ENPC 6th edition Questions and Answers
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A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and
dry mucous membranes. Vital signs reveal deep respirations at 44 breaths per
minute, BP of 70/44 mm Hg, and HR of 144 beats per minut...
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and
dry mucous membranes. Vital signs reveal deep respirations at 44 breaths per
minute, BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of the
following laboratory values would be most expected in this child? -
ANS✓✓Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis.
Manifestations include signs of dehydration ( dry mucous membranes,
hypotension, tachycardia), incontinence (polyuria), vomiting, abdominal pain,
Kussmaul respirations (to counter the acidosis), polydipsia, anorexia, and weight
loss. Expected laboratory values would reveal an acidotic state with a pH level
below 7.3, an elevated serum bIcarbonate level, and an elevated blood glucose
level > 200 mg.dL.
An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted
on auscultation in the right upper lobe of the lung field after a choking event 4 days
ago. The white blood cell count is elevated and the patient noted to be tachypneic,
tachycardic, agitated, and has an increased respiratory effort. At the time of the
event, the patient was started on antibiotics with subsequent increasing
manifestations instead of improvement. Which of the following would be
considered to be definitive treatment for the suspected diagnosis? -
ANS✓✓Computed tomography (wrong)
Remediation feedback:
Manifestations of a lower airway foreign body include a choking incident with
subsequent failure to improve on antibiotics. Wheezing or decreased lung sounds
, in one area of the pulmonary system is a high indicator for a foreign body along
with signs of hypoxia such as cyanosis, tachypnea, tachycardia, increased
respiratory effort, agitation or lethargy, and elevated white blood cell counts
indicating an infectious process. The definitive treatment would be a bronchoscopy
in order to retrieve the suspected foreign body instead of diagnostic tests to locate
the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and manual
ventilations with a bag-mask device. Once return of spontaneous circulation has
been confirmed, which of the following would be the priority intervention? -
ANS✓✓Establishing a secure airway
Parents report their 3-year-old child has developed noisy breathing. On assessment,
high-pitched wheezes are audible and auscultated on inspiration and expiration.
What medication would be appropriate to administer first? - ANS✓✓Humidified
oxygen (wrong)
Remediation feedback:
Wheezing is most often identified with asthma in the pediatric population. Initial
medication intervention includes an inhaled short-acting beta agonist.
A 6-week-old is brought to the emergency department by the caregivers for poor
feeding, listlessness, and fever. Assessment reveals a crying infant, HR 160
beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C), and a
bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings
what is the most likely diagnostic test the nurse should anticipate? -
ANS✓✓Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis.
Which of the following intravenous medication orders should the nurse question? -
ANS✓✓Hydromorphone (wrong)
Remediation feedback:
Ketorolac is an appropriate medication for moderate to severe pain, however, it
should not be used pre-operatively due to its potential to increase the bleeding risk.
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