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ENPC FINAL EXAM LATEST REAL EXAM 150 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) | AGRADE
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ENPC FINAL EXAM LATEST 2023-2024 REAL EXAM 150 QUESTIONSAND CORRECT ANSWERS (VERIFIED ANSWERS) | AGRADE
When a poison has been ingested by a child, the parents should be instructed to do
which of the following first?
a) Induce vomiting.
b) Call the local poison control center.
c) Administer an emetic.
d) Get to an emergency facility. - ANSWER- Call the local poison control center.
Correct
RATIONALE:
Not all poisons should be vomited. Strong acids, for example, could cause as much
destruction of tissue being vomited as being swallowed. The poison control center
will provide the most accurate information on the next steps for the patient.
Assessment of a child reveals a tension pneumothorax. The nurse would prepare
the child for which of the following?
a) Needle thoracotomy
b) Suctioning
c) Intubation
d) Defibrillation - ANSWER- Needle thoracotomy
Correct
RATIONALE:
A needle thoracotomy is indicated for tension pneumothorax to relieve the air
collected in the space. Intubation is indicated for apnea and in situations in which
the airway cannot be maintained. Suctioning would be indicated for excessive
airway secretions that influence airway patency. Defibrillation is used to stimulate
or alter the heart's electrical rhythm.
A 6-year-old girl who is being treated for shock is pulseless with an irregular heart
rate of 32 BPM. Choose the priority intervention:
,a) Administer doses defibrillator shocks in a row
b) Initiate cardiac compressions
c) Give three doses of epinephrine
d) Defibrillate once followed by three cycles of cardiopulmonary
resuscitation (CPR) - ANSWER- Initiate cardiac compressions
Correct
RATIONALE:
The American Heart Association (AHA) emphasizes the importance of cardiac
compressions in pulseless clients with arrhythmias, making this the priority
intervention in this situation. Current AHA recommendations are for
defibrillation to be administered once followed by five cycles of CPR. The AHA
now recommends against using multiple doses of epinephrine because they have
not been shown to be helpful and may actually cause harm to the child.
A 3-year-old girl had a near-drowning incident when she fell into a wading pool.
Which intervention would be of the highest priority?
a) Inserting a nasogastric tube to decompress stomach
b) Assuring the child stays still during an X-ray
c) Suctioning the upper airway to ensure airway patency
d) Covering the child with warming blankets - ANSWER- Suctioning the upper
airway to ensure airway patency
Correct
RATIONALE:
Due to the potentially devastating effects of drowning-related hypoxia on a child's
brain, airway interventions must be initiated immediately. The child's airway
should be suctioned to ensure patency. Other interventions such as covering the
child with blankets, inserting a nasogastric tube, and assuring that the child
remains still during X-ray are interventions that are appropriate once airway
patency is achieved and maintained.
The nurse is preparing an in-service program on pediatric cardiopulmonary
resuscitation. The nurse would include a discussion that cardiopulmonary arrest in
infants and children is most likely the result of which of the following?
a) Underlying heart disease
b) Respiratory failure
c) Neurologic trauma
d) Lethal arrhythmia - ANSWER- Respiratory failure
,Correct
RATIONALE:
Cardiopulmonary arrest in infants and children typically results from disorders that
lead to respiratory failure and shock. In adults, the most common causes of
cardiopulmonary arrest are lethal arrhythmias secondary to heart disease. Although
neurologic trauma can lead to respiratory failure, it alone is not the most likely
factor.
A 13-year-old girl suffered a serious fall while hiking with friends and injured her
head. She is now being evaluated by a nurse in the emergency room. The nurse
notices clear fluid flowing from the girl's nose. The girl's friend said that she had
been suffering from pollen allergy recently. Which of the following interventions
should the nurse implement to determine whether the fluid is cerebrospinal fluid
(CSF) or rhinitis from an allergy?
a) Evaluate the client's level of consciousness
b) Assess the client's blood pressure
c) Perform a skull x-ray
d) Test the fluid with a glucose reagent strip - ANSWER- Test the fluid with a
glucose reagent strip
Correct
RATIONALE:
Rhinorrhea or otorrhea (clear fluid draining from the nose or ear, respectively) may
be noticeable. The fluid is cerebrospinal fluid (CSF) and is a serious finding
because it means that the child's central nervous system is open to infection. If it's
not clear if the fluid is CSF or rhinitis from an allergy, test the fluid with a glucose
reagent strip. CSF will test positive for glucose, whereas the clear, watery drainage
from an upper respiratory tract infection or allergy will not. The other interventions
would not help determine whether the fluid was CSF or rhinitis.
Which medication is used for symptomatic bradycardia unresponsive to ventilation
and oxygenation?
a) Atropine
b) Naloxone
c) Sodium bicarbonate
d) Calcium carbonate - ANSWER- Atropine
Correct
RATIONALE:
, Atropine is used for symptomatic bradycardia unresponsive to ventilation and
oxygenation. Sodium bicarbonate is used for metabolic acidosis. Naloxone
reverses the effect of opioids. Calcium carbonate is used for documented or
suspected hypocalcemia, hyperkalemia, hypermagnesemia, and calcium channel
blocker overdose.
The nurse must calculate the adolescent's cardiac output. The child's heart rate is
76 beats per minute and the stroke volume is 75 mL. Calculate the child's
cardiac output. - ANSWER- 5700
RATIONALE:
Cardiac output (CO) is equal to heart rate (HR) times ventricular stroke volume
(SV). That is, CO = HR x SV 76 beats per minute x 75 mL = 5,700
A 4-year-old girl has been admitted to the emergency department after accidently
ingesting a cleaning product. Which of the following treatments is most likely
appropriate in the immediate treatment of the girl's poisoning?
a) Intravenous rehydration
b) Administration of activated charcoal
c) Gastric lavage
d) Inducing vomiting - ANSWER- Administration of activated charcoal
RATIONALE:
Explanation:
Activated charcoal is the most common treatment for many poisonings and is more
effective and safe than induced vomiting or gastric lavage. Rehydration is likely
necessary, but this does not actively treat the girl's poisoning.
The child's ability to perfuse well is poor due to inadequate circulation. The
physician writes an order for the child to receive 20 mL of normal saline for each
kilogram of body weight. The child will receive the normal saline as a bolus
through a central intravenous line. The child weighs 78 pounds. Calculate
the amount of normal saline the nurse should administer as a bolus. Round to the
nearest whole number.
mL - ANSWER- 709
RATIONALE:
78 pounds x 1 kg/2.2 pounds = 35.455 kg x 20 mL/kg = 709.1 mL. When rounded
to the nearest whole number = 709 mL
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