ENPC 6th Edition Test Questions and Answers 2024, Exams of Nursing

Download ENPC 6th Edition Test Questions and Answers 2024 and more Exams Nursing in PDF only on Docsity! 1 ENPC 6th Edition Test Questions and Answers 2024 1. 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? • Answer: Applying a splint to the affected extremity 2. Assessment of the fontanelle provides the most useful information for which two components of the primary survey? • Answer: Circulation and disability 3. 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? • Answer: Cystic fibrosis 4. A 4-day-old who is brought to the emergency department with the parental complaint of “not acting right” is found to be hypoglycemic. What is the appropriate glucose concentration to administer to this neonate? • Answer: Dextrose 10% 5. Which of the following indicates the need for additional caregiver education regarding a urinary tract infection? • Answer: My child will grow out of their frequent urinary tract infections. 6. You need to draw blood from a 2-year-old. Which of the following is the best approach for this patient? • Answer: Have them watch a cartoon on an I-pad or cell phone 7. The caregiver of a 2-month-old infant states the patient has had trouble breathing for the past two days. Pediatric assessment triangle (PAT) reveals an age-appropriate general appearance, rapid breathing with mild distress, and pink skin. Mucous is noted in both nares. Which of the following is the best next step? • Answer: Suction nasal passages using a bulb syringe 8. An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated prior to arrival. Which of the following is the priority assessment or intervention? • Answer: Assess endotracheal tube placement 9. Which of the following patients should be evaluated first? 2 • Answer: An 18-month-old with bilious emesis 10. A nurse providing trauma informed care to the family of a seriously ill child should be doing which of the following? • Answer: Appointing one staff member to stay with the family 11. What is the priority intervention for symptomatic bradycardia in a four- year-old child? • Answer: Initiate bag-mask ventilation 12. 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? • Answer: Endotracheal intubation to provide positive pressure ventilation 13. 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? • Answer: Weak peripheral pulses 14. Which of the following is a known cause of pediatric seizures? • Answer: Overdiluted formula 15. For the infant, what duration of time is considered apneic? • Answer: 20 seconds 16. For the infant, what duration of time is considered apneic? • Answer: 20 seconds 17. A 9-month pregnant woman presents to the emergency department and delivers a term neonate vaginally. The neonate is dried and stimulated and the mouth and nose are suctioned using a bulb syringe. After repositioning the head, the neonate remains limp and apneic and the HR is 80 beats/minute. What is the priority intervention? • Answer: Initiate positive pressure ventilation 18. A 5-year-old with no health problems presents to the emergency department with a sudden onset of chest pain and shortness of breath. Parents state that the family was involved in a bad car crash one week ago. A thorough assessment and workup has not revealed any abnormalities. Which of the following the best next step to take? • Answer: Ask about any new bed-wetting or sleep disturbances 5 • Remediation feedback: Ketorolac is an appropriate medication for moderate to severe pain, however, it should not be used pre-operatively due to its potential to increase the bleeding risk. 7. A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and having vaginal bleeding. The patient is unsure of the gestational age and has not had any prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions. Which of the following is the most appropriate action for the nurse to take at this point? • Answer: Have the boyfriend leave the room during the pelvic exam. 8. 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? • Answer: Intraosseous in the patient’s medial tibia. 9. A child with an electrical injury is seen 1 hour post event. Which of the following types of specimen samples would provide visual information regarding a potential complication of this injury? • Answer: Sputum (wrong) • Remediation feedback: Electrical injuries, though they may appear to be small, can produce large amounts of damage internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine. 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? • Answer: Providing frequent updates and re-educating them on the care that is being provided 11. When taking vital signs on a stable infant, which of the following should be done first? • Answer: Respiratory rate 12. A laceration on a toddler’s arm is prepared for suturing. Which of the following preparations for topical anesthesia would be the best choice for this procedure? • Answer: LET (lidocaine/epinephrine/tetracaine) 6 13. Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acetaminophen overdose? • Answer: A bolus infusion of 150 mg/kg NAC should be administered. 14. A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is noted: hypotension, tachycardia, absent breath sounds from the left chest with an increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow Coma Score of 7. Which of the following orders will prompt the nurse to have a discussion with the provider before initiating? • Answer: Assist with chest tube insertion (wrong) • Remediation feedback: Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the areas is also a contraindication for this adjunct. 15. A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-smelling urine. The child is hypotensive and tachycardic. Which of the following methods for obtaining a urine sample is most appropriate in this circumstance? • Answer: Urinary catherization 16. A child with bipolar disorder is brought to the emergency department for increasing irritability, agitation, pressured speech, and a decreased need for sleep. What should be included in the plan of care for this child? • Answer: Performing a suicide risk assessment 17. You are discharging a patient home who has a history of depression. Discharge teaching should include which of the following? • Answer: Ensuring all firearms in the home are locked up with no access available by the patient. 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? • Answer: Administer intramuscular epinephrine 19. Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis? • Answer: Constipation 7 20. A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5 seconds. Which of the following would be most indicative of the need for intravenous rehydration therapy for this patient? • Answer: Capillary refill 21. Which of the following is a family-centered care concept? • Answer: Cultural backgrounds are assessed and incorporated into the plan of care. 22. An 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-bilious vomiting, and a low grade fever. On assessment the child is intermittently inconsolable followed by periods of normal activity. A sausage-shaped mass is noted during palpation of the abdomen. The nurse should prepare for which of the following? • Answer: Enema with air 23. A caregiver presents to the emergency department with an 18-month-old and reports the child is not using their left arm after playing a game with an older sibling. The child is alert and curious, with regular, even respirations, and skin color is appropriate. Using the Pediatric Assessment Triangle (PAT), how would you categorize this patient? • Answer: Sick 24. A 13-year -old male presents to the triage desk complaining of nausea and vomiting. The patient looks distressed and pale. He complains of spasming pain in his right scrotum which has now become constant and more severe. Which of the following assessment findings would the nurse expect with this patient? • Answer: Elevated right testicle 25. 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? • Answer: Ensure safety of the patient and staff 26. A 12-year-old presents to the emergency department with a severe headache. The mother reports that the child has been experiencing headaches and has had multiple seizures for the past several months. The child was seen by their primary doctor and prescribed an anti-seizure 10 or perineal discolorations with edema to the areas is also a contraindication for this adjunct. 40. **Which of the followingContinuing with the flashcards: 41. Which of the following is a first-line treatment for atopic dermatitis? • Answer: Skin hydration therapy 41. After a seizure at home, a 9-month-old infant is awake and interacting appropriately. Vital signs on arrival are HR 150 beats/minutes, RR 36 breaths/minute (unlabored), BP 80/52 mm Hg, SaO2 97% without supplemental oxygen, and T 102.7°F (39.3°C) rectally. During re- evaluation 2 hours after arrival, which of the following assessments would indicate appropriate measures were taken in treating this child? • Answer: Temperature 37.7°C (99.9°F) 42. During a diaper change on a 4-month-old infant, the nurse measures the infant’s urinary output. After subtracting the weight of a dry diaper, the wet diaper weighs 22 grams. What is the infant’s estimated urinary output? • Answer: 22 mL 43. 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? • Answer: Prolonged capillary refill (wrong) • Remediation feedback: In the early compensated phase of shock attributed to fluid volume loss, the diastolic pressure will increase due to vasoconstriction (increasing systemic vascular resistance) as a compensatory mechanism causing a narrowed pulse pressure. A normal systolic pressure is maintained during this phase. Other manifestations of early shock states are tachycardia, normal capillary refill, decreased urine output, mild irritability, tachypnea, and weak peripheral pulses. ENPC 6th Edition Make-Up Exam Answers 51. 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. What is the initial intervention for this child? • Answer: Administration of nebulized epinephrine 52. 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 11 child, how can the nurse facilitate their grieving process until legally required notification has been made? • Answer: Provide simple, straightforward information 53. During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of 70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of 89%. What is the priority intervention for this patient? • Answer: Prepare for intubation 54. A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about? • Answer: The likelihood of the infant ingesting a harmful substance (wrong) • Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula. 55. 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? • Answer: Heart rate between 120 to 200 beats/minute 56. 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? • Answer: Administration of nebulized epinephrine 57. 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? • Answer: Provide simple, straightforward information 58. During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of 70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of 89%. What is the priority intervention for this patient? • Answer: Prepare for intubation 12 59. A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about? • Answer: The likelihood of the infant ingesting a harmful substance (wrong) • Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula. 60. 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? • Answer: Heart rate between 120 to 200 beats/minute 61. A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra- abdominal trauma? • Answer: Constant left shoulder pain 62. Which of the following questions reflects the concept of the “teach-back” method? • Answer: “Would you repeat those instructions, so I can make sure I was clear?” 63. Which of the following physiological changes in an infant increase the chances of drowning? • Answer: Weak neck muscles 64. Immediately following birth, a full-term neonate is not breathing and has a heart rate of 45 beats/minute. The neonate has been warmed, dried, stimulated, and suctioned without improvement. What the next step in resuscitation? • Answer: Initiate positive-pressure ventilation with 21% oxygen at 40-60 breaths per minute. 65. 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? 15 79. A 2-year-old arrives with parents stating the child may have ingested a button battery. The patient initially choked and coughed and is now drooling with bloody sputum. Which of the following is the priority intervention? • Answer: Prepare the patient for hospitalization 80. During the assessment of a 16-year-old patient, the ED nurse identifies them as a potential sex trafficking victim. Which of the following trauma- informed care principles has the highest priority for this patient? Continuing with the flashcards: 81. During the assessment of a 16-year-old patient, the ED nurse identifies them as a potential sex trafficking victim. Which of the following trauma- informed care principles has the highest priority for this patient? • Answer: Physical and psychological safety 81. A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and hypotension after eating lunch. Which of the following is the priority intervention? • Answer: Intramuscular epinephrine A six-week-old infant presents to the emergency department with seizures. The infant is afebrile with a normal glucose level, and caregivers report no signs of illness other than formula intolerance, which they treated by adding extra water to the formula. The nurse would expect to find which of the following laboratory abnormalities? • Answer: Hyponatremia 82. 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? • Answer: Sickle cell disease 83. A 6-year-old child weighing 20 kg (44.1 lb) arrives in full arrest following an electrocution event. CPR is in progress after defibrillation for ventricular fibrillation. What is the intravenous dose of epinephrine for this patient? • Answer: 0.01 mg (wrong) • Remediation feedback: The pediatric dose of intravenous epinephrine during a cardiac arrest is 0.01 mg/kg. 84. 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 16 nauseated and vomited. Further assessment reveals a swollen scrotum. What is the priority intervention for this patient? • Answer: Preparing the patient for ultrasound 85. Which of the following is the recommended method of insulin administration for a pediatric patient with diabetic ketoacidosis? • Answer: Insulin infusion 86. A child was found unresponsive under the monkey bars during recess and arrives with the following assessment: eyes open only with supraorbital pressure stimulus, no verbal response is elicited, and withdraws arms and legs when a swab is inserted in the nose. Which of the following is the priority intervention for this child? • Answer: Prepare for immediate intubation 87. A term infant is delivered in the emergency department. Which assessment finding is most concerning? • Answer: Acrocyanosis (wrong) • Remediation feedback: Normal findings for a newborn include a heart rate between 90-180 bpm, respiratory rate of 30-55 breaths/minute, and systolic blood pressure of 67-84 mm Hg. They may also exhibit acrocyanosis, particularly when in cool environments. 88. 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? • Answer: Administration of nebulized epinephrine 89. 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? • Answer: Provide simple, straightforward information 90. During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of 70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of 89%. What is the priority intervention for this patient? • Answer: Prepare for intubation A parent brings in a 4-month-old infant reporting seizure-like activity at home. – False 17 92. A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about? • Answer: The likelihood of the infant ingesting a harmful substance (wrong) • Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula. 93. 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? • Answer: Heart rate between 120 to 200 beats/minute 94. A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra- abdominal trauma? • Answer: Constant left shoulder pain 95. Which of the following questions reflects the concept of the “teach-back” method? • Answer: “Would you repeat those instructions, so I can make sure I was clear?” 96. Which of the following physiological changes in an infant increase the chances of drowning? • Answer: Weak neck muscles 97. Immediately following birth, a full-term neonate is not breathing and has a heart rate of 45 beats/minute. The neonate has been warmed, dried, stimulated, and suctioned without improvement. What the next step in resuscitation? • Answer: Initiate positive-pressure ventilation with 21% oxygen at 40-60 breaths per minute. 98. 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?