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ENPC exam questions with correct answers latest complete
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- Which of the following would be an abnormal finding in a patient with glomerulonephritis? Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. Decreased energy Hypertension Nausea, vomiting
- A 3-year-old is brought to the emergency department with a 2-day history of a runny nose, low- grade fever, and a "barky" cough at night. The caregiver tells the emergency department nurse the coughing is getting worse. The child is awake and alert, with stridor. The nurse should anticipate which of the following? Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. Delivery of humidified oxygen Bag-valve-mask ventilations Suctioning secretions from the oropharynx
- The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? Allow the extended to family members to serve as interpreters during the procedure. Dedicate a healthcare team member to be with the family during the procedure.
Allowing caregivers to remain with the pediatric patient is more supportive in this situation. Allow family members to serve as interpreters during the procedure Provide access to nondenominational clergy in a quiet area
- Which of the following patient presentations should increase suspicion of potential child maltreatment? Right radial spiral fracture in a 10-year-old practicing martial arts Bruising to the left ear of a newborn from sleeping on his side Any bruise in a non- exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse. Closed greenstick wrist fracture in a 4 year old who fell off his bicycle Bruises in various stages of healing to the lower extremities of a 2-year-old
- A 14-year-old high school student who was pitching for his baseball team was hit in the chest by the ball and had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest? Aortic Dissection Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey. Pericardial Tamponade
Obtain the patient's weight in kilograms This is the preferred measurement for medication calculations for pediatric and adult patients. Verifying the patient dose during shift report at nursing station Dual confirmation of a hard to read order Confirming patient's attending provider
- Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases? Mononucleosis Hemophilia Sickle cell anemia These are all complications of sickle cell anemia. Acute rheumatic fever
- During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential sex trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for these types of patients. Which of the following care principles has the highest priority? Empowerment, voice and choice
Physical and psychological safety Create an environment where patients feel safe, both physically and psychologically. Increase awareness of the patient’s interpersonal interactions with others to screen for risk of harm. Prioritize the patient being in a safe location. Peer support Trustworthiness and transparency
- A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes? Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis. Bronchopulmonary Dysplasia Pneumonitis Reactive Airway Disease
- The emergency nurse is caring for a patient with significant facial trauma and a suspected globe rupture. Which of the following medication orders would the nurse question? Ondansetron Midzaolam Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided.
- A 5-year-old patient presents to the emergency department with severe dehydration due to viral gastroenteritis. He has signs of shock due to his hypovolemia. Which of the following physiologic responses to shock has the greatest impact on improving cardiac output in the pediatric patient? Decreasing preload Decreasing contractility Increasing afterload Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output.
- A toddler has a chemical eye injury. Which of the following is the priority intervention? Consult with ophthalmology within 24 hours Copious eye irrigation with an isotonic solution Normal saline or Ringer's lactate solution are both acceptable for irrigation. Irrigate until the pH of the eye returns to normal. The pH of Ringer's lactate is closer to that of human tears and may be more comfortable than normal saline. Elevate the head of the bed to 30 to 45 degrees. Administration of an ocular antibiotic
- A 5 year-old with no health problems presents to the Emergency Department with a sudden onset of chest pain and shortness of breath. Parents state that the family was involved in a bad car crash one week ago. A thorough assessment and workup has not revealed any abnormalities. Which of the following steps is the best next step to take? Discharge to home with follow-up instructions to contact their primary care physician
Ask about any new bed-wetting or sleep disturbances Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for other behavioral symptoms to facilitate appropriate care and follow-up. Consult cardiology for appropriate follow-up Repeat a head-to-toe exam to identify any missed traumatic injuries
- Which of the following is the most appropriate intervention for a child experiencing a seizure? Prepare to administer intranasal midazolam Midazolam has gained favor because of its ease of use and quick onset of action. Place the child in a prone position Prepare to administer rectal diazepam Place the child in a supine position
- An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated prior to arrival. Which of the following is the priority assessment or intervention? Reposition the endotracheal tube Assess the endotracheal tube placement and patency If a patient arrives with an artificial airway (endotracheal tube or tracheostomy) in place, assess its placement, tube patency, and the oral airway (in that order) before moving to the next step of the primary survey. Insert an orogastric tube
Handing the family a list of potential behavioral health facilities to call for follow-up. Emphasizing to the family to come back to the hospital for any escalation in behavior rather than calling authorities. Ensuring all firearms in the home are locked in a safe place with no access by the patient. Promote injury prevention with caregivers of patients with a history of depression or suicidal ideation by encouraging that all firearms and medications are under lock to prevent overdoses or suicide attempt. Discussion with the family on the importance of keeping all medications stored on the top shelf of a closet.
- A 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department, the child has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale skin. Vital signs are HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The child is most likely in which of the following shock states? Hypovolemic shock The mechanism and presentation lead to a suspicion of blood loss. Obstructive shock Cardiogenic shock Distributive shock
- Which of the following is the priority intervention for a pediatric patient with diabetic ketoacidosis? Subcutaneous insulin Intramuscular insulin
Insulin infusion A continuous infusion of insulin at 0.05–0.1 unit/kg/hr should be used to decrease blood glucose. Insulin bolus
- Which of the following describes a neonate’s normal position? Extension with extremities close to the body Flexion with extremities away from the body Extension with extremities away from the body Flexion with extremities close to the body A neonate’s normal position is flexion with extremities close to the body.
- The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the radius and ulna after falling from a bicycle. Which of the following pain interventions is most likely to result in improvement in symptoms? Topical application of lidocaine-based cream Application of warm compresses to the affected extremity Placing the extremity at the level of the heart Application of a splint to the affected extremity Splinting is an effective non- pharmacologic intervention to reduce pain associated with fractures.
Dysrhythmias QRS prolongation and ventricular dysrhythmias are symptoms of cyclic overdose. antidepressant Miosis Diuresis Hypotension
- The parents of a 5-year-old child arrive at the emergency department. The child's lips and face are swollen with hives on the face. The parents report the child ate peanut butter crackers in the last hour. The child has no known allergies. The nurse recognizes the findings are associated with: Food allergy This a clinical manifestation seen in food allergies. Nutritional sensitivity Medication sensitivity Latex allergy
- Which of the following statements demonstrates a nurse's understanding of pediatric submersion injuries? Laryngospasm; a reflexive response to submersion, prevents fluid from entering the lungs for extended periods of time
The negative impact of lactic acid on the renal tubules is evidenced by a urinary decrease output in in the immediate post-submersion phase The best indicator of survival after submersion is the duration of time of submersion The duration of submersion is the best predictor of survival after drowning. In general, shorter times correlate to better outcomes. Hypoxemia and respiratory alkalosis may adversely impact myocardial function
- A 2-month-old infant is brought to the emergency department. The mother states he has had trouble breathing for the past two days. The PAT reveals an age-appropriate general appearance, rapid breathing with mild distress, and pink skin. Mucous is noted to both nares. Which of the following is the best next step? Administer oxygen via face mask Reposition the infant Suction the nares with a bulb syringe Infants are preferential nose breathers and can have respiratory distress when the nares are occluded. Suctioning the nares is the priority intervention to open the airway. Assess breath sounds
- During the tertiary survey, the emergency nurse should continue to conduct reevaluations of the Pediatric Assessment Triangle (PAT), abnormal findings, and which of the following other assessment components? Secondary survey, vital signs, pain management and effectiveness of therapeutic interventions Primary survey, pain management, Pediatric Glasgow Coma Scale Airway assessment, check pulses, neurological assessment, and pain management
I should encourage my child to drink fluids My child will grow out of their frequent urinary tract infections UTIs are not a normal occurrence in children and may require additional investigation and follow up. I should encourage my child to use the bathroom when they feel they need to My child should complete all of their antibiotics
- A 4-day-old who is brought to the emergency department with the parental complaint of "not acting right" is found to be hypoglycemic. The appropriate glucose concentration to administer to this neonate is which of the following? D10 D10 is the preferred concentration for neonates to protect their fragile vasculature. D D D
- Which of the following actions by the nurse promotes pediatric patient safety? Silencing alarms on IV pump to promote patient resting Overriding medication guardrails to accommodate pediatric medication doses Securing and covering the IV site to ensure patency and decrease anxiety
Preparing medications in a distraction-free area To decrease errors, the focused nurse and should systematic be in verifying patient identification, medication order, route, time, and dose.
- A 16-year-old trauma patient is noted to have external rotation and shortening of the left lower extremity and pain with palpation of the pelvis after being ejected from a motorcycle. Which of the following assessment findings is most concerning for a potentially life-threatening condition? Diminished tactile sensation to the left lower extremity Tenderness to palpation of left iliac crest Open wound to left lower extremity with no active bleeding Bony crepitus and instability with gentle anteroposterior compression of the iliac crests Bony crepitus and instability to palpation of the pelvis are common findings in patients with unstable pelvic fractures. Unstable pelvic fractures may be associated with injury to major blood vessels and contribute to hypovolemic shock.
- A 10-year-old patient was recently diagnosed with Marfan syndrome. The emergency nurse understands that this patient may be at risk for developing which of the following conditions? Myocarditis Aortic Aneurism Cardiovascular defects associated with Marfan syndrome are mitral valve prolapse, heart failure, and aortic dissection/aneurysm. Rheumatic heart disease Pericarditis
Labor Trafficking Physical Abuse Sex Trafficking Red flags for sex trafficking include multiple bruises, unwanted or unintended pregnancy and being withdrawn or anxious in the presence of the caregiver. Psychological Abuse
- All of the vaccine administrations listed are appropriate EXCEPT for which of the following? Fifth Disease at 6 months There is an animal vaccine but not a human vaccine for fifth disease. Haemophilus influenzae B at 2 months Measles, Mumps, Rubella at 12 months Hepatitis B at birth
- Which of the following statements indicates the caregiver understands your discharge teaching on influenza? My child can't get influenza again since they have had it once and received the vaccine. My child can interact with others after taking the first dose of antibiotics. My child can go to daycare since they have been off of Tylenol and fever free for 24 hours. Yes, the patient needs to be afebrile WITHOUT the use of antipyretics to be able to go back to daycare or school.
My child cannot get influenza if they wash their hands.
- A fertilizer silo exploded during a school tour of a working farm. The children are able to manage their own secretions but are all incontinent and salivating with excess tearing. Which of the followiing is the priority intervention? Rapid administration of atropine Establishing patient identification Removal of clothing and decontamination Decontamination of nerve agents requires removal of clothing and flushing the skin with copious amounts of soap and water. Providing supportive treatment
- A 2-year old has uniformly demarcated burns to bilateral lower extremities, approximately 30% of the child’s total body surface area. The father states he briefly left the room while the child was in the bath and the child apparently played with the faucet. Which of the following interventions has the highest priority? Cover burns with moist sterile sheets Contact child welfare to report suspicious burn Calculate and administer resuscitation and maintenance fluids. Obtain vascular access for analgesic and fluid administration Rapid vascular access and fluid administration are the priority interventions.
- Which of the following findings would be most concerning for a secondary headache?
