Download ENPC Exam 6th edition actual questions and answers complete material guide 2024 and more Exams Nursing in PDF only on Docsity! ENPC Exam 6th edition actual questions and answers complete material guide 2024 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? A. Administer intramuscular epinephrine B. Auscultate bilateral breath sounds C. Insert an intravenous catheter D. Administer inhaled albuterol - - answer A. Administer intramuscular epinephrine An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing? A. SpO2 of 94 % on room air B. Widened pulse pressure C. Extreme lethargy D. Flash capillary refill - - answer A. SpO2 of 94 % on room air 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? A. Delivery of humidified oxygen by nasal cannula B. Administration of nebulized epinephrine C. Suctioning secretions from the oropharynx D. Administration of albuterol with a spacer - - answer B. Administration of nebulized epinephrine A 14-year-old patient had a reduction of a temporomandibular joint dislocation in the ED. Which of the following should be included in the discharge instructions? A. Practice yawning three to four times a day B. Resume eating a regular diet later today C. Apply hot packs to the joint area for pain control D. Use a nonsteroidal anti-inflammatory for pain control - - answer D. Use a nonsteroidal anti- inflammatory for pain control Which of the following parameters would indicate that appropriate post resuscitation interventions were successfully carried out in the pediatric patient? A. Pulse oximetry reading of 96% B. Temperature of 99.8°F (37.6°C) C. Capillary refill of < 1 second D. Capnography reading of 60 mm Hg - - answer A. Pulse oximetry reading of 96% An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms? A. Anaphylaxis B. Renal colic C. Crohn's Disease D. Menarche - - answer A. Anaphylaxis 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? C. Occurrence of photophobia D. Nausea, vomiting - - answer A. Presence of ataxia 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 priority? A. Medicate with ondansetron for emesis B. Identify the type of formula the caregiver uses C. Obtain a stool specimen for culture D. Initiate intravenous access with 0.9% sodium chloride - - answer B. Identify the type of formula the caregiver uses 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? A. EMLA (lidocaine 2.5% and prilocaine 2.5%) B. LET (lidocaine/epinephrine/tetracaine) C. LMX (lidocaine 4%) D. Tetracaine 4% - - answer B. LET (lidocaine/epinephrine/tetracaine) A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic event. Assessment findings include a patient who is active and alert, in the 10th percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture of the left femur. Which of the following is the most likely cause? A. Osteomyelitis B. Physical maltreatment C. Ehlers-Danlos syndrome D. Osteogenesis imperfecta - - answer D. Osteogenesis imperfecta 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? A. Increased diastolic blood pressure B. Bounding peripheral pulses C. Prolonged capillary refill D. Increased urine output - - answer A. Increased diastolic blood pressure 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? A. Chest pain with deep inspiration B. Thoracic spine pain with palpation C. Intermittent shortness of breath D. Constant left shoulder pain - - answer D. Constant left shoulder pain 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? A. Empowerment, voice, and choice B. Peer support C. Trustworthiness and transparency D. Physical and psychological safety - - answer D. Physical and psychological safety. 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? A. Chest pain with deep inspiration B. Thoracic spine pain with palpation C. Intermittent shortness of breath D. Constant left shoulder pain - - answer D. Constant left shoulder pain 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? A. Integumentary B. Renal C. Gastrointestinal D. Neurological - - answer A. Integumentary A neonate presents to the emergency department with irritability, weak cry, and hypotonia. Which of the following is a priority intervention? A. Prostaglandin infusion B. Toxin screening C. Head compterized tomography scan D. Serum blood glucose - - answer D. Serum blood glucose An 8-year-old arrives post bicycle crash with swelling and bleeding from the right side of his face, deformities to the jawline, nasal swelling, and epistaxis. He is unresponsive with snoring respirations and an absent gag reflex. Which of the following airway adjuncts would be most appropriate for this patient? A. Nasopharyngeal airway (NPA) B. Head tilt - chin lift maneuver C. Elevate the head of the bed D. Oropharyngeal airway (OPA) - - answer D. Oropharyngeal airway (OPA) 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? A. Hypokalemia B. Hyponatremia C. Hyperkalemia D. Hypernatremia - - answer B. Hyponatremia 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? A. Application of compression dressings B. Elevation of left lower extremity C. Assist with escharotomy D. Preparation for thrombectomy - - answer C. Assist with escharotomy 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? A. Prepare the patient for hospitalization B. Administer 5 -10 ml of honey orally C. Discharge with specific return instructions D. Offer the child sips of water intermittently - - answer A. Prepare the patient for hospitalization When caring for a potential crime victim, what evidence collection principle is imperative? A. Evidence collection is prioritized over nursing assessment. B. Suspicious clothing should be placed in separate, clean, clearly marked plastic bags. C. Clothing should always be cut along seam lines to preserve evidence. D. Clothing should not be placed on the floor in order to prevent contamination. - - answer D. Clothing should not be placed on the floor in order to prevent contamination. 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? A. Serum B. Urine C. Stool D. Sputum - - answer B. Urine 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? A. Intraosseous in the patient's medial tibia. B. Peripherally inserted central catheter C. Assisting with central line placement. D. Intraosseous in the patient's scapula. - - answer A. Intraosseous in the patient's medial tibia. A child has a nondisplaced fracture of the radius that has been splinted, with a sling in place and NSAIDs given for pain. Prior to discharge home with follow-up at a pediatric facility, what actions must be completed? A. Discharge instructions including follow-up contact information. B. Ensure the receiving facility has space and qualified personnel. C. Certify that medical benefits of discharge outweigh risks. D. Complete doctor-to-doctor communication with receiving facility. - - answer A. Discharge instructions including follow-up contact information. The nurse is triaging an infant brought to the emergency department by their caregiver. Which finding by the nurse leads the infant to be placed in isolation? A. Barking cough B. Purpuric rash C. High-pitched cry D. Mottled skin - - answer B. Purpuric rash 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? A. Taking the child to the radiographic studies while the parents rest in the room B. Providing frequent updates and re-educating them on the care that is being provided C. Ensuring adequate lighting and keeping the door closed to provide privacy D. Answering questions only when the parents ask them in order to reduce information overload - - answer B. Providing frequent updates and re-educating them on the care that is being provided An infant presents to the emergency department with difficulty breathing. The patient is pale and respirations appear rapid and shallow. Which location on the torso is the most effective site for assessing bilateral breath sounds? A. Bilateral posterior back B. Over the epigastrium C. Bilateral midaxillary D. Bilateral anterior chest - - answer C. Bilateral midaxillary 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? A. Infuse a bolus of crystalloid solution