ENPC Emergency Nurse Pediatric Course 6th Edition Course Exam Practice Guide 2025-2026, Exams of Pediatrics

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ENPC 6th Edition Course Exam Practice Guide 2025- 2026

A4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous H membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg, and H i HR of 144 beats per minute. Which of the following laboratory values would be most expected in I I this child? - CORRECT ANSWER-Hypoglyccimia (wrong) I ! Re Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include ! signs of dchydration (dry mucous membranes, hypotension, tachycardia), inconLincnee s), polydipsia, I (polyuria), vomiling, abdominal pain, Kussmaul respirations (Lo counter the acidos anorexia, and weight loss. Expected laboratory values would reveal an acidotic state with a pH H level below 7.3, an elevated serum blearbonate level, and an elevated blood glucose level > 200 H me.dL. ! . oe cy . I I An 18-month-old is seen for fever, slight circumoral cyanosis, and wheezing noted on I I auscultation in the right upper lobe of the lung field afier a choking event 4 days ago. The white I bload cell count is clevated and the patient nated to be lachypneic, tachycardic, agilated, and I 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 | I following would be considered to be definitive treatment for the suspected diagnosis? - I RE! R-Computed tomography (wrong) Remediation feedback: H Manifestations of a lower airway foreign body include a choking incident with subsequent H H failure to improve on antibiotics. Wheezing or decreased ling sounds in one area of the H I pulmonary system is a high indicator for a foreign body along with signs of hypoxia such as I 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 tself, ! tests to locate the foreign body Achild in cardiopulmonary arrest is receiving chest compressions and manual ventilations with e. Once return of spontaneous circulation has been confirmed, which of the I vention? - CORRECT ANSWER-Establishing a sccure I a bag-mask de following would be the priority intc airway Parents report their 3-year-old child has developed noisy breathing. On assessment, high- pitched wheezes are audible and anseultated on inspiration and expiration. Whal medication - CORRECT ANSWER-Humidilied oxygen (wrong) would be appropriate Lo administer Sirs ! x I I Wheezing is most often identified with asthma in the pediatric population. Initial medication I I intervention includes an inhaled short-acting beta agonist. I A G-weel-old is brought to the emergency department by the caregivers for poor feeding, I listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 42 breaths/minute, rectal temperature of 96.0 F 5.5 C), and a bulging anterior fontanel. Capillary | refill is 4 seconds. Based on t! findings what is the mast likely diagnost. +, the nurse - CORRECT. ANSWER-Luumbar puncture should anticipate’ I /\12-ycar-ald is being prepped for surgical intervention of acule appendicitis. Which of the | following intravenous medication orders should the nurse question? H Hydromorphone (wrong) H R 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 laceration on a toddler’s arm is prepared for suturing. Which of the following preparations for topical anesthesia would be the best choice for this procedure? - CORRECT. ANSWER-LET (idocaine/epinephrine/tetracaine) Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acclaminophen overdose? - CORRECT. ANS administered. essmient is note A 10-year-old arrives at the ED post motor vehicle crash. The following as hypotcnsion, tachycardia, absent. breath sounds from the left chest with an inercased respiratory rato, pain on palpation of the pelvis, Linge of blood nated at the urinary meatus, moderate aclive 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 have a discussion with the provider before initiating? - CORRECT. /\ssist with ches tube insertion (wrong) Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perinoal discolorations with edema Lo the areas is also a contraindication for this adiuncl. A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul- smelling urine. The child is hypotensive and tachycardic. Which of the following methods for obtaining a urine sample is most appropriate in this circumstance? - CORRECT. ANSWER- Urinary catherization Acchild with bipolar disorder is brought to the emergency department for increasing irritability, ured specch, and a decreased need for sleep. What should be included in the plan ORRECT ANSWER-Performing a suicide risk as agilalion, pr of care for this child? - sssiment A SS SS SS ac ac You are discharging a patient home who has a history of depression. Discharge teaching should include which of the following? - CORRECT. ANSWER-Ensuring all fi locked up with no access available by the pa earms in the home are A5-year-old child presents with hives, swelling of the lips and face, and stridor that developed aboul an hour after cating lunch. The child has no known allergies. Which of the following is the priority intervention? - CORRECT ANSWER-Administer intramuscular epinephrine Which of the following pathologic processes would most likely be attributed to a primary ic librosis? - CORRECT ANSWER-Constipation diagnosis of cys /\2-ycar-ald arrives wilh a 2-day history of vomiting and diarrhea. The patient has a fover of 38.40C (101.2° F), resting HR of 152 beats/minute, RR of 34 breaths/minute, and blood pressure of 94/56 mm Hg. Assessment reveals a capillary refill time of > 5 seconds. Which of the following would be most indicative of the need for intravenous rehydration therapy for this patient? - ANSWER-Capillary refill Which of the following is a family-centered care concept ?- CORRECT ANSWER-Cultural sod and incorporated into the plan of backgrounds are as /\n 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-bilious vomiting, and a low grade fever. On assessment the child is intermittently inconsolable followed by periods of normal activily. A sansage-shaped mass is noted during palpation of the abdomen. The nurse should prepare for which of the following? - CORRECT ANSWER-Enema with air A caregiver presents to the emergency department with an 18-month-old and reports the child is not using their left arm after playing a game with an older sibling. The child is alert and curious. with regular, even respirations, and skin color is appropriate. Using the Pediatric Assessment Triangle (PAT), how would you categorize this patient? - CORRECT. ANSWER-Sick A SS SS SS Assessment findings include a patient who is active and alert, in the 10th percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture of the left femur. Which of the following is the most likely cause? - CO. Remediation focdback: Osteogenesis imperfecta is a genetic disorder that includes short stature, blue-grey color to the Such patients are susceptible Lo fractures, sclera, discolored tecth, and laxily of the ligaments. especially of the midshaft of long bones. These patients are often mistaken for victims of child maltreatment. 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? - CO. SWER- to four times a day (wrong) Practice yawning thr s that involve extreme Patients with temporomandibular joint dislocation should avoid activiti Jaw joint opening. Cold or warm, not hot, compresses are recommended along with nonsteroidal antiinflammatory medications for pain control. /\5-ycar-ald pationt presents wilh severe dchydration and signs of shock duc to viral gastroenteritis. Which of the following physiologic responses by this patient will have the greal. impacl on improving their cardiac output? - CORRECT. ANSWER-Inereased heart rato A\n 8-ycar-ald male presents to the emergency deparimont with incoherent speech, hallucinations, and violent behavior. What is the priority in caring for this patient? - CORRECT. ANSWER-Ensure safety of the patient and staff A SS SS SS ac A 12-year-old presents to the emergency department with a severe headache. The mother reports that the child has been experiencing headaches and has had multiple seizures for the past several months. The child was seen by their primary doctor and prescribed an anti-seizure medication, bul the prescription was not filled because “the doctor just wants money." This is an example of what type of neglect? - CORRECT ANSWER-Medical A14-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 pauicnl? - CORRECT srvical spine radiographs The nurse is triaging an infant brought to the emergency department by their caregiver. Which R-Barking cough (wrong) Remediation feedback Triage begins when the child is initially visualized using the pediatric assessment triangle. Appearance, work of breathing, and circulation to the skin are components that guide the priorilizalion of the child’s care. The presence of a purpuric rash necessitates the infant to be placed in isolation immediately as this is a symptom of possible meningitis. EMS is transporting a 12-year-old restrained passenger involved in a high-speed motor vehicle collision. The patient complains of increasing dyspnea. Breath sounds are clear and equal, and heart sounds are difficult to auscultate. Vitals include HR 132 beats/minute, RR 36 breaths/minute, and BP 89/55 mm Hg. Which of the following is the priority intervention? - /\3-ycar-ald is assessed for the presence of increasing amounts of serosanguincous drainage from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely etiology? - CORRECT ANSWER-Button battery A SS SS SS ac A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of consciousness with no pulses. Which of the following is the priority inte CORRECT ANSWER Utilize AED/defibrillator A 12-year-old female patient arrives awake and alert with an acute onset of abdominal pain on the right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right side and there is tenderness to the breasts. Which of the followmg laboratory tests is the priority for this patient? - CORRECT. Al would most likely rule out the potential of a primary Pulsating, unilateral pain (wrong) Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the areas is also a contraindication for this adjunct. Which of the following is a first-line treatment for atopic dermatitis? - CORRECT ANSWER- Skin hydration therapy After a seizure at home, a 9-month-old infant is awake and interacting appropriately. Vital signs on arrival are HR 150 beats/minutes. RR 36 breaths/minute (unlabored), BP 80/52 mm Hg, SaQ2 97% wilhout supplemental oxygen, and T 102.7° F (39.3° C) rectally. During re-evaluation 2 hours after arrival, which of the following assessments would indicate appropriate measures were taken in treating this child? - CORRECT ANSWER-Temperature 37.7° C (99.9" F) A SS SS SS ac During a diaper change on a 4-month-old infant, the nurse measures the infant’s urinary output. After subtracting the weight ofa dry diaper, the wet diaper weighs 22 grams. What is the infant’s estimated urinary output? - CORRECT ANSWER-22 mL I A3 year-old patient presents following frequent emesis and diarrhea over the past 12 hours. I Which of the folowing ass nent findings indicate that the palicnt’ body is compens the fluid loss? - CORRECT ANSWER-Prolonged capillary refill (wrong) Remediation feedback: I Tn the carly compensated phase of shock altributed to nid volume loss, the diastolic pressure will increase due to vasoconstriction (increasing systemic vascular resistance) as a compensatory mechanism causing a narrowed pulse pressure. A normal systolic pressure is maintained during this phase. Other manifestations of early shock states are tachycardia, normal H capillary refill, decreased urine output, mild irritability, tachypnea, and weak peripheral pulses. H I I I I