of a child when applying the PAT?: TICLS 17.A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of consciousness with no pulses. Which of the following is the priority intervention?: Utilize AED/Defib Prepare for needle

9 / decompression Administer intravenous Intubate with endotracheal tube 18.A 5-year-old child presents with hives, swelling of the lips and face, and stridor that developed about an hour after eating lunch. The child has no known allergies. Which of the following is the priority intervention?: IM Epi- nephrine 19.What is the first step in the care of the newly born infant?: APGAR 20.A 5-year-old arrives in the ED with a 4 day history of vomiting. Vital signs: HR 136 beats/minute, RR 36 breaths/minute, BP 92/56 mm Hg, T 38oC (100.4oF), and pulse oximetry 93% on room air. The child is pale with warm, dry skin and a capillary refill of 3 seconds. A fluid bolus is completed. Which of the following reassessment findings indicate that a second fluid bolus is necessary?: *BP 92/ HR of 114 Cap Refill 2 sec Respiratory Rate of 26 BPM 21.Which of the following is the highest priority intervention for a well-

10 / appear- ing 2-month-old with a fever?: Lumbar Puncture Urine Culture Intravenous Fluid Bolus Chest XR 22.A 3-week old is brought to the emergency department with a history of fussiness, spitting up, crying, and watery stools.Assessment reveals an alert child with moist mucous membranes. Which of the following should be the

11 / priority?: Identify the type of Formula Stool Sample Medicate with zofran intitiane iv access 23.A 6-week-old is brought to the emergency department by the caregivers for poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test the nurse should anticipate?: B.Lumbar puncture 24.A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After several attempts, your team has been unsuccessful at establishing vascular access. Of the following, which is the next best option for establishing access quickly?: Intraosseous in the patient's medial tibia. 25.A 13-year-old is experiencing a sudden onset of testicular pain, swelling, and vomiting. The cremasteric reflex is absent. Which of the

12 / following diag- noses is of highest suspicion in this situation?: Testicular Torsion 26.After an explosion at a school, you are helping triage patients. In your field triage room you find a 5-year-old patient who is not breathing. What is the appropriate initial intervention?: Open the Airway and assess for breathing 27.A parent presents to the emergency department carrying her 12-week-old infant. The PAT reveals an infant who is quiet and opens eyes with stimulation, whose breathing is regular and even, and whose skin is pale, with a scattered vesicular rash. What is the priority intervention for this infant?: Initiate isolation precautions 28.A 12-year-old complains of a severe headache for the past 8 hours. Which of the following past history disease processes would be considered a "red flag" and warrant immediate evaluation for this patient?: Sickle Cell 29.A 14-year-old patient presents to the emergency department with her aunt after being assaulted. The patient has multiple bruises inconsistent with the assault history and seems guarded with her answers. A urine test is positive for pregnancy, although the patient denies being sexually active. The aunt repeatedly asks when they will be discharged. The ED nurse

13 / recognizes these finding as red flags for which of the following?: Sex Trafficking 30.A 12-year-old presents to the emergency department with a severe headache. The mother reports that the child has been experiencing headaches

14 / and has had multiple seizures for the past several months. The child was seen by their primary doctor and prescribed an anti-seizure medication, but the prescription was not filled because "the doctor just wants money." This is an example of what type of neglect?: Medical 31.Which of the following is the recommended method of insulin administra- tion for a pediatric patient with diabetic ketoacidosis?: Insulin Infusion

32. Which of the following is the priority intervention for the nurse caring for an immunocompromised pediatric patient with a fever: Negative Pressure Room 33.An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hy- potension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms?: Anaphylaxis 34.A school-aged child arrives in the emergency department with a 2-day history of vomiting. The child is cool and pale, with weak pulses, elevated heart rate, and capillary refill of 4 to 5 seconds. Which of the following is the

15 / priority intervention for the child?: Fluids 35.A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a bag-mask device. Once return of spontaneous circulation has been confirmed, which of the following would be the priority intervention?: Establishing Airway 36.An 8-year-old pedestrian is thrown onto the hood of a moving vehicle strik- ing the windshield. On arrival to the ED. the patient is minimally responsive with active bleeding from the nose and mouth. The patient is vomiting. Which of the following interventions would most likely be considered?: Intubation 37.Which of the following parameters would indicate that appropriate post resuscitation interventions were successfully carried out in the pediatric patient?: Pulse Ox 96% 38.A 12-year-old involved in a house fire has full thickness, circumferential burns to bilateral lower extremities. Fluid resuscitation is in progress on arrival at the ED. On assessment the left pedal and posterior tibialis pulses are absent, with delayed capillary refill. Which of the following is the priority intervention?: Elevate 39.A 5-year-old presents with sudden onset nausea, vomiting, abdominal

16 / cramping, hives, and hypotension after eating lunch. Which of the following is the priority intervention?: IM Epi 40.An 8-year-old male presents to the emergency department with incoherent speech, hallucinations, and violent behavior. What is the priority in caring for this patient?: Ensure safety

17 / 41.A 3-year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child?: Neb Epi 42.A child with an electrical injury is seen 1 hour post event. Which of the following specimen samples would provide visual information regarding a potential complication of this injury?: Urine 43.Which of the following is appropriate administration of N- acetylcysteine (NAC) for an acetaminophen overdose?: Bolus 150mg/kg

44. When caring for a potential crime victim, what evidence collection principle is imperative?: Clothing should not be placed on the floor 45.An 8-year-old trauma patient suddenly develops increased respiratory distress with a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt hypotensive event. Distention of the jugular veins is noted. Which of the following emergent interventions should be anticipated first?: High Flow O 46.A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous membranes. Vital signs reveal deep respirations at 44

18 / breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory values would be most expected in this child?: Low pH Level 47.A caregiver reports their one-month-old has had a yellowish color to their eyes and skin over the last two weeks. If left untreated, which body system can this affect?: Neurologial 48.The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak the local language. Which of the following interventions is most supportive of the family during the procedure?: Dedicat- ing a healthcare team member with a qualified interpreter to be with the family 49.A 5-year-old presents with decreased level of consciousness and a wide complex and rapid rate on the electrocardiogram. Which of the following characteristics would indicate ventricular tachycardia as opposed to other tachydysrhythmias?: HR greater than 220 50.A 3 year-old patient presents following frequent emesis and diarrhea over the past 12 hours. Which of the following assessment findings indicate that the patient' body is compensating for the fluid loss?: Increased

19 / diastolic blood pressure