ULTIMATE ENPC EXAM 2024
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 ANSWERmost 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.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and
the presence of foul-smelling urine. The child is hypotensive and
tachycardic. Which of the following methods for obtaining a urine
sample is most appropriate in this circumstance? - ANSWER
Urinary catherization
You are discharging a patient home who has a history of depression.
Discharge teaching should include which of the following? -
