ENPC 6TH EDITION LATEST 2024-2025 WITH ACTUAL
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A 4-day-old who is brought to the emergency department with the parental
complaint of "not acting right" is found to be hypoglycemic. What is the
appropriate glucose concentration to administer to this neonate?
A.Dextrose 5%
B.Dextrose 10%
C.Dextrose 25%
D.Dextrose 50% - ANSWER-B
Dextrose 10% is the preferred concentration for neonates with hypoglycemia to
protect their fragile vasculature while providing needed glucose. Dextrose 5% is
not used to treat hypoglycemia in children. Dextrose 25% is used for children
above the age of 5 years. Dextrose 50% is not recommended for use in
pediatrics unless it is diluted.
Assessment of the fontanelle provides the most useful information for which
two components of the primary survey?
A.Circulation and disability
B.Breathing and circulation
C.Disability and exposure
D.Circulation and exposure - ANSWER-A
,A sunken fontanelle is a red flag for circulation assessment in pediatric triage
and may indicate dehydration . A bulging fontanel is a red flag for disability
assessment in pediatric triage and can indicate increased intracranial pressure.
Which of the following indicates the need for additional caregiver education
regarding a urinary tract infection?
A.I should encourage my child to drink extra fluids.
B.I need to make a follow-up appointment with child's physician.
C.My child will grow out of their frequent urinary tract infections.
D.My child should complete all of their antibiotic medication. - ANSWER-C
A nurse providing trauma informed care to the family of a seriously ill child
should be doing which of the following?
A.Placing the family in a quiet, secluded room
B.Referring to their child as "the patient"
C.Making sure the family does not stay at the bedside.
D.Appointing one staff member to stay with the family - ANSWER-D
Caregivers experiencing the crisis of a critically ill child have low attentiveness
and increased stress so would benefit from having a member of the healthcare
team to stay with them as much as possible and communicate updates on the
plan of care. Caregivers should be allowed to stay with their child as much as
possible and not placed in a secluded room away for them.
The caregiver of a 7-year old reports witnessing a seizure at home, but no
seizure history. 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 caregiver states the burns accidentally occurred three days ago, but was
, afraid to bring the patient in due to an ongoing child welfare
investigation.Which of the following groups of interventions are the priority for
this patient?
A.Call police and child welfare authorities and have security detain the
caregiver
B.Administer intravenous analgesics and obtain a point of care glucose
C.Draw a metabolic panel, point of care glucose, and administer a fluid bolus
D.Administer lorazepam and a fluid bolus and place on seizure precautions -
ANSWER-C
Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and
electrolyte imbalances. Early identification and treatment of electrolyte
imbalances can help prevent further seizures. Contacting child protective
services and other authorities can wait. The patient is post-ictal so does not
require lorazepam medication at this time. Pain medication can and should be
considered with significant burns, but is not a priority.
What is the priority intervention for symptomatic bradycardia in a four-year-old
child?
A.Administer intravenous atropine
B.Administer intravenous epinephrine
C.Initiate bag-mask ventilation
D.Initiate transcutaneous pacing - ANSWER-C
\
Identifying and treating other causes, chest compressions, and epinephrine are
interventions for pediatric bradycardia with signs of poor perfusion that are not
improved by adequate oxygenation and ventilation. Atropine and pacing may
be considered if there is no response to the other interventions.
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