ENPC 6th edition Pre Exam Questions and
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A 14-year-old patient sustained a displaced fracture of the radius and ulna after
falling from a bicycle. Which of the following pain control interventions is most
likely to result in improvement in symptoms...
A 14-year-old patient sustained a displaced fracture of the radius and ulna after
falling from a bicycle. Which of the following pain control interventions is most
likely to result in improvement in symptoms related to pain? -ANS✓✓Applying a
splint to the affected extremity
Rationale
Splinting is an effective non-pharmacologic intervention to reduce pain associated
with fractures. This will also help to minimize complications. Topical creams and
elevation of the extremity will not help with pain control. The application of ice in
an appropriate manner can help, but not warmth which would be contraindicated in
the early stages of the injury.
Assessment of the fontanelle provides the most useful information for which two
components of the primary survey? -ANS✓✓Circulation and disability
Rationale
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.
A 6-month-old is seen for a recurrent respiratory infection. During the assessment,
the mother adds that the patient's stools seem to be fatty or "greasy". Which of the
following disease processes would be a primary concern for this child? -
ANS✓✓Cystic fibrosis
, Rationale
In patients with cystic fibrosis, thick mucus inhibits the release of pancreatic
enzymes necessary for digestion. This results in impaired absorption and the
inability to utilize ingested fats. These fats are excreted in the stools and can
present as "fatty" or "greasy". Combined with the recurrent upper respiratory
infections for an infant, cystic fibrosis should be ruled out. The other three disease
processes frequently present with respiratory issues but fatty stools would not
normally be seen.
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? -ANS✓✓Dextrose
10%
Rationale
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.
Which of the following indicates the need for additional caregiver education
regarding a urinary tract infection? -ANS✓✓My child will grow out of their
frequent urinary tract infections.
Rationale
Urinary tract infections are not a normal occurrence in children and are not
something children will "grow out of." Additional investigation and follow-up are
needed when a child has frequent urinary tract infections. Drinking extra fluids
should be encouraged. Patients should always finish the complete course of
antibiotics to eliminate the infection. And follow-up should be done to make sure
the infection has been eliminated.
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