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ENPC EXAM 6TH UNIT 2025 EXAM
WITH CORRECT SOLUTIONS.
A 5 - year-old child presents with hives, swelling of the lips and face, and stridor that developed about an hour after eating lunch. The child has no known allergies. Which of the following is the priority intervention?
A. Administer intramuscular epinephrine
B. Auscultate bilateral breath sounds
C. Insert an intravenous catheter
D. Administer inhaled albuterol - correct answer- A. Administer
intramuscular epinephrine An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing?
A. SpO2 of 94 % on room air
B. Widened pulse pressure
C. Extreme lethargy
D. Flash capillary refill - correct answer- A. SpO2 of 94 % on room air
A 3 - year-old has a two-day history of runny nose, low-grade fever, and a "barky" cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child?
A. Delivery of humidified oxygen by nasal cannula
B. Administration of nebulized epinephrine
C. Suctioning secretions from the oropharynx
D. Administration of albuterol with a spacer - correct answer- B.
Administration of nebulized epinephrine A 14 - year-old patient had a reduction of a temporomandibular joint dislocation in the ED. Which of the following should be included in the discharge instructions?
A. Practice yawning three to four times a day
B. Resume eating a regular diet later today
C. Apply hot packs to the joint area for pain control
D. Use a nonsteroidal anti-inflammatory for pain control - correct
answer- D. Use a nonsteroidal anti-inflammatory for pain control Which of the following parameters would indicate that appropriate post resuscitation interventions were successfully carried out in the pediatric patient?
A. Pulse oximetry reading of 96%
B. Temperature of 99.8°F (37.6°C)
C. Capillary refill of < 1 second
D. Capnography reading of 60 mm Hg - correct answer- A. Pulse
oximetry reading of 96% An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms?
A. Anaphylaxis
beats per minute. Which of the following laboratory values would be most expected in this child?
A. Hypoglycemia
B. Severe anemia
C. Low pH level
D. Elevated serum bicarbonate - correct answer- C. Low pH level
Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis?
A. Hypernatremia
B. Constipation
C. Obesity
D. Epiglottitis - correct answer- B. Constipation
Which of the following is the highest priority intervention for a well- appearing 2-month-old with a fever?
A. Lumbar puncture
B. Urine culture
C. Intravenous fluid bolus
D. Chest radiograph - correct answer- B. Urine culture
The caregivers of a 6-year-old report the child developed a cough with nasal congestion and "pink-eye" that started two days ago. Today they noticed a raised, red rash on the face, and grey papules in the mouth. Which of the following is the priority intervention for this patient?
A. Obtain a nasopharyngeal swab
B. Place in airborne isolation
C. Place in contact isolation
D. Obtain a fingerstick glucose - correct answer- C. Place in contact
isolation A 14 - Year-Old Patient With Down Syndrome Presents With An Abnormal Gait, Head Tilted To The Left, Decreased Sensation To The Extremities, And Urinary Incontinence. The Patient Has No History Of Trauma. Which Of The Following Diagnostics Is The Priority For This Patient?
A. Lumbar Spine Magnetic Resonance Imaging
B. Complete Neurologic Exam
C. Urinalysis By Straight Catheterization
D. Cervical Spine Radiographs - Correct Answer- D. Cervical Spine
Radiographs A 7 - Year-Old Is Being Seen For New Onset Of Headaches. Which Of The Following Manifestations Would Most Likely Rule Out The Potential Of A Primary Etiology?
A. Presence Of Ataxia
B. Pulsating, Unilateral Pain
C. Occurrence Of Photophobia
D. Nausea, Vomiting - Correct Answer- A. Presence Of Ataxia
A 3 - Week Old Is Brought To The Emergency Department With A History Of Fussiness, Spitting Up, Crying, And Watery Stools. Assessment Reveals An Alert Child With Moist Mucous Membranes. Which Of The Following Should Be The Priority?
Indicate That The Patient' Body Is Compensating For The Fluid Loss?
A. Increased Diastolic Blood Pressure
B. Bounding Peripheral Pulses
C. Prolonged Capillary Refill
D. Increased Urine Output - Correct Answer- A. Increased
Diastolic Blood Pressure A 6 - Year-Old Involved In A Boating Crash Is Awaiting Admission For Surgical Repair Of A Fractured Ankle. Which Of The Following Manifestations During Reassessments Would Cause The Greatest Concern For Possible Intra-Abdominal Trauma?
A. Chest Pain With Deep Inspiration
B. Thoracic Spine Pain With Palpation
C. Intermittent Shortness Of Breath
D. Constant Left Shoulder Pain - Correct Answer- D. Constant Left
Shoulder Pain During The Assessment Of A 16-Year-Old Patient, The ED Nurse Identifies Them As A Potential Sex Trafficking Victim. Which Of The Following Trauma-Informed Care Principles Has The Highest Priority For This Patient?
A. Empowerment, Voice, And Choice
B. Peer Support
C. Trustworthiness And Transparency
D. Physical And Psychological Safety - Correct Answer- D.
Physical And Psychological Safety.
A 6 - Year-Old Involved In A Boating Crash Is Awaiting Admission For Surgical Repair Of A Fractured Ankle. Which Of The Following Manifestations During Reassessments Would Cause The Greatest Concern For Possible Intra-Abdominal Trauma?
A. Chest Pain With Deep Inspiration
B. Thoracic Spine Pain With Palpation
C. Intermittent Shortness Of Breath
D. Constant Left Shoulder Pain - Correct Answer- D. Constant Left
Shoulder Pain A Caregiver Reports Their One-Month-Old Has Had A Yellowish Color To Their Eyes And Skin Over The Last Two Weeks. If Left Untreated, Which Body System Can This Affect?
A. Integumentary
B. Renal
C. Gastrointestinal
D. Neurological - Correct Answer- A. Integumentary
A Neonate Presents To The Emergency Department With Irritability, Weak Cry, And Hypotonia. Which Of The Following Is A Priority Intervention?
A. Prostaglandin Infusion
B. Toxin Screening
C. Head Compterized Tomography Scan
D. Serum Blood Glucose - Correct Answer- D. Serum Blood
Glucose
D. Sick - correct answer- D. Sick
An 8 - Year-Old Male Presents To The Emergency Department With Incoherent Speech, Hallucinations, And Violent Behavior. What Is The Priority In Caring For This Patient?
A. Administer Antipsychotic Medications
B. Evaluate Laboratory Values
C. Allow Family And Friend Visitation
D. Ensure Safety Of The Patient And Staff - Correct Answer- D.
Ensure Safety Of The Patient And Staff A 2 - Year-Old Child Is Seen With Acute Respiratory Distress After Playing Alone. Caregiver Statements Indicate The Child Was Found Playing With Irregular, ½ - ¾ Inch Sized Pieces Of A Game. Which Of The Following Assessment Findings Would Most Likely Be Expected For This Situation?
A. Audible Wheezing And Retractions
B. Inspiratory Stridor And Coughing
C. Grunting Respirations And Tachypnea
D. Quiet Tachypnea And Coarse Crackles - Correct Answer- B.
Inspiratory Stridor And Coughing A 15 - Year-Old Presents Alone Requesting Care. Which Of The Following Chief Complaints Would Most Likely Be Considered Legal Or Appropriate To Treat Without Parental Consent?
A. Lower back pain
B. Itching rash to arms
C. Possible pregnancy
D. Dental pain - correct answer- C. Possible pregnancy
An 11 - Year-Old Child Presents With Right Arm Pain After Falling Off A Bicycle. The Child Is Tearful And Holding His Right Arm. What Pain Scale Would Be The Most Appropriate To Use When Assessing This Child's Pain?
A. Faces scale
B. FLACC scale
C. Numbers scale
D. NIPS scale - correct answer- C. Numbers scale
A 10 - year-old arrives at the ED post motor vehicle crash. The following assessment is noted: hypotension, tachycardia, absent breath sounds from the left chest with an increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the urinary meatus, moderate active bleeding from a laceration to left thigh, pulse oximetry of 86% without supplemental oxygen, deformity to the left upper leg, and a Glasgow Coma Score of 7. Which of the following orders will prompt the nurse to - correct answer- A. Insert urinary catheter A Six-Week-Old Infant Presents To The Emergency Department With Seizures. The Infant Is Afebrile With A Normal Glucose Level ,And Caregivers Report No Signs Of Illness Other Than Formula Intolerance, Which They Treated By Adding Extra Water To The Formula. The Nurse Would Expect To Find Which Of The Following Laboratory Abnormalities?
A. Hypokalemia
B. Hyponatremia
B. Suspicious Clothing Should Be Placed In Separate, Clean, Clearly
Marked Plastic Bags.
C. Clothing Should Always Be Cut Along Seam Lines To Preserve
Evidence.
D. Clothing Should Not Be Placed On The Floor In Order To Prevent
Contamination. - Correct Answer- D. Clothing Should Not Be Placed On The Floor In Order To Prevent Contamination. 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?
A. Serum
B. Urine
C. Stool
D. Sputum - correct answer- B. Urine
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?
A. Intraosseous In The Patient's Medial Tibia.
B. Peripherally Inserted Central Catheter
C. Assisting With Central Line Placement.
D. Intraosseous In The Patient's Scapula. - Correct Answer- A.
Intraosseous In The Patient's Medial Tibia. A Child Has A Nondisplaced Fracture Of The Radius That Has Been Splinted, With A Sling In Place And Nsaids Given For Pain. Prior
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To Discharge Home With Follow-Up At A Pediatric Facility, What Actions Must Be Completed?
A. Discharge Instructions Including Follow-Up Contact
Information.
B. Ensure The Receiving Facility Has Space And Qualified
Personnel.
C. Certify That Medical Benefits Of Discharge Outweigh Risks.
D. Complete Doctor-To-Doctor Communication With Receiving
Facility. - Correct Answer- A. Discharge Instructions Including Follow- Up Contact Information. The Nurse Is Triaging An Infant Brought To The Emergency Department By Their Caregiver. Which Finding By The Nurse Leads The Infant To Be Placed In Isolation?
A. Barking Cough
B. Purpuric Rash
C. High-Pitched Cry
D. Mottled Skin - Correct Answer- B. Purpuric Rash
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?
A. Taking The Child To The Radiographic Studies While The Parents Rest
In The Room
B. Providing Frequent Updates And Re-Educating Them On The Care
That Is Being Provided
C. Ensuring Adequate Lighting And Keeping The Door Closed To
Provide Privacy - Correct Answer- B. Providing Frequent Updates And Re- Educating Them On The Care That Is Being Provided
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D. Intravenous Ondansetron - Correct Answer- A. Intramuscular
Epinephrine A 12 - Year-Old Is Being Prepped For Surgical Intervention Of Acute Appendicitis. Which Of The Following Intravenous Medication Orders Should The Nurse Question?
A. Morphine
B. Acetaminophen
C. Hydromorphone
D. Ketorolac - correct answer- D. Ketorolac
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 def - correct answer- C. Bronchoscopy 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?
A. Humidified Oxygen
B. Inhaled Beta-Agonist
C. Oral Steroids
D. Nebulized Magnesium Sulfate - Correct Answer- B. Inhaled Beta-
Agonist
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A 3 - Year-Old Child Who Was Found In A Pool Unresponsive Has Return Of Spontaneous Circulation (ROSC) After Prolonged Resuscitation. Intubation Was Performed In The Field. Upon Arrival To The ED, Which Intervention Is Of Highest Priority?
A. Administer Sedation As Ordered.
B. Utilize A Length-Based Resuscitation Tape To Determine The
Approximate Weight.
C. Auscultate Breath Sounds Over The Epigastrium And Lung
Fields.
D. Obtain A Bedside Blood Glucose Reading. - Correct Answer-
C. Auscultate Breath Sounds Over The Epigastrium And Lung Fields. A 3 - Year-Old Is Assessed For The Presence Of Increasing Amounts Of Serosanguineous Drainage From His Left Nares Over The Past 6 Hours. Which Of The Following Foreign Bodies Is The Most Likely Etiology? A. Magnet B. Button Battery C. Dried Bean D. Fishing Weight - Correct Answer- B. Button Battery
