ENPC 6th Edition Actual Exam
Questions And Answers With
Explanations \ Rationales
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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 minute.
Which of the following laboratory values would be most
expected in this child? - ANSWER : 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? - ANSWER : 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 : 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
A 12-year-old is being prepped for surgical intervention of
acute appendicitis. Which of the following intravenous
medication orders should the nurse question? - ANSWER
: Ketorolac
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.
A 17-year-old female arrives in the ED with her boyfriend
who states she is pregnant and having vaginal bleeding.
The patient is unsure of the gestational age and has not
had any prenatal treatment. The patient is quiet and lets
her boyfriend answer most of the questions. Which of the
following is the most appropriate action for the nurse to
take at this point? - ANSWER : Have the boyfriend leave
the room during the pelvic exam.
A 2-year-old arrives at the ED in hypovolemic shock and
needs fluids immediately. After several attempts, your
team has been unsuccessful at establishing vascular
access. Of the following, which is the next best option for
establishing access quickly? - ANSWER : Intraosseous in
the patient's medial tibia.
, A child with an electrical injury is seen 1 hour post event.
Which of the following types of specimen samples would
provide visual information regarding a potential
complication of this injury? - ANSWER : Myoglobin is
excreted in the urine and is evidenced by dark, red-tinged
urine.
Parents with an infant requiring multiple laboratory tests,
radiographic studies, and invasive procedures appear to
be distressed and withdrawn. Which of the following
interventions would best ensure a sense of comfort and
control for these parents? - ANSWER : Providing frequent
updates and re-educating them on the care that is being
provided
When taking vital signs on a stable infant, which of the
following should be done first? - ANSWER : Respiratory
rate
A laceration on a toddler's arm is prepared for suturing.
Which of the following preparations for topical anesthesia
would be the best choice for this procedure? - ANSWER :
LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-
acetylcysteine (NAC) for an acetaminophen overdose? -
ANSWER : A bolus infusion of 150 mg/kg NAC should be
administered.
