Download ENPC 6th Edition Course Exam Newest 2025/2026 and more Exams Nursing in PDF only on Docsity!
ENPC 6th Edition Course Exam Newest
A II! 4 - year-old II!presents II!with II!vomiting, II!lethargy, II!frequent II!urination, II!weight II!loss, II!and II!dry II!mucous II!membranes. II!Vital II!signs II!reveal II!deep II!respirations II!at II! 44 II!breaths II!per II!minute, II!BP II!of II!70/44 II!mm II!Hg, II!and II!HR II!of II! 144 II!beats II!per II!minute. II!Which II!of II!the II!following II!laboratory II!values II!would II!be II!most II!expected II!in II!this II!child? II!- II! II!Correct II!Answers II! II! II! II!Hypoglycemia II!(wrong) Remediation II!feedback: Children II!can II!present II!with II!new II!onset II!diabetes II!in II!diabetic II!ketoacidosis. II!Manifestations II!include II!signs II!of II!dehydration II!( II!dryII!mucous II!membranes, II!hypotension, II!tachycardia), II!incontinence II!(polyuria), II!vomiting, II!abdominal II!pain, II!Kussmaul II!respirations II!(to II!counter II!the II!acidosis), II!polydipsia, II!anorexia, II!and II!weight II!loss. II!Expected II!laboratory II!values II!would II!reveal II!an II!acidotic II!state II!with II!a II!pH II!level II!below II!7.3, II!an II!elevated II!serum II!bIcarbonate II!level, II!and II!an II!elevated II!blood II!glucose II!level II!> II! 200 II!mg.dL. II!An II! 18 - month-old II!is II!seen II!for II!fever, II!slight II!circumoral II!cyanosis, II!and II!wheezing II!noted II!on II!auscultation II!in II!the II!right II!upper II!lobe II!of II!the II!lung II!field II!after II!a II!choking II!event II! 4 II!days II!ago. II!The II!white II!blood II!cell II!count II!is II!elevated II!and II!the II!patient II!noted II!to II!be II!tachypneic, II!tachycardic, II!agitated, II!and II!has II!an II!increased II!respiratory II!effort. II!At II!the II!time II!of II!the II!event, II!the II!patient II!was II!started II!on II!antibiotics II!with II!subsequent II!increasing II!manifestations II!instead II!of II!improvement. II!Which II!of II!the II!following II!would II!be II!considered II!to II!be II!definitive II!treatment II!for II!the II!suspected II!diagnosis? II!- II! II!Correct II!Answers II! II! II! II!Computed II!tomography II!(wrong) Remediation II!feedback: Manifestations II!of II!a II!lowerII!airway II!foreign II!body II!include II!a II!choking II!incident II!with II!subsequent II!failure II!to II!improve II!on II!antibiotics. II!Wheezing II!or II!decreased II!lung II!sounds II!in II!one II!area II!of II!the II!pulmonary II!system II!is II!a II!high II!indicator II!for II!a II!foreign II!body II!along II!with II!signs II!of II!hypoxia II!such II!as II!cyanosis, II!tachypnea, II!tachycardia, II!increased II!respiratory II!effort, II!agitation II!or II!lethargy, II!and II!elevated II!white II!blood II!cell II!counts II!indicating II!an II!infectious II!process. II!The II!definitive II!treatment II!would II!be II!a II!bronchoscopy II!in II!order II!to II!retrieve II!the II!suspected II!foreign II!body II!instead II!of II!diagnostic II!tests II!to II!locate II!the II!foreign II!body II!itself.
II!A II!child II!in II!cardiopulmonary II!arrest II!is II!receiving II!chest II!compressions II!and II!manual II!ventilations II!with II!a II!bag-mask II!device. II!Once II!return II!of II!spontaneous II!circulation II!has II!been II!confirmed, II!which II!of II!the II!following II!would II!be II!the II!priority II!intervention? II!- II! II!Correct II!Answers II! II! II! II!Establishing II!a II!secure II!airway II!Parents II!report II!their II! 3 - year-old II!child II!has II!developed II!noisy II!breathing. II!On II!assessment, II!high-pitched II!wheezes II!are II!audible II!and II!auscultated II!on II!inspiration II!and II!expiration. II!What II!medication II!would II!be II!appropriate II!to II!administer II!first? II!- II! II!Correct II!Answers II! II! II! II!Humidified II!oxygen II!(wrong) Remediation II!feedback: Wheezing II!is II!most II!often II!identified II!with II!asthma II!in II!the II!pediatric II!population. II!Initial II!medication II!intervention II!includes II!an II!inhaled II!short-actingII!beta II!agonist. II!A II! 6 - week-old II!isII!brought II!to II!the II!emergency II!department II!by II!the II!caregivers II!for II!poor II!feeding, II!listlessness, II!and II!fever. II!Assessment II!reveals II!a II!crying II!infant, II!HR II! 160 II!beats/minute, II!RR II! 52 II!breaths/minute, II!rectal II!temperature II!of II!96.0 II!F II!(35.5 II!C), II!and II!a II!bulging II!anteriorII!fontanel. II!Capillary II!refill II!is II! 4 II!seconds. II!Based II!on II!these II!findings II!what II!is II!the II!most II!likely II!diagnostic II!test II!the II!nurse II!should II!anticipate? II!- II! II!Correct II!Answers II! II! II! II!Lumbar II!puncture II!A II! 12 - year-old II!is II!being II!prepped II!for II!surgical II!intervention II!of II!acute II!appendicitis. II!Which II!of II!the II!following II!intravenous II!medication II!orders II!should II!the II!nurse II!question? II!- II! II!Correct II!Answers II! II! II! II!Hydromorphone II!(wrong) Remediation II!feedback: Ketorolac II!is II!an II!appropriate II!medication II!for II!moderate II!to II!severe II!pain, II!however, II!it II!should II!not II!be II!used II!pre-operatively II!due II!to II!its II!potential II!to II!increase II!the II!bleeding II!risk. II!A II! 17 - year-old II!female II!arrives II!in II!the II!ED II!with II!her II!boyfriend II!who II!states II!she II!is II!pregnant II!and II!having II!vaginal II!bleeding. II!The II!patient II!is II!unsure II!of II!the II!gestational II!age II!and II!has II!not II!had II!any II!prenatal II!treatment. II!The II!patient II!is II!quiet II!and II!lets II!her II!boyfriend II!answer II!most II!of II!the II!questions. II!Which II!of II!the
II!Which II!of II!the II!following II!is II!appropriate II!administration II!of II!N-acetylcysteine II!(NAC) II!for II!an II!acetaminophen II!overdose? II!- II! II!Correct II!Answers II! II! II! II!A II!bolus II!infusion II!of II! 150 II!mg/kg II!NAC II!should II!be II!administered. II!A II! 10 - year-old II!arrives II!at II!the II!ED II!post II!motor II!vehicle II!crash. II!The II!following II!assessment II!is II!noted: II!hypotension, II!tachycardia, II!absent II!breath II!sounds II!from II!the II!left II!chest II!with II!an II!increased II!respiratory II!rate, II!pain II!on II!palpation II!ofII!the II!pelvis, II!tinge II!of II!blood II!noted II!at II!the II!urinary II!meatus, II!moderate II!active II!bleeding II!from II!a II!laceration II!to II!left II!thigh, II!pulse II!oximetry II!of II!86% II!without II!supplemental II!oxygen, II!deformity II!to II!the II!left II!upper II!leg, II!and II!a II!Glasgow II!Coma II!Score II!of II!7. II!Which II!of II!the II!following II!orders II!will II!prompt II!the II!nurse II!to II!have II!a II!discussion II!with II!the II!provider II!before II!initiating? II!- II! II!Correct II!Answers II! II! II! II!Assist II!with II!chest II!tube II!insertion II!(wrong) Remediation II!feedback: Urinary II!catheters II!are II!contraindicated II!for II!placement II!if II!pelvic II!injury II!is II!suspected II!or II!blood II!is II!noted II!at II!the II!urinary II!meatus. II!Scrotal II!or II!perineal II!discolorations II!with II!edema II!to II!the II!areas II!is II!also II!a II!contraindication II!for II!this II!adjunct. II!A II! 2 - year-old II!is II!seen II!with II!a II! 3 - day II!history II!of II!irritability, II!vomiting, II!and II!the II!presence II!of II!foul-smelling II!urine. II!The II!child II!is II!hypotensive II!and II!tachycardic. II!Which II!of II!the II!following II!methods II!for II!obtaining II!a II!urine II!sample II!is II!most II!appropriate II!in II!this II!circumstance? II!- II! II!Correct II!Answers II! II! II! II!Urinary II!catherization II!A II!child II!with II!bipolar II!disorder II!is II!brought II!to II!the II!emergency II!department II!for II!increasing II!irritability, II!agitation, II!pressured II!speech, II!and II!a II!decreased II!need II!for II!sleep. II!What II!should II!be II!included II!in II!the II!plan II!of II!care II!for II!thisII!child? II!- II! II!Correct II!Answers II! II! II! II!Performing II!a II!suicide II!risk II!assessment II!You II!are II!discharging II!a II!patient II!home II!who II!has II!a II!history II!of II!depression. II!Discharge II!teaching II!should II!include II!which II!of II!the II!following? II!- II! II!Correct II!Answers II! II! II! II!Ensuring II!all II!firearms II!in II!the II!home II!are II!locked II!up II!with II!no II!access II!available II!by II!the II!patient. II!A II! 5 - year-old II!child II!presents II!with II!hives, II!swelling II!of II!the II!lips II!and II!face,II!and II!stridor II!that II!developed II!about II!an II!hour II!after II!eating II!lunch. II!The II!child II!has II!no II!known II!allergies. II!Which II!of II!the II!following II!isII!the II!priority II!intervention? II!- II! II!Correct II!Answers II! II! II! II!Administer II!intramuscular II!epinephrine
II!Which II!of II!the II!following II!pathologic II!processes II!would II!most II!likely II!be II!attributed II!to II!a II!primary II!diagnosis II!of II!cystic II!fibrosis? II!- II! II!Correct II!Answers II! II! II! II!Constipation II!A II! 2 - year-old II!arrives II!with II!a II! 2 - day II!history II!of II!vomiting II!and II!diarrhea. II!The II!patient II!has II!a II!fever II!of II!38.4oC II!(101.2°F), II!resting II!HR II!of II! 152 II!beats/minute, II!RR II!of II! 34 II!breaths/minute, II!and II!blood II!pressure II!of II!94/ II! 56 II!mm II!Hg. II!Assessment II!reveals II!a II!capillary II!refill II!time II!of II!> II! 5 II!seconds. II!Which II!of II!the II!following II!would II!be II!most II!indicative II!of II!the II!need II!for II!intravenous II!rehydration II!therapy II!for II!this II!patient? II!- II! II!Correct II!Answers II! II! II! II!Capillary II!refill II!Which II!of II!the II!following II!is II!a II!family-centered II!care II!concept II!? II!- II! II!Correct II!Answers II! II! II! II!Cultural II!backgrounds II!are II!assessed II!and II!incorporated II!into II!the II!plan II!of II!care. II!An II! 8 - month-old II!arrives II!with II!a II! 12 - hour II!history II!of II!intermittent II!abdominal II!pain, II!non-bilious II!vomiting, II!and II!a II!low II!grade II!fever. II!On II!assessment II!the II!child II!is II!intermittently II!inconsolable II!followed II!by II!periods II!of II!normal II!activity. II!A II!sausage-shaped II!mass II!is II!noted II!during II!palpation II!of II!the II!abdomen. II!The II!nurse II!should II!prepare II!for II!which II!of II!the II!following? II!- II! II!Correct II!Answers II! II! II! II!Enema II!with II!air II!A II!caregiver II!presents II!to II!the II!emergency II!department II!with II!an II! 18 - month-old II!and II!reports II!the II!child II!is II!not II!using II!their II!left II!arm II!after II!playing II!a II!game II!with II!an II!older II!sibling. II!The II!child II!is II!alert II!and II!curious, II!with II!regular, II!even II!respirations, II!and II!skin II!color II!is II!appropriate. II!Using II!the II!Pediatric II!Assessment II!Triangle II!(PAT), II!how II!would II!you II!categorize II!this II!patient? II!- II! II!Correct II!Answers II! II! II! II!Sick II!A II! 13 - year II!-old II!male II!presents II!to II!the II!triage II!desk II!complaining II!of II!nausea II!and II!vomiting. II!The II!patient II!looks II!distressed II!and II!pale. II!He II!complains II!of II!spasming II!pain II!in II!his II!right II!scrotum II!which II!has II!now II!become II!constant II!and II!more II!severe. II!Which II!of II!the II!following II!assessment II!findings II!would II!the II!nurse II!expect II!with II!this II!patient? II!- II! II!Correct II!Answers II! II! II! II!Elevated II!right II!testicle II!An II! 8 - year-old II!trauma II!patient II!suddenly II!develops II!increased II!respiratory II!distress II!with II!a II!rise II!in II!heart II!rate II!from II! 112 II!beats/minute II!to II! 142 II!beats/minute II!associated II!with II!an II!abrupt II!hypotensive II!event. II!Distention II!of II!the II!jugular II!veins II!is II!noted. II!Which II!of II!the II!following II!emergent II!interventions II!should II!be II!anticipated II!first? II!- II! II!Correct II!Answers II! II! II! II!Drug II!assisted II!intubation II!(wrong)
II!A II! 14 - year-old II!patient II!had II!a II!reduction II!of II!a II!temporomandibular II!joint II!dislocation II!in II!the II!ED. II!Which II!of II!the II!following II!should II!be II!included II!in II!the II!discharge II!instructions? II!- II! II!Correct II!Answers II! II! II! II!Practice II!yawning II!three II!to II!four II!times II!a II!day II!(wrong) II! Remediation II!feedback: II! Patients II!with II!temporomandibular II!joint II!dislocation II!should II!avoid II!activities II!that II!involve II!extreme II!jaw II!joint II!opening. II!Cold II!or II!warm, II!not II!hot, II!compresses II!are II!recommended II!along II!with II!nonsteroidal II!anti-inflammatory II!medications II!for II!pain II!control. II!A II! 5 - year-old II!patient II!presents II!with II!severe II!dehydration II!and II!signs II!of II!shock II!due II!to II!viral II!gastroenteritis. II!Which II!of II!the II!following II!physiologic II!responses II!by II!this II!patient II!will II!have II!the II!greatest II!impact II!on II!improving II!their II!cardiac II!output? II!- II! II!Correct II!Answers II! II! II! II!Increased II!heart II!rate II!An II! 8 - year-old II!male II!presents II!to II!the II!emergency II!department II!with II!incoherent II!speech, II!hallucinations, II!and II!violent II!behavior. II!What II!is II!the II!priority II!in II!caring II!for II!this II!patient? II!- II! II!Correct II!Answers II! II! II! II!Ensure II!safety II!of II!the II!patient II!and II!staff II!A II! 12 - year-old II!presents II!to II!the II!emergency II!department II!with II!a II!severe II!headache. II!The II!mother II!reports II!that II!the II!child II!has II!been II!experiencing II!headaches II!and II!has II!had II!multiple II!seizures II!for II!the II!past II!several II!months. II!The II!child II!was II!seen II!by II!their II!primary II!doctor II!and II!prescribed II!an II!anti-seizure II!medication, II!but II!the II!prescription II!was II!not II!filled II!because II!"the II!doctor II!just II!wants II!money." II!This II!isII!an II!example II!of II!what II!type II!of II!neglect? II!- II! II!Correct II!Answers II! II! II! II!Medical II!A II! 14 - year-old II!patient II!with II!Down II!syndrome II!presents II!with II!an II!abnormal II!gait, II!head II!tilted II!to II!the II!left, II!decreased II!sensation II!to II!the II!extremities, II!and II!urinary II!incontinence. II!The II!patient II!has II!no II!history II!of II!trauma. II!Which II!of II!the II!following II!diagnostics II!is II!the II!priority II!for II!this II!patient?II!- II! II!Correct II!Answers II! II! II! II!Cervical II!spine II!radiographs
II!The II!nurse II!is II!triaging II!an II!infant II!brought II!to II!the II!emergency II!department II!by II!their II!caregiver. II!Which II!finding II!by II!the II!nurse II!leads II!the II!infant II!to II!be II!placed II!in II!isolation? II!- II! II!Correct II!Answers II! II! II! II!Barking II!cough II!(wrong) Remediation II!feedback Triage II!begins II!when II!the II!child II!isII!initially II!visualized II!using II!the II!pediatric II!assessment II!triangle. II!Appearance, II!work II!of II!breathing, II!and II!circulation II!to II!the II!skin II!are II!components II!that II!guide II!the II!prioritization II!of II!the II!child's II!care. II!The II!presence II!of II!a II!purpuric II!rash II!necessitates II!the II!infant II!to II!be II!placed II!in II!isolation II!immediately II!as II!this II!is II!a II!symptom II!of II!possible II!meningitis. II!EMS II!is II!transporting II!a II! 12 - year-old II!restrained II!passenger II!involved II!in II!a II!high-speed II!motor II!vehicle II!collision. II!The II!patient II!complains II!of II!increasing II!dyspnea. II!Breath II!sounds II!are II!clear II!and II!equal, II!and II!heart II!sounds II!are II!difficult II!to II!auscultate. II!Vitals II!include II!HR II! 132 II!beats/minute, II!RR II! 36 II!breaths/minute, II!and II!BP II!80/55 II!mm II!Hg. II!Which II!of II!the II!following II!is II!the II!priority II!intervention? II!- II! II!Correct II!Answers II! II! II! II!Pericardiocentesis II!A II! 3 - year-old II!is II!assessed II!for II!the II!presence II!of II!increasing II!amounts II!of II!serosanguineous II!drainage II!from II!his II!left II!nares II!over II!the II!past II! 6 II!hours. II!Which II!of II!the II!following II!foreign II!bodies II!is II!the II!most II!likely II!etiology? II!- II! II!Correct II!Answers II! II! II! II!Button II!battery II!An II!infant II!presents II!to II!the II!emergency II!department II!with II!difficulty II!breathing. II!The II!patient II!is II!pale II!and II!respirations II!appear II!rapid II!and II!shallow. II!Which II!location II!on II!the II!torso II!is II!the II!most II!effective II!site II!for II!assessing II!bilateral II!breath II!sounds? II!- II! II!Correct II!Answers II! II! II! II!Bilateral II!midaxillary II!A II!child II!presents II!with II!a II!history II!of II!poor II!oral II!intake. II!The II!patient II!is II!pale, II!lethargic, II!and II!has II!shallow, II!rapid II!respirations. II!Central II!pulses II!are II!weak II!and II!capillary II!refill II!time II!is II!four II!seconds. II!Which II!of II!the II!following II!interventions II!has II!the II!highest II!priority? II!- II! II!Correct II!Answers II! II! II! II!Initiate II!an II!intravenous II!fluid II!bolus II!A II! 5 - year-old II!arrives II!in II!the II!ED II!with II!a II! 4 II!day II!history II!of II!vomiting. II!Vital II!signs: II!HR II! 136 II!beats/minute, II!RR II! 36 II!breaths/minute, II!BP II!92/56 II!mm II!Hg, II!T II!38oC II!(100.4oF), II!and II!pulse II!oximetry II!93% II!on II!room II!air. II!The II!child II!is II!pale II!with II!warm, II!dry II!skin II!and II!a II!capillary II!refill II!of II! 3 II!seconds. II!A II!fluid II!bolus II!isII!completed.
Remediation II!feedback: Urinary II!catheters II!are II!contraindicated II!for II!placement II!if II!pelvic II!injury II!is II!suspected II!or II!blood II!is II!noted II!at II!the II!urinary II!meatus. II!Scrotal II!or II!perineal II!discolorations II!with II!edema II!to II!the II!areas II!is II!also II!a II!contraindication II!for II!this II!adjunct. II!Which II!of II!the II!following II!is II!a II!first-line II!treatment II!for II!atopic II!dermatitis? II!- II! II!Correct II!Answers II! II! II! II!Skin II!hydration II!therapy II!After II!a II!seizure II!at II!home, II!a II! 9 - month-old II!infant II!isII!awake II!and II!interacting II!appropriately. II!Vital II!signs II!on II!arrival II!are II!HR II! 150 II!beats/minutes, II!RR II! 36 II!breaths/minute II!(unlabored), II!BP II!80/52 II!mm II!Hg, II!SaO II!97% II!without II!supplemental II!oxygen, II!and II!T II!102.7°F II!(39.3°C) II!rectally. II!During II!re-evaluation II! 2 II!hours II!after II!arrival, II!which II!of II!theII!following II!assessments II!would II!indicate II!appropriate II!measures II!were II!taken II!in II!treating II!this II!child? II!- II! II!Correct II!Answers II! II! II! II!Temperature II!37.7°C II!(99.9°F) II!During II!a II!diaper II!change II!on II!a II! 4 - month-old II!infant, II!the II!nurse II!measures II!the II!infant's II!urinary II!output. II!After II!subtracting II!the II!weight II!of II!a II!dry II!diaper, II!the II!wet II!diaper II!weighs II! 22 II!grams. II!What II!is II!the II!infant's II!estimated II!urinary II!output? II!- II! II!Correct II!Answers II! II! II! II! 22 II!mL II!A II! 3 II!year-old II!patient II!presents II!following II!frequent II!emesis II!and II!diarrhea II!over II!the II!past II! 12 II!hours. II!Which II!of II!the II!following II!assessment II!findings II!indicate II!that II!the II!patient' II!body II!isII!compensating II!for II!the II!fluid II!loss? II!- II! II!Correct II!Answers II! II! II! II!Prolonged II!capillary II!refill II!(wrong) Remediation II!feedback: In II!the II!early II!compensated II!phase II!of II!shock II!attributed II!to II!fluid II!volume II!loss, II!the II!diastolic II!pressure II!will II!increase II!due II!to II!vasoconstriction II!(increasing II!systemic II!vascular II!resistance) II!as II!a II!compensatory II!mechanism II!causing II!a II!narrowed II!pulse II!pressure. II!A II!normal II!systolic II!pressure II!is II!maintained II!during II!this II!phase. II!Other II!manifestations II!of II!early II!shock II!states II!are II!tachycardia, II!normal II!capillary II!refill, II!decreased II!urine II!output, II!mild II!irritability, II!tachypnea, II!and II!weak II!peripheral II!pulses.
