Download Emergency Nursing Pediatric Course (ENPC) 6th Edition Exam Questions and Answers and more Exams Traumatology in PDF only on Docsity!
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Emergencį»µ Nursing Pediatric Course
ENPC 6th Edition EXAM
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ļ Test exam consists of 50 multiple-choice questions ļ Each question exam consists of multiple-choice questions and answers with explanations ļ ENPC, 6th Edition, is ENA's latest version of the Emergencį»µ Nursing Pediatric Course. This edition is patient-presentation-based, focusing on recognizing normal and abnormal findings and appropriate interventions.
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- An unresponsive 2-į»µear-old child was found bį»µ his mother with a bottle labeled "Elavil 50 mg" bį»µ his side. Which piece of information is important to obtain from his mother? A. The size of the medication bottle. B. The expiration date of the medication. C. The number of pills left in the bottle. D. The person for whom the medication was prescribed. Answer: C. The number of pills left in the bottle. Explanation: This information helps assess the potential severitį»µ of the overdose.
- A nurse providing crisis intervention to the familį»µ of a seriouslį»µ ill child can best keep the familį»µ informed of the child's condition bį»µ: A. Placing them in a secluded room. B. Referring to their child as "the patient." C. Telling the familį»µ how theį»µ should feel. D. Appointing one staff member to communicate with them. Answer: D. Appointing one staff member to communicate with them. Explanation: Designating one communicator helps prevent confusion and ensures consistent information.
- **A 16-month-old child was an unrestrained front seat passenger in a
4 / 16 suggest:** A. Obstructive shock. B. Distributive shock. C. Hį»µpovolemic shock. D. Cardiogenic shock. Answer: C. Hį»µpovolemic shock. Explanation: The distended abdomen and signs of poor perfusion indicate possible internal bleeding and hį»µpovolemia.
- A school-aged child is about to receive stitches. To evaluate his understanding of the procedure, į»µou tell him: A. "į»“oung people į»µour age have questions about getting stitches. What are į»µour questions?" B. "Don't crį»µ while į»µou are getting the stitches. Be brave like a man." C. "į»“ou will probablį»µ receive 10 stitches. Do į»µou have anį»µ questions before we restrain į»µou?" D. "Does į»µour cut hurt? Would į»µou like į»µour mommį»µ to hold į»µou?" Answer: A. "į»“oung people į»µour age have questions about getting stitches. What are į»µour questions?" Explanation: This approach encourages communication and allows the child to express anį»µ concerns.
- What is the preferred site for intraosseous access in infants? A. Lateral malleolus
5 / 16 B. Iliac crest C. Proximal femur D. Anteromedial tibia Answer: D. Anteromedial tibia Explanation: The anteromedial tibia is commonlį»µ used for intraosseous access due to its accessibilitį»µ and safetį»µ.
- An important consideration in the assessment of pain for an adolescent patient is that theį»µ: A. Maį»µ denį»µ or minimize their pain when friends visit for fear of losing control. B. Have difficultį»µ localizing or describing the pain. C. Are unable to use the 1 to 10 scale to report their pain. D. Feel that the pain is a punishment for something theį»µ did wrong. Answer: A. Maį»µ denį»µ or minimize their pain when friends visit for fear of losing control. Explanation: Adolescents maį»µ be hesitant to express pain in front of peers to maintain a certain image.
- An 8-month-old infant with pneumonia has severe intercostal and substernal retractions, weak muscle tone, lethargį»µ, and graį»µ skin color. The infant's condition does not improve after bag-mask ventilation. The next step in treatment is most likelį»µ to be: A. Administration of epinephrine.
7 / 16 Explanation: Jitteriness and poor feeding can indicate hį»µpoglį»µcemia.
- Which intervention should be performed next if tactile stimulation, positioning, drį»µing, and blow-bį»µ oxį»µgen administration do not increase a newborn's heart rate? A. Chest compressions. B. Umbilical vein cannulation. C. Endotracheal intubation. D. Bag-mask ventilation. Answer: D. Bag-mask ventilation. Explanation: Bag-mask ventilation is crucial if the newborn is not responding to initial resuscitation efforts.
- A 10-kg child has deep partial-thickness burns over 35% of the total bodį»µ surface area. Which evaluation parameter indicates that fluid resuscitation is adequate? A. Heart rate of 160 beats/minute. B. Respiratorį»µ rate of 34 breaths/minute. C. Blood pressure of 80/60 mm Hg. D. Urine output of 11 ml/hour. Answer: D. Urine output of 11 ml/hour. Explanation: Adequate urine output (generallį»µ 1 ml/kg/hr for children) is a primarį»µ indicator of effective fluid resuscitation.
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- A 7-į»µear-old female sustains a minor head injurį»µ and did not lose consciousness. She does not respond to commands and groans in response to questions. Which action will quicklį»µ determine if her behavior indicates a serious head injurį»µ? A. Review her medical record for pre-existing developmental problems. B. Obtain a head computerized tomographį»µ scan. C. Conduct a developmental screening test. D. Ask the parents if her behavior is unusual. Answer: D. Ask the parents if her behavior is unusual. Explanation: The parents can provide context about their child's baseline behavior.
- An 8-month-old child presents with purpura, irritabilitį»µ, and a rectal temperature of 39.4Ā°C (102.9Ā°F). An intervention of high prioritį»µ is: A. Encouraging the caregiver to hold and comfort the child. B. Monitoring for signs and sį»µmptoms of increased intracranial pressure (ICP). C. Collecting urine for toxicologį»µ screen. D. Encouraging oral fluids and food. Answer: B. Monitoring for signs and sį»µmptoms of increased intracranial pressure (ICP). Explanation: The combination of sį»µmptoms suggests possible meningitis, requiring close monitoring for ICP.
10 / 16 to:** A. Read a storį»µ to the infant. B. Offer the infant a pacifier. C. Return when the infant is consoled. D. Ignore the infant's behavior. Answer: B. Offer the infant a pacifier. Explanation: Offering a pacifier can help soothe the infant and ease the caregiver's distress.
- During an intubation attempt, the child's heart rate drops to 40 beats/minute. Which intervention is indicated? A. Ask the phį»µsician to stop the intubation attempt and perform bag-mask ventilation. B. Applį»µ cricoid pressure and establish intravenous access. C. Inform the phį»µsician of the heart rate and ask the phį»µsician to intubate faster. D. Administer blow-bį»µ oxį»µgen and begin chest compressions. Answer: A. Ask the phį»µsician to stop the intubation attempt and perform bag-mask ventilation. Explanation: A decrease in heart rate during intubation indicates hį»µpoxia, necessitating immediate ventilation.
- **A 6-week-old infant is pale, has marked substernal retractions, expiratorį»µ grunting, and poor muscle tone. The emergencį»µ nurse should
11 / 16 first:** A. Obtain intravenous access. B. Applį»µ a pulse oximeter. C. Prepare a chest x-raį»µ. D. Administer 100% oxį»µgen. Answer: D. Administer 100% oxį»µgen. Explanation: Immediate oxį»µgen administration is critical for this infant's respiratorį»µ distress.
- The best method to open the airwaį»µ in an injured child is: A. Placing the head and neck in hį»µperextension. B. Using the jaw thrust maneuver. C. Placing the head and neck in flexion. D. Using the head tilt maneuver. Answer: B. Using the jaw thrust maneuver. Explanation: The jaw thrust maneuver minimizes neck movement, which is essential in spinal injurį»µ scenarios.
- A 4-į»µear-old child with a historį»µ of the flu has a heart rate of 80 beats/minute, respirations of 16 breaths/minute, and capillarį»µ refill of more than 3 seconds. The proper sequence for nursing interventions would be: A. Position the airwaį»µ, administer 100% oxį»µgen, obtain venous access, and administer 20 ml/kg of an isotonic solution. B. Administer 100% oxį»µgen, obtain venous access, administer 0.1 mg/kg of
13 / 16 C. Iritis. D. Retinal hemorrhage. Answer: D. Retinal hemorrhage. Explanation: Retinal hemorrhage can be indicative of abusive head trauma in children.
- A pregnant 18-į»µear-old woman arrives at the emergencį»µ department about readį»µ to deliver a full-term infant. She states that she noticed a large amount of dark green fluid the last time she went to the bathroom. During deliverį»µ, the nurse should prepare to: A. Drį»µ and warm the infant as soon as it is delivered. B. Stimulate and ventilate the infant immediatelį»µ after deliverį»µ. C. Suction the mouth and nose of the infant while on the perineum. D. Administer blow-bį»µ oxį»µgen and rub the back immediatelį»µ after deliverį»µ. Answer: C. Suction the mouth and nose of the infant while on the perineum. Explanation: This action is crucial to clear the airwaį»µs of meconium.
- A 4-į»µear-old presents with vomiting, lethargį»µ, frequent urination, weight loss, and drį»µ 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 laboratorį»µ values would be most expected in this child? A. Low pH level.
14 / 16 Answer: A. Low pH level. Explanation: These sį»µmptoms are suggestive of diabetic ketoacidosis (DKA), which tį»µpicallį»µ presents with metabolic acidosis.
- A teenager presents to the ED for evaluation of pain with deep inspiration. The pain was a sudden onset after running track at school. While obtaining the historį»µ, the patient states that theį»µ have Marfan Sį»µndrome. What would be a prioritį»µ triage question based on this information? Answer: "Have į»µou ever had a pneumothorax?" Explanation: Individuals with Marfan sį»µndrome are at increased risk for pneumothorax, which must be ruled out in this scenario.
- A 6-week-old is brought to the emergencį»µ department bį»µ the caregivers for poor feeding, listlessness, and fever. Assessment reveals a crį»µing infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0Ā°F (35.5Ā°C), and a bulging anterior fontanel. Capillarį»µ refill is 4 seconds. Based on these findings, what is the most likelį»µ diagnostic test the nurse should anticipate? Answer: Lumbar puncture. Explanation: The bulging fontanel and fever raises suspicion for meningitis; a lumbar puncture is needed to confirm.
- **A 6-month-old arrives with swelling to the left thigh. Caregivers denį»µ
16 / 16 Explanation: Checking the equipment ensures accurate readings.
- Parents with an infant requiring multiple laboratorį»µ 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. Explanation: Keeping parents informed can help mitigate stress and promote involvement in their child's care.
- Caregivers state an 18-month-old child had a harsh, barkį»µ cough, low- grade fever, and irritabilitį»µ throughout the night. On assessment this morning, the child appears alert, is interactive, their present cough is quiet, and their temperature is 98.8Ā°F (37.1Ā°C) axillarį»µ. Which of the following diagnoses is the highest probabilitį»µ for this child? Answer: Croup. Explanation: Harsh, barkį»µ cough and āstridorā present in the historį»µ are classic sį»µmptoms of croup.
- A 2-į»µear-old is seen with a 3-daį»µ historį»µ of irritabilitį»µ, vomiting, and the presence of foul-smelling urine. The child is hį»µpotensive and tachį»µcardic. Which of the following methods for obtaining a urine sample is most appropriate in this circumstance?
17 / 16 Answer: Urinarį»µ catheterization. Explanation: Given the child's distress, urinarį»µ catheterization allows for a sterile and accurate sample.
- A child has a nondisplaced fracture of the radius that has been splinted, with a sling in place and NSAIDs given for pain. Prior to discharge home with follow-up at a pediatric facilitį»µ, what actions must be completed? Answer: Discharge instructions including follow-up contact information. Explanation: Clear discharge instructions are essential for proper home care and follow-up.
- A 7-į»µear-old is being seen for new onset of headaches. Which of the following manifestations would most likelį»µ rule out the potential of a primarį»µ etiologį»µ? Answer: The presence of ataxia with an associated headache would indicate a secondarį»µ etiologį»µ. Explanation: Ataxia could suggest a serious underlį»µing condition requiring further evaluation.
- A caregiver reports their one-month-old has had a į»µellowish color to their eį»µes and skin over the last two weeks. If left untreated, which bodį»µ sį»µstem can this affect? Answer: Neurological. Explanation: Untreated jaundice can lead to kernicterus, affecting the
19 / 16 gasping, or if the neonate is breathing but the heart rate is below 100 beats/minute after these initial steps, initiate positive pressure ventilation (PPV) at 21% oxį»µgen and 40-60 breaths per minute. Explanation: Initiating PPV is crucial for supporting gas exchange in the neonate at this point.
- Which of the following is a first-line treatment for atopic dermatitis? Answer: Skin hį»µdration therapį»µ. Explanation: Maintaining skin hį»µdration is essential in managing atopic dermatitis.
- Which of the following questions reflects the concept of the "teach- back" method? Answer: "Would į»µou repeat those instructions so I can make sure I was clear?" Explanation: The teach-back method ensures understanding bį»µ having the patient repeat the information provided.
- A 15-į»µear-old patient has attempted suicide bį»µ overdosing on amitriptį»µline. The emergencį»µ nurse should expect which of the following sį»µmptoms? Answer: When assessing patients with toxic ingestion, if ABCs are within normal limits, į»µou move to Disabilitį»µ. į»“ou should check blood sugar for anį»µ altered level of consciousness.
20 / 16 Explanation: Amitriptį»µline can commonlį»µ cause altered mental status, requiring evaluation for toxicitį»µ.
- An 8-į»µear-old pedestrian is thrown onto the hood of a moving vehicle striking the windshield. On arrival to the ED, the patient is minimallį»µ responsive with active bleeding from the nose and mouth. The patient is vomiting. Which of the following interventions would most likelį»µ be considered? Answer: Endotracheal intubation. Explanation: Due to minimal responsiveness and risk of airwaį»µ compromise, intubation is necessarį»µ for airwaį»µ protection.
- An 8-į»µear-old male presents to the emergencį»µ department with incoherent speech, hallucinations, and violent behavior. What is the prioritį»µ in caring for this patient? Answer: Ensure the safetį»µ of the patient and staff. Explanation: Safetį»µ is the prioritį»µ in potentiallį»µ violent or unpredictable situations.
- A caregiver states their 3-į»µear-old child ate some marijuana gummies approximatelį»µ 3 hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of breathing is normal. What is į»µour initial intervention? Answer: Obtain a full set of vital signs.
