ENPC EXAM 2024 QUESTIONS AND ANSWERS
WELL SORTED DETAILED ANSWERS GRADED A+
During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential sex
trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for
these types of patients. Which of the following care principles has the highest priority? - ANSWER-
Physical and psychological safety Create an environment where patients feel safe, both physically and
psychologically. Increase awareness of the patient's interpersonal interactions with others to screen for
risk of harm. Prioritize the patient being in a safe location
A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When
gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory
symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of
the following disease processes? - ANSWER-Cystic Fibrosis Pancreatic insufficiency leads to fat
malabsorption, which results in the fatty stools seen with cystic fibrosis.
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 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, administer a fluid bolus, and obtain a point of care glucose Significant burns can cause
electrolyte imbalances. Electrolyte imbalances may be the cause of the patient's seizure. Electrolyte
imbalances need to be identified and treated.
In which of the following primary survey components can assessment of the fontanel provide the most
useful information? - ANSWER-Circulation and disability A sunken fontanel may indicate dehydration; a
bulging fontanel can indicate increased intracranial pressure.
,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 In pediatric patients, tachycardia is the primary compensatory
mechanism to increase cardiac output.
A toddler has a chemical eye injury. Which of the following is the priority intervention? - ANSWER-
Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to
increase cardiac output.
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.
Which of the following is the most appropriate intervention for a child experiencing a seizure? -
ANSWER-Prepare to administer intranasal midazolam Midazolam has gained favor because of its ease of
use and quick onset of action.
An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated prior to
arrival. Which of the following is the priority assessment or intervention? - ANSWER-Assess the
endotracheal tube placement and patency If a patient arrives with an artificial airway (endotracheal
tube or tracheostomy) in place, assess its placement, tube patency, and the oral airway (in that order)
before moving to the next step of the primary survey.
A three-year-old is rescued after being submerged in a residential pool for several minutes. On arrival at
the Emergency Department he is responsive to painful stimuli, has shallow respirations with diminished
breath sounds throughout, and has an occasional cough. What is the initial management priority? -
ANSWER-Endotracheal intubation with positive pressure ventilation Airway control and positive
pressure ventilation are the priority interventions for this patient.
A nurse providing crisis intervention to the family of a seriously ill child can best keep the family
informed of the child's condition by doing which of the following? - ANSWER-Appointing one staff
member to communicate with them. This will help create a solid patient-staff bond and facilitate
communication.
, 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. Promote 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 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department, the child
has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale skin. Vital signs are
HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The child is most likely in which of
the following shock states? - ANSWER-Hypovolemic shock The mechanism and presentation lead to a
suspicion of blood loss.
Which of the following is the priority intervention for a pediatric patient with diabetic ketoacidosis? -
ANSWER-Insulin infusion A continuous infusion of insulin at 0.05-0.1 unit/kg/hr should be used to
decrease blood glucose.
Which of the following describes a neonate's normal position? - ANSWER-Flexion with extremities close
to the body A neonate's normal position is flexion with extremities close to the body.
The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the radius
and ulna after falling from a bicycle. Which of the following pain interventions is most likely to result in
improvement in symptoms? - ANSWER-Application of a splint to the affected extremity Splinting is an
effective non-pharmacologic intervention to reduce pain associated with fractures.
The type of vascular access is appropriate in all of the patient situations given EXCEPT for which of the
following? - ANSWER-Peripherally inserted central catheter line for one time fluid bolus This vascular
access is most appropriate for long term medication administration and multiple blood draws.
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-Widening pulse pressure Narrowing pulse pressure and increasing heart rate are early
indications of ongoing blood loss.
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