ENPC 6th Edition Course Exam
Questions And Answers
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? -
correct 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? -
correct answer ✅Computed tomography (wrong)
,ENPC 6th Edition Course Exam
Questions And Answers
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? -
correct 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? -
correct answer ✅Humidified oxygen (wrong)
Remediation feedback:
, ENPC 6th Edition Course Exam
Questions And Answers
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? -
correct 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? -
correct answer ✅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.
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
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