ENPC EXAM LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS|ALREADY GRADED A, Exams of Nursing

Download ENPC EXAM LATEST ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS|ALREADY GRADED A and more Exams Nursing in PDF only on Docsity!

ENPC EXAM LATEST ACTUAL EXAM 100 QUESTIONS

AND CORRECT DETAILED ANSWERS|ALREADY

GRADED A+ LATEST EDITION FOR 2024 EXAM

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? A. High flow oxygen B. Drug assisted intubation C. Chest tube insertion D. Needle decompression - ANSWER >>>>D. Needle decompression A 4-week-old infant born prematurely is brought to the emergency department due to the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on these findings, what condition should the nurse suspect? A. Necrotizing enterocolitis B. Pyloric stenosis C. Megacolon D. Congenital diaphragmatic hernia - ANSWER >>>>A. Necrotizing enterocolitis A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous membranes. Vital signs reveal deep respirations at 44 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? A. Hypoglycemia B. Severe anemia

C. Low pH level D. Elevated serum bicarbonate - ANSWER >>>>C. Low pH level Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis? A. Hypernatremia B. Constipation C. Obesity D. Epiglottitis - ANSWER >>>>B. Constipation Which of the following is the highest priority intervention for a well- appearing 2-month-old with a fever? A. Lumbar puncture B. Urine culture C. Intravenous fluid bolus D. Chest radiograph - ANSWER >>>>B. Urine culture 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? A. Obtain a nasopharyngeal swab B. Place in airborne isolation C. Place in contact isolation D. Obtain a fingerstick glucose - ANSWER >>>>C. Place in contact isolation 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?

A. Lumbar spine magnetic resonance imaging B. Complete neurologic exam C. Urinalysis by straight catheterization D. Cervical spine radiographs - ANSWER >>>>D. Cervical spine radiographs A 7-year-old is being seen for new onset of headaches. Which of the following manifestations would most likely rule out the potential of a primary etiology? A. Presence of ataxia B. Pulsating, unilateral pain 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 3-year-old is assessed for the presence of increasing amounts of serosanguineous drainage from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely etiology? A. Magnet B. Button battery C. Dried bean D. Fishing weight - ANSWER >>>>A. Magnet A caregiver presents to the emergency department with an 18month-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? A. Sicker B. Sickest C. Stable D. Sick - ANSWER >>>>D. Sick 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? A. Administer antipsychotic medications B. Evaluate laboratory values C. Allow family and friend visitation D. Ensure safety of the patient and staff - ANSWER >>>>D. Ensure safety of the patient and staff A 2-year-old child is seen with acute respiratory distress after playing alone. Caregiver statements indicate the child was found playing with irregular, ½ - ¾ inch sized pieces of a game. Which of the following assessment findings would most likely be expected for this situation? A. Audible wheezing and retractions B. Inspiratory stridor and coughing C. Grunting respirations and tachypnea D. Quiet tachypnea and coarse crackles - ANSWER >>>>B. Inspiratory stridor and coughing 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? A. Lower back pain B. Itching rash to arms C. Possible pregnancy

D. Dental pain - ANSWER >>>>C. Possible pregnancy An 11-year-old child presents with right arm pain after falling off a bicycle. The child is tearful and holding his right arm. What pain scale would be the most appropriate to use when assessing this child's pain? A. Faces scale B. FLACC scale C. Numbers scale D. NIPS scale - ANSWER >>>>C. Numbers scale 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? A. Insert urinary catheter B. Prepare for intubation C. Assist with chest tube insertion D. Place orogastric tube - ANSWER >>>>A. Insert urinary catheter 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 B. Expose the child's body for full exam C. Log roll to assess posterior aspect D. Prepare for immediate intubation - ANSWER >>>>D. Prepare for immediate intubation 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? A. Intramuscular epinephrine B. Inhaled albuterol C. Oral diphenhydramine D. Intravenous ondansetron - ANSWER >>>>A. Intramuscular epinephrine A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the following intravenous medication orders should the nurse question? A. Morphine B. Acetaminophen C. Hydromorphone D. Ketorolac - ANSWER >>>>D. Ketorolac An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on auscultation in the right upper lobe of the lung

field after a choking event 4 days ago. The white blood cell count is elevated and the patient noted to be tachypneic, tachycardic, agitated, and has an increased respiratory effort. At the time of the event, the patient was started on antibiotics with subsequent increasing manifestations instead of improvement. Which of the following would be considered to be definitive treatment for the suspected diagnosis? A. Computed tomography B. Magnetic resonance imaging C. Bronchoscopy D. Ultrasound - ANSWER >>>>C. Bronchoscopy Parents report their 3-year-old child has developed noisy breathing. On assessment, high-pitched wheezes are audible and auscultated on inspiration and expiration. What medication would be appropriate to administer first? A. Humidified oxygen B. Inhaled beta-agonist C. Oral steroids D. Nebulized magnesium sulfate - ANSWER >>>>B. Inhaled beta-agonist A 3-year-old child who was found in a pool unresponsive has return of spontaneous circulation (ROSC) after prolonged resuscitation. Intubation was performed in the field. Upon arrival to the ED, which intervention is of highest priority? A. Administer sedation as ordered. B. Utilize a length-based resuscitation tape to determine the approximate weight. C. Auscultate breath sounds over the epigastrium and lung fields. D. Obtain a bedside blood glucose reading. - ANSWER >>>>C. Auscultate breath sounds over the epigastrium and lung fields.

A 3-year-old is assessed for the presence of increasing amounts of serosanguineous drainage from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely etiology? A. Magnet B. Button battery C. Dried bean D. Fishing weight - ANSWER >>>>B. Button battery Which of the following would be an abnormal finding in a patient with glomerulonephritis? - ANSWER >>>>Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. - ANSWER >>>>Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. 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 English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? - ANSWER

Allow the extended to family members to serve as interpreters during the procedure. Which of the following patient presentations should increase suspicion of potential child maltreatment? - ANSWER Bruising to the left ear of a newborn from sleeping on his

side Any bruise in a non-exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse Bruising to the left ear of a newborn from sleeping on his side Any bruise in a non-exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse - ANSWER >>>>Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is brought to the emergency department with severe muscle rigidity and hyperthermia. These symptoms are most likely caused by which of the following? - ANSWER >>>>Neuroleptic malignant syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare reaction to antipsychotic medications. Which of the following patients should be evaluated first - ANSWER >>>>An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always considered an emergent symptom indicative of a life-threatening bowel obstruction.

1. Which of the following tasks can the nurse do to decrease adverse medication events? - ANSWER >>>>Obtain the patient's weight in kilograms This is the preferred measurement for medication calculations for pediatric and adult patients Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases? - ANSWER

Sickle cell anemia These are all complications of sickle cell anemia. During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential sex trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for these types of patients. Which of the following care principles has the highest priority? - ANSWER >>>>Physical and psychological safety Create an environment where patients feel safe, both physically and psychologically. Increase awareness of the patient's interpersonal interactions with others to screen for risk of harm. Prioritize the patient being in a safe location A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes? - ANSWER >>>>Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis. The emergency nurse is caring for a patient with significant facial trauma and a suspected globe rupture. Which of the following medication orders would the nurse question? - ANSWER Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided. A 7-year-old arrives via ambulance. The patient's mother reports witnessing a seizure at home. The patient has no seizure history. Upon examination, the patient is post-ictal with a heart rate of 142 beats per minute, respiratory rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg. Significant burns are noted to the

patient's back and lower extremities. The mother states the burns accidentally occurred 3 days ago, but she was afraid to bring patient in due to an ongoing child welfare investigation. Which of the following are the MOST appropriate immediate interventions?

• ANSWER >>>>Draw and send a metabolic panel, administer a fluid bolus, and obtain a point of care glucose Significant burns can cause electrolyte imbalances. Electrolyte imbalances may be the cause of the patient's seizure. Electrolyte imbalances need to be identified and treated. In which of the following primary survey components can assessment of the fontanel provide the most useful information? - ANSWER >>>>Circulation and disability A sunken fontanel may indicate dehydration; a bulging fontanel can indicate increased intracranial pressure. A 5-year-old patient presents to the emergency department with severe dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the following physiologic responses to shock has the greatest impact on improving cardiac output in the pediatric patient? - ANSWER >>>>Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. A toddler has a chemical eye injury. Which of the following is the priority intervention? - ANSWER >>>>Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. 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 steps is the best next step to take? - ANSWER >>>>Ask about any new bedwetting or sleep disturbances Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other behavioral symptoms to facilitate appropriate care and follow-up. Which of the following is the most appropriate intervention for a child experiencing a seizure? - ANSWER >>>>Prepare to administer intranasal midazolam Midazolam has gained favor because of its ease of use and quick onset of action. 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 the endotracheal tube placement and patency If a patient arrives with an artificial airway (endotracheal tube or tracheostomy) in place, assess its placement, tube patency, and the oral airway (in that order) before moving to the next step of the primary survey. A three-year-old is rescued after being submerged in a residential pool for several minutes. On arrival at the Emergency Department he is responsive to painful stimuli, has shallow respirations with diminished breath sounds throughout, and has an occasional cough. What is the initial management priority? - ANSWER Endotracheal intubation with positive pressure ventilation Airway control and positive pressure ventilation are the priority interventions for this patient. A nurse providing crisis intervention to the family of a seriously ill child can best keep the family informed of the child's condition by doing which of the following? - ANSWER >>>>Appointing one

staff member to communicate with them. This will help create a solid patient-staff bond and facilitate communication. You are discharging a patient to home with a history of depression. Discharge teaching should include which of the following? - ANSWER >>>>Ensuring all firearms in the home are locked in a safe place with no access by the patient. Promote injury prevention with caregivers of patients with a history of depression or suicidal ideation by encouraging that all firearms and medications are under lock to prevent overdoses or suicide attempt. A 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department, the child has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale skin. Vital signs are HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The child is most likely in which of the following shock states? - ANSWER >>>>Hypovolemic shock The mechanism and presentation lead to a suspicion of blood loss. Which of the following is the priority intervention for a pediatric patient with diabetic ketoacidosis? - ANSWER >>>>Insulin infusion A continuous infusion of insulin at 0.05-0.1 unit/kg/hr should be used to decrease blood glucose. Which of the following describes a neonate's normal position? - ANSWER >>>>Flexion with extremities close to the body A neonate's normal position is flexion with extremities close to the body. The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the radius and ulna after falling

from a bicycle. Which of the following pain interventions is most likely to result in improvement in symptoms? - ANSWER

Application of a splint to the affected extremity Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures. The type of vascular access is appropriate in all of the patient situations given EXCEPT for which of the following? - ANSWER Peripherally inserted central catheter line for one time fluid bolus This vascular access is most appropriate for long term medication administration and multiple blood draws. A 5-year-old child presents to the emergency department after being hit by a car. She 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 >>>>Widening pulse pressure Narrowing pulse pressure and increasing heart rate are early indications of ongoing blood loss. A 15-year-old patient has attempted suicide by overdosing on amitriptyline. The emergency nurse should expect which of the following symptoms? - ANSWER >>>>Dysrhythmias QRS prolongation and ventricular dysrhythmias are symptoms of cyclic antidepressant overdose. The parents of a 5-year-old child arrive at the emergency department. The child's lips and face are swollen with hives on the face. The parents report the child ate peanut butter crackers in the last hour. The child has no known allergies. The nurse recognizes the findings are associated with: - ANSWER

Food allergy This a clinical manifestation seen in food allergies. Which of the following statements demonstrates a nurse's understanding of pediatric submersion injuries? - ANSWER The best indicator of survival after submersion is the duration of time of submersion The duration of submersion is the best predictor of survival after drowning. In general, shorter times correlate to better outcomes. A 2-month-old infant is brought to the emergency department. The mother states he has had trouble breathing for the past two days. The PAT reveals an age-appropriate general appearance, rapid breathing with mild distress, and pink skin. Mucous is noted to both nares. Which of the following is the best next step? - ANSWER >>>>Suction the nares with a bulb syringe Infants are preferential nose breathers and can have respiratory distress when the nares are occluded. Suctioning the nares is the priority intervention to open the airway. During the tertiary survey, the emergency nurse should continue to conduct reevaluations of the Pediatric Assessment Triangle (PAT), abnormal findings, and which of the following other assessment components? - ANSWER >>>>Primary survey, vital signs, pain management, and effectiveness of therapeutic interventions The additional components of the reevaluation in the tertiary survey include the primary survey, vital signs, pain management, and effectiveness of therapeutic interventions. Which of the following interventions would the nurse anticipate for a pediatric patient with a fever and a history of a hematologic or oncologic condition? - ANSWER >>>>Intravenous antibiotics This patient population is at risk for life-threatening sepsis, and

treatment with intravenous antibiotics is indicated. Prioritizing pediatric patients presenting with fever is often difficult. Which of the following patients is at greatest risk of serious illness? - ANSWER >>>>A 7-year old boy with a history of sickle cell anemia and an oral temperature of 38.3°C (101°F) Children with chronic illnesses such as sickle cell disease are at greatest risk for life-threatening fever-related illnesses. Which of the following indicates the need for additional parent/guardian education regarding a UTI? - ANSWER >>>>My child will grow out of their frequent urinary tract infections UTIs are not a normal occurrence in children and may require additional investigation and follow up. A 4-day-old who is brought to the emergency department with the parental complaint of "not acting right" is found to be hypoglycemic. The appropriate glucose concentration to administer to this neonate is which of the following? - ANSWER

D10 D10 is the preferred concentration for neonates to protect their fragile vasculature. Which of the following actions by the nurse promotes pediatric patient safety? - ANSWER >>>>Preparing medications in a distraction-free area To decrease errors, the nurse should be focused and systematic in verifying patient identification, medication order, route, time, and dose. A 16-year-old trauma patient is noted to have external rotation and shortening of the left lower extremity and pain with palpation of the pelvis after being ejected from a motorcycle. Which of the following assessment findings is most concerning for a potentially

life-threatening condition? - ANSWER >>>>Bony crepitus and instability with gentle anteroposterior compression of the iliac crests Bony crepitus and instability to palpation of the pelvis are common findings in patients with unstable pelvic fractures. Unstable pelvic fractures may be associated with injury to major blood vessels and contribute to hypovolemic shock. A 10-year-old patient was recently diagnosed with Marfan syndrome. The emergency nurse understands that this patient may be at risk for developing which of the following conditions? - ANSWER >>>>Aortic Aneurism Cardiovascular defects associated with Marfan syndrome are mitral valve prolapse, heart failure, and aortic dissection/aneurysm. A 2-month-old child with intermittent irritability, poor feeding and apneic episodes has a heart rate of 188 and an irregular respiratory rate. After three 0.9% sodium chloride fluid boluses at 20 ml/kg each with only minimal clinical improvement, what treatment should the emergency nurse anticipate next? - ANSWER >>>>Start a vasopressor infusion A child in septic shock who is not responding to fluid resuscitation likely needs vasopressors to compensate for the vasodilation caused by the septic shock state. Spinal shock results in which of the following transient conditions?

• ANSWER >>>>Pain at the site of injury and hyperesthesia above the level of the injury Spinal cord shock results in pain at the site of injury and hyperesthesia above the level of the injury. 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