ENPC STUDY QUESTIONS WITH VERIFIED ANSWERS 2023/2024 LATEST VERSION, Exams of Nursing

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ENPC STUDY QUESTIONS WITH

VERIFIED ANSWERS 2023/

LATEST VERSION

1.An unresponsive 2 - year-old child was found by his mother with a bottle labeled "Elavil 50 mg" by his side. Which piece of information is important to obtain from his mother? A. The size of the medication bottle. B. The expiration date of the medication. C. The number of pills left in the bottle.

D. The person for whom the medication was prescribe. 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: A. Placing them in a secluded room. B. Referring to their child as "the patient". C. Telling the family how they should feel. D. Appointing one staff member to communicate with them. A 16 - month-old child was an unrestrained front seat passenger in a motor vehicle crash. The chest x-ray reveals multiple rib fractures. These findings suggest what type of injury? A. Minor surface injury. B. Significant underlying injury. C. Significant surface injury. D. Minor underlying injury. Which piece of information is most important to know prior to transferring a patient to another facility? A. Documentation of the family's health insurance coverage. B. Pertinent family health history. C. Confirmation of acceptance from the receiving hospital. D. Confirmation of a medical diagnosis. A 10 - year-old child who was struck by a car has a distended, tense abdomen. The child's heartrate is 144 beats/minute, respirations 24 breaths/minute, and blood pressure 120/ mm Hg. Capillary refill is more than 3 seconds, and skin is pale and cool. The patient's signs and symptoms suggest: A. Obstructive shock. B. Distributive shock. C. Hypovolemic shock. D. Cardiogenic shock. A school-aged child is about to receive stitches. To evaluate his understanding of the procedure, you tell him: A. "Young people your age have questions about getting stitches. What are your questions?" B. "Don't cry while you are getting the stitches. Be brave like a man." C. "You will probably receive 10 stitches. Do you have any questions before we restrain you?" D. "Does your cut hurt? Would you like your mommy to hold you?"

What is the preferred sit for intraosseous access in the infant? A. Lateral malleolus B. Iliac crest C. Proximal femur D. Anteromedial tibia An important consideration in the assessment of pain for an adolescent patient is that they: A. May deny or minimize their pain when friends visit for fear of losing control. B. Have difficulty localizing or describing the pain. C. Are unable to use the 1 to 10 scale to report their pain. D. Feel that the pain is a punishment for something they did wrong. An 8-month-old infant with pneumonia has severe intercostal and substernal retractions, weak muscle tone, lethargy, and gray skin color. The infant's condition does not improve after bag-mask ventilation. The next step in treatment is most likely to be: A. Administration of epinephrine. B. Supplemental warming measures. C. Rapid sequence intubation. D. Administration of albuterol. Which combination of medications is best to have prepared for a pediatric resuscitation? A. Dopamine and sodium bicarbonate. B. Epinephrine and glucose. C. Naloxone and lidocaine. D. Pentothal and vecuronium. A 20 - day-old infant has a 1 - week history of not eating well. The infant has a weak cry and is jittery. Which laboratory test is indicated? A. Arterial blood gas. B. Finger-stick glucose. C. Complete blood count with differential. D. Toxicology screen. Which intervention should be performed next if tactile stimulation, positioning, drying, and blow-by oxygen administration do not increase a newborn's heart rate? A. Chest compressions. B. Umbilical vein cannulation. C. Endotracheal intubation. D. Bag-mask ventilation. A 10 - kg child has deep partial-thickness burns over 35% of the total body surface area. Which evaluation parameter indicates that fluid resuscitation is adequate? A. Heart rate of 160 beats/minute. B. Respiratory rate of 34 breaths/minute.

C. Blood pressure of 80/60 mm Hg. D. Urine output of 11 ml/hour. A 7 - year-old female sustains a minor head injury and did not lose consciousness. She does not respond to commands and groans in response to questions. Which action will quickly determine if her behavior indicates a serious head injury? A. Review her medical record for pre-existing developmental problems. B. Obtain a head computerized tomography scan. C. Conduct a developmental screening test. D. Ask the parents if her behavior is unusual. An 8 - month-old child presents with purpura, irritability, and a rectal temperature of 39.4�C (102.9�F). An intervention of high priority is: A. Encouraging the caregiver to hold and comfort the child. B. Monitoring for signs and symptoms of increased intracranial pressure (ICP). C. Collecting urine for toxicology screen. D. Encouraging oral fluids and food. The Pediatric Assessment Triangle is used to: A. Identify all life-threatening conditions that the child presents with. B. Perform a complete head-to-toe assessment on the child. C. Assess the status of the child's airway only upon arrive in the ED. D. Determine the severity of the child's illness or injury using the "across-the-room" assessment.. The caregivers of a 6 - year-old boy who is brought to the emergency department for abdominal pain should first be asked: A. "Are his immunizations current?" B. "Has anything happened to him at school recently?" C. "What is the reason for the child's visit and how long has he been ill?" D. "Has he been complaining of a sore throat or earache?" A 9 - month-old infant is crying loudly through the nursing assessment, and the caregiver is becoming distraught. The nurse should ask the caregiver to: A. Read a story to the infant. B. Offer the infant a pacifier. C. Return when the infant is consoled. D. Ignore the infant's behavior. During an intubation attempt, the child�s heart rate drops to 40 beats/minute. Which intervention is indicated? A. Ask the physician to stop the intubation attempt and perform bag-mask ventilation. B. Apply cricoid pressure and establish intravenous access. C. Inform the physician of the heart rate and ask the physician to intubate faster.

D. Administer blow-by oxygen and begin chest compressions. A 6 - week-old infant is pale, has marked substernal retractions, expiratory grunting, and poor muscle tone. The emergency nurse should first: A. Obtain intravenous access. B. Apply a pulse oximeter. C. Prepare a chest x-ray. D. Administer 100% oxygen. The best method to open the airway in an injured child is: A. Placing the head and neck in hyperextension. B. Using the jaw thrust maneuver. C. Placing the head and neck in flexion. D. Using the head tilt maneuver. A 4 - year-old child with a history of the flu has a heart rate of 80 beats/minute, respirations of 16 breaths/minute, and capillary refill of more than 3 seconds. The proper sequence for nursing interventions would be: A. Position the airway, administer 100% oxygen, obtain venous access, and administer 20 ml/kg of an isotonic solution. B. Administer 100% oxygen, obtain venous access, administer 0. 1 mg/kg of epinephrine 1:10,000, and prepare for endotracheal intubation. C. Position the airway, provide bag-mask ventilation, provide synchronized cardioversion, and provide supplemental warmth. D. Administer 100% oxygen, prepare for a venous cutdown, administer 20 ml/kg of an isotonic solution, and obtain a chest x-ray. A 3 - year-old is transported by prehospital personnel after being struck by a car. The parents are en route. The child is screaming and uncooperative. Which is the best approach while conducting the secondary survey? A. Hold the child to comfort him. B. Wait for the parent's arrival. C. Observe for behavioral pain cues. D. Use a doll to demonstrate the examination Which ocular finding is associated with child maltreatment? A. Glaucoma. B. Conjunctivitis. C. Iritis. D. Retinal hemorrhage. A pregnant 18 - year-old woman arrives at the emergency department about ready to deliver a full-term infant. She states that she noticed a large amount of dark green fluid the last time she went to the bathroom. During the delivery, the nurse should prepare to:

A. Dry and arm the infant as soon as is it delivered. B. Stimulate and ventilate the infant immediately after delivery. C. Suction the mouth and nose of the infant while on the perineum. D. Administer blow-by oxygen and rub the back immediately after delivery. A preschooler has a small laceration that required 2 stitches. The nurse covers the wound with a bandage knowing that it will comfort the child to have it covered. What is the developmental reason for this intervention? A. Preschoolers are magical thinkers and imagine bandages keep their insides from coming out B. Preschoolers fear physical disability and believe a bandage will prevent disability C. Preschoolers explore orally and will likely chew or suck on the stitches if left uncovered D. Preschoolers are concerned with body image and don't want to appear different than peers A 7 - month-old presents to the emergency department with a complaint of fever. Assessment reveals a patent airway and slight cyanosis around his lips and nail beds. He is alert and interactive. His vital signs are 38.5 °C (101.3 °F), HR 134, RR 32, BP 78/54 mm Hg, and SpO 84%. The nurse notes a healed surgical scar on his chest. Based on this assessment, what is the nurse's priority? A. Administer ibuprofen to treat the fever B. Begin oxygen via a nonrebreather mask C. Obtain a surgical history D. Ask if the SpO2 is normal for him An 11-year-old presents to the emergency department with a complaint of hitting his head while playing soccer. The nurse enters the room and performs an across-the-room assessment. He is staring at the wall. He has no increased work of breathing, and his color is pink. Using the pediatric assessment triangle (PAT), what classification will the nurse assign? A. Well B. Sick C. Sicker D. Sickest The pediatric prioritization process components include the focused assessment, focused history, acuity rating decision and: A. the pediatric assessment triangle (PAT). B. developmental characteristics. C. head-to-toe assessment. D. life-saving interventions. A 2-year-old is brought to the emergency department by her father when he found her face down in the pool. She remains unresponsive and is breathing shallowly and slowly. Her color is pale. What is the priority? A. Administer 100% oxygen B. Immobilize the cervical spine C. Begin bag-mask ventilation D. Insert an oral airway

A 2 - year-old has a suspected cervical spinal injury. In order to ensure neutral spinal alignment, padding should be placed under which area? A. Shoulders B. Head C. Neck D. Waist The nurse is preparing to administer a feeding through a nasogastric feeding tube. The tube position was verified by radiograph after insertion 2 hours ago. How will the nurse verify placement before feeding? A. Instill air and listen over the epigastrium B. Test the pH of the gastric contents C. Observe color of a gastric aspirate sample. D. Repeat the radiograph What is the best method to rapidly administer a 20 mL/kg bolus of 0.9% normal saline to a pediatric patient weighing 16 kg? A. A 20 - mL syringe with a stopcock B. An infusion pump C. A rapid infuser D. A pressure bag Immediately after intraosseous insertion the nurse assesses the infusion and notes that the fluid is not dripping. How should the nurse respond? A. Use an infusion pump to deliver the fluids B. Remove the device and insert in another site C. Advance the device and reassess the flow D. Attempt to aspirate bone marrow A 13 - month-old presents to the emergency department with a 2 - day history of a low-grade fever, increased work of breathing, and tonight developed a barking cough and inspiratory stridor. What condition does the nurse suspect? A. Epiglottitis B. Foreign body aspiration C. Tracheomalacia D. Croup In providing education to a family regarding obtaining baseline peak airway flow for a child with asthma, the nurse will recommend what time of day? A. At bedtime B. Before exercise C. In the morning D. After meals The nurse is planning to begin oral rehydration therapy for a 9-month-old with mild dehydration. She provides the caregivers with a glucose and sodium solution and instructs them to administer small amounts: A. Every 2 to 5 minutes B. Every 10 to 12 minutes C. Every 15 minutes

D. Every 30 minutes Caregivers bring in their 3-week-old neonate and describe nonbilious vomiting after every feeding that is becoming more forceful over the past 24 hours. The last time he vomited the vomitus hit a chair 2 feet away. They say he cries, roots, and sucks vigorously on his pacifier right after vomiting as though still hungry. He is not experiencing any diarrhea. What condition is the most likely cause of these signs and symptoms? A. Intussusception B. Volvulus C. Gastroenteritis D. Pyloric stenosis A neonate is delivered in the emergency department and placed on a radiant warmer. There is no staining of the amniotic fluid. What is the first step in neonatal resuscitation? A. Dry and warm the neonate B. Suction the mouth and nose C. Assess for effective breathing D. Palpate a central pulse rate In discussing the legal care of the adolescent patient, what is a mature minor? A. A minor who lives independently and is legally able to make health decisions B. A minor who is able to make decisions regarding his or her own sexual or mental health C. A minor who is able to make decisions regarding health care as a parent of his or her own child D. A minor who lives with a parent or guardian but legally is able to make health decisions Which of the following screening statements/questions is most appropriate in assessing an adolescent for dating violence? A. "What triggers violence you've experienced from your partner?" B. "Does your partner feel entitled to sex even if you say 'no'?" C. "Tell me about a time when you've felt unsafe in your relationship." D. "Do you feel if you tried harder to please, your partner will not become violent?" Which sign distinguishes compensated shock from decompensated shock in the pediatric patient? A. Peripheral pulses B. Blood pressure C. Capillary refill D. Level of consciousness A 5-year-old arrives to the emergency department unconscious with a heart rate of 32 beats/minute, weak, thready pulses, and pale, mottled skin. The team has begun bag-mask ventilation with 100% oxygen and chest compressions with no improvement in the heart rate. An intraosseous line is in place. Which of the following interventions is the priority? A. Administration of atropine B. Transcutaneous pacing C. Administration of epinephrine D. Attempt vagal stimulation A 9 - month-old infant pulled himself up onto the hearth of a fireplace. While doing so, he fell forward onto the hot glass doors and sustained deep partial thickness burns to the bilateral

palmar aspects of both hands. What is the approximate percentage of total body surface area burned? A. 1% B. 2% C. 4% D. 5% An ambulance arrives with a 13-year-old pedestrian hit by a car. Identified injuries reported by paramedics include multiple abrasions to the head and face, a large, actively bleeding laceration to the forehead, hip pain with the leg externally rotated, and bruising across the chest and abdomen. The patient is in full spinal immobilization and has two intravenous catheters and a nonrebreather oxygen mask in place. Vital signs are BP 110/70 mm Hg, HR 118 beats/minute, RR 24 breaths/minute, and SpO2 96%. The Glasgow coma scale score is 15. What is the priority? A. Computed tomography B. Immobilize the femur C. A pressure dressing to the forehead D. Focused assessment with sonography for trauma (FAST) A 15-year-old with a history of schizophrenia is taking risperidone (Risperdal) and lithium (Eskalith). She presents with dystonia, akinesia, a shuffling gait, muscle rigidity, and tremors. What does the nurse suspect is the cause of these signs and symptoms? A. Extrapyramidal symptoms B. Tardive dyskinesia C. Neuroleptic malignant syndrome D. Serotonin syndrome Which of the following burn injury patterns and history indicates suspected child maltreatment? A. A 5 - cm (2 inch) linear, superficial partial-thickness burn with irregular edges on the leg of a preschooler, reportedly from touching a curling iron left on a low table B. A deep partial-thickness, sharply demarcated burn on the buttocks of a toddler, reportedly from the child turning on the hot water while in the bath C. A 2 - cm (0.75 inch) linear partial-thickness burn on the arm of toddler, reportedly from walking and bumping into a lighted cigarette D. A partial-thickness burn with irregular edges and splash pattern on the chest and right hand of a 7 - year-old reportedly spilling a bowl of soup from the microwave A mother presents to the emergency department with a 6-week-old infant with no medical issues after a normal delivery, until yesterday. Mom states he has been eating poorly, vomiting, and that "he's hard to wake up." The infant is responsive only to painful stimuli. The anterior fontanel is bulging. He is mildly tachycardic, but otherwise vital signs are normal. What diagnostic evaluation will the nurse expect for this infant? A. Upper gastrointestinal (GI) series B. Skeletal survey C. Lumbar puncture D. Blood gas analysis A malfunctioning oxygen tank explodes near a child's bed in the emergency department, resulting in an extensive burn injury to the child. Four nurses participate in the child's immediate care. Which nurse requires intervention after this critical incident?

A. One who refuses to participate in critical incident stress debriefing B. One who readily talks about the incident and how he reacted C. One who admits experiencing burnout and asks for a week leave of absence D. One who is not sleeping because of dreams of the incident Two ambulances collide in front of the hospital. The victims include three pediatric victims. Using the JumpSTART triage system, which category assignment will the nurse give to a 2 - year- old who is lying on the ground, alert and crying with spontaneous respirations of 36 breaths/minute and present peripheral pulses? A. Green B. Yellow C. Red D. Black