ENPC 5th edition And 6th Edition Latest Update 2023 A+ Latest Upload Question And Answers.
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ENPC 5th edition And 6th Edition Latest Update 2023 A+ Latest Upload Question And Answers.
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 a...
ENPC 5th edition And 6th Edition Latest
Update 2023 A+ Latest Upload Question
And Answers.
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 bed-wetting 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.
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.
Promoting 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 2-year old has uniformly demarcated burns to bilateral lower extremities,
approximately 30% of the childs total body surface area. The father states he briefly left
the room while the child was in the bath and the child apparently played with the faucet.
Which of the following interventions has the highest priority? - ANSWER- Obtain
vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions.
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 and venous blood gas, administer a fluid bolus, and obtain
a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent another seizure.
,What is the priority intervention for symptomatic bradycardia in a four-year-old child? -
ANSWER- ventilation to address hypoxia is the priority intervention.
A 14-year-old high school student who was pitching for his baseball team was hit in the
chest by the ball and had a sudden cardiac arrest. Of the following, which is the most
likely cause of the cardiac arrest? - ANSWER- Commotio cordis
Comotio Cordis "occurs when chest is struck during the refractory period of the cardiac
conduction cycle. This type of injury usually occurs in recreational sports such as
baseball or ice hockey."
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- Focused Assessment:
Vital Signs: "As the patient compensates for altered tissue perfusion, the pulse pressure
narrows and the heart rate increases" - (need to rewrite either the question or the
answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign
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
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is primarily regulate
by increasing heart rate
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
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck) in children
younger than 4
Pg 11Any bruising in a child younger than 4 months.
All of the vaccine administrations listed are appropriate EXCEPT for which of the
following? - ANSWER- Fifth Disease at 6 months
There is an animal vaccine, but not a human vaccine for Fifth Disease.
, Which of the following statements indicates the caregiver understands your discharge
teaching on influenza? - ANSWER- My child can go to daycare since they have been off
of Tylenol and fever free for 24 hours.
Yes, the patient needs to be afebrile WITHOUT the use of antipyretics to be able to go
back to daycare or school.
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- Dedicate a healthcare team
member with a qualified interpreter to be with the family during the procedure.
Providing the option for family presence with an assigned team member to facilitate
communication is most supportive of the family in this situation.
A 6 year-old child presents to the emergency department with caregivers who report a
cough with nasal congestion and pink-eye that started 2 days ago. They have been
treating with an over-the-counter medicine without relief. Today they noticed a raised
red rash on the face and papules in the mouth. You suspect which of the following? -
ANSWER- Rubeola On presentation the child starts with cough, nasal inflammation
(coryza) and a non-purulent conjunctivitis.
After 2-4 days a rash begins as erythematous macules and papules on the face that
spreads to the torso and extremities.
A fertilizer silo exploded during a school tour of a working farm. The children are able to
manage their own secretions but are all incontinent and salivating with excess tearing.
Which of the following is the priority intervention? - ANSWER- removal of clothing and
decontamination
Decontamination of nerve agents requires removal of clothing and flushing the skin with
copious amounts of soap and water
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 toddler has a chemical eye injury. Which of the following is the priority intervention? -
ANSWER- Copious eye irrigation with an isotonic solution
Normal saline or Ringer's lactate solution are both acceptable for irrigation. Irrigate until
the pH of the eye returns to normal. The pH of Ringer's lactate is closer to that of human
tears and may be more comfortable than normal saline.
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