ENPC 6TH EDITION COURSE EXAM 2024/ACTUAL EXAM WITH CORRECT DETAILED ANSWERS WITH RATIONALES/A+ GRADE
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...
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. This of the following would
be considered to be def - ANSWER bronchoscopy
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? - answer 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? - ANSWER 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? - ANSWER Lumbar puncture
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