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ENPC EXAM/ NEW EDITION-2025 WITH CORRECT
DETAILED AND VERIFIED ANSWERS WITH
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A 14 - year-old patient sustained a displaced fracture of the radius and ulna after falling from a bicycle. Which of the following pain control interventions is most likely to result in improvement in symptoms related to pain? Applying a splint to the affected extremity Rationale Splinting is an effective non-pharmacologic intervention to reduce pain associated with fractures. This will also help to minimize complications. Topical creams and elevation ofthe extremity will not help with pain control. The application of ice in an appropriate manner can help, but not warmth which would be contraindicated in the early stages of the injury. Assessment of the fontanelle provides the most useful information for which two components of the primary survey? Circulation and disability Rationale A sunken fontanelle is a red flag for circulation assessment in pediatric triage and mayindicate dehydration. A bulging fontanel is a red flag for disability assessment in pediatric triage and can indicate increased intracranial pressure. A 6-month-old is seen for a recurrent respiratory infection. During the assessment, the mother adds that the patient's stools seem to be fatty or "greasy". Which of the following disease processes would be a primary concernfor this child? Cystic fibrosis
Rationale In patients with cystic fibrosis, thick mucus inhibits the release of pancreatic enzymes necessary for digestion. This results in impaired absorption and the inability to utilize ingested fats. These fats are excreted in the stools and can present as "fatty" or "greasy". Combined with the recurrent upper respiratory infections for an infant, cystic fibrosis should be ruled out. The other three disease processes frequently present withrespiratory issues but fatty stools would not normally be seen. A 4 - day-old who is brought to the emergency department with the parental complaint of "not acting right" is found to be hypoglycemic. What is the appropriate glucose concentration to administer to this neonate? Dextrose 10% Rationale Dextrose 10% is the preferred concentration for neonates with hypoglycemia to protecttheir fragile vasculature while providing needed glucose. Dextrose 5% is not used to treat hypoglycemia in children. Dextrose 25% is used for children above the age of 5 years. Dextrose 50% is not recommended for use in pediatrics unless it is diluted. Which of the following indicates the need for additional caregiver education regarding a urinary tract infection? My child will grow out of their frequent urinary tract infections.
Rationale Infants up to four months old are obligate nose breathers and can have respiratory distress when nares are occluded. Mucous can be gently suctioned using a bulb syringeor suction catheter. A good, thorough history should always include immunization statusfor pediatric patients. The nose needs to be clear before applying oxygen via nasal cannula. Respiratory assessment includes interventions to improve breathing so you would not move to move to circulation until that is accomplished. 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? Assess endotracheal tube placement Rationale If a patient arrives with an artificial airway (endotracheal tube or tracheostomy) in place,assess its placement, patency, and the oral airway (in that order) before moving to the next step of the primary survey. The oropharynx should be checked for fluids or objects such as broken teeth. Inserting a gastric tube in an intubated patient and starting a second large caliber IV line should also be done, but they don't take priority over airway. Which of the following patients should be evaluated first? An 18 - month-old with bilious emesis
Rationale The presence of bilious emesis is especially concerning because it may be indicative ofan immediately life-threatening bowel obstruction. A dislodged gastrostomy tube shouldbe reinserted within 4-6 hours to prevent stoma closure. Vomiting following a handlebarinjury may be indicative of many possible injuries, but does not take precedence unlessother symptoms are present. Infantile colic is described as inconsolable crying in infants, 2 weeks to 4 months old, for up to 3 hours per day, more than 3 days per week,and lasting for more than 3 weeks. A nurse providing trauma informed care to the family of a seriously ill child should be doing which of the following? Appointing one staff member to stay with the family Rationale Caregivers experiencing the crisis of a critically ill child have low attentiveness and increased stress so would benefit from having a member of the healthcare team to staywith them as much as possible and communicate updates on the plan of care. Caregivers should be allowed to stay with their child as much as possible and not placed in a secluded room away for them. What is the priority intervention for symptomatic bradycardia in a four-year-old child? Initiate bag-mask ventilation Rationale Identifying and treating other causes, chest compressions, and epinephrine are
With intubation an orogastric tube will be placed and abdominal thrusts are notnecessary to remove fluid from the abdomen. A 5 - year-old child presents to the emergency department after being hit by a car. The patient complains of left upper quadrant pain, and the focused assessment with sonography for trauma (FAST) exam shows fluid around her spleen. Which of the following findings would be an early indication of ongoing blood loss? Weak peripheral pulses Rationale Early signs of hypovolemic shock include tachycardia and delayed capillary refill. The nurse may note a strong central pulse but weaker peripheral pulses, indicating the childis compensating by shunting blood to their core. Which of the following is a known cause of pediatric seizures? Overdiluted formula Rationale Water overload is a well-documented etiology of hyponatremia in infants, which can be caused by excess dilution of formula. Hyponatremia is a known cause of seizures. Benzodiazepine overdose is more likely to result is respiratory depression and coma. CHD and SVT are not readily known to cause seizures. For the infant, what duration of time is consider apneic? 20 seconds Rationale The respiratory rate, depth, and regularity all continue to change the first year of life,
making respiratory assessments different than those of older children. Infants breathe faster and less regularly, with apnea not considered as such until 20 seconds without a breath or associated with other physiologic effects such as bradycardia. A 9 month pregnant woman presents to the emergency department and delivers a term neonate vaginally. The neonate is dried and stimulated and the mouth and nose are suctioned using a bulb syringe. After repositioning the head, the neonate remains limp and apneic and the HR is 80 beats/minute. What is the priority intervention? Initiate positive pressure ventilation Rationale Immediately after delivery all neonates should be warmed, stimulated, and have their mouth then nose suctioned using a bulb syringe. Following this, if the neonate is not breathing or is gasping and/or has a heart rate of less than 100 beats per minute positive pressure ventilation at 21% FiO2 at a rate of 40-60 breaths per minute should be immediately initiated. The heart rate should be assessed after 15 seconds of PPV and if not improving additional measures should be taken (MRSOPA). Vascular accessis not always needed but can be worked on by another team member while airway and breathing interventions are being completed. A 5 - year-old with no health problems presents to the emergency department witha sudden onset of chest pain and shortness of breath. Parents state that the
Any bruises in a non-exploratory location (especially torso, ears, and neck) in children younger than 4 years old and ANY bruising in a child younger than 4 months old is suspicious for child maltreatment. Bruises to the lower extremities of a 2-year-old who is learning to walk on their own is not uncommon. Greenstick fractures are a more common fracture is children due to the immaturity of their bone structure. Martial arts includes many moves that could produce a spiral fracture. The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure history. The patient is post-ictal with a heart rate of 142 beats per minute, respiratory rate of 36 breaths per minute, and blood pressure of 86/72 mm Hg. Significant burns are noted to the patient's back and lower extremities. The caregiver states the burns accidentally occurred three days ago, but was afraid tobring the patient in due to an ongoing child welfare investigation. Which of the following groups of interventions are the priority for this patient? Draw a metabolic panel, point of care glucose, and administer a fluid bolus Rationale Burn injuries result in fluid and electrolyte shifts leading to hypovolemia and electrolyte imbalances. Early identification and treatment of electrolyte imbalances can help prevent further seizures. Contacting child protective services and other authorities can wait. The patient is post-ictal so does not require lorazepam medication at this time. Pain medication can and should be considered with significant burns, but is not apriority. At age 85, Lyle's immune system does not respond to vaccines as well as it did when he was younger. The atrophy of which endocrine gland is likely responsiblefor this?
Thymus Which organ is responsible for synthesizing atrial natriuretic peptide? The heart Mineralcorticoid is to aldosterone as glucocorticoid is to. Cortisol One of the least complicated of the endocrine control systems directly respondsto changing blood levels of ions and nutrients. What is this mechanism? Humoral stimulation Thyroid hormone enters target cells in a manner similar to. steroid hormones Normal development of the immune response is due in part to hormones from the . Thymus gland The most important mineralcorticoid regulator of electrolytes in extracellular fluid is. Aldosterone Lisa starts to feel hungry and worries her blood sugar level may be dropping. What hormone helps prevent a drop in blood sugar level? Glucagon Steroid hormones exert their action by. entering the nucleus of a cell and initiating or altering the expression of a gene Aldosterone. functions to increase sodium reabsorption Which of the following is NOT a parathyroid gland mechanism to maintain adequate levels of blood calcium?
hormone treatment before her growth plates ossify in her long bones. Which hormone is recommended? Growth hormone Andrenocorticotropic hormone. secretion is regulated by a hypothalamic regulatory hormone Which hormone has only one known effect: to stimulate milk production in the breasts? Prolactin Which anterior pituitary hormone does NOT target another endocrine gland? Growth hormone Chemical substances secreted by the cells into the extracellular fluids are called . Hormones The ability of a specific tissue or organ to respond to the presence of a hormoneis dependent on. The presence of appropriate receptors As a result of stress, the anterior pituitary releases ACTH The mechanism of transportation from hypothalamus to anterior pituitary gland is through the. hypophyseal portal system Gloconeogenesis is due to the action of. Cortisol The size and shape of a pea; produces hormones that stimulate other endocrine glands
Pituitary gland (hypophysis) Is part of the sympathetic nervous system Adrenal medulla Produces hormones that regulate glucose levels in the body Pancreas Primary regulators of blood calcium levels Parathyroid glands Produces the body's major metabolic hormones Thyroid gland Which of the events below does NOT occur when the semilunar valves are open Ventricles are in diastole No visible cytoplasmic granules are present in Monocytes Which of the following is not true regarding fenestrated capillaries Fenestrated capillaries form the blood- brain barrier Which of the following transports for oxygen rich blood Pulmonary vein What do the ductus arterious and the foramen ovale become at birth Ligamentum arteriousum; fossa ovalis Which of the following is nit part of the intrinsic conduction system of the heart Artioventricular (AV) valve An individual who is blood type AB negative can Receive any type of blood in moderate amount except that with the Rh antigen The fact that the left ventricle of the heart is thicker than the right ventricle reveals that it
Connected the two atria in the fetal heart Which of the following recives blood during ventricular sytole Pulmonary arteries only In the brain the fluid filters that filters out of capillaries is highly regulated. You would expect to see feeding the brain Continuous capillaries, with no intercellular clefts A mismatch of blood types during a transfusion is dangerous because Preformed antibodies in the recipients blood will bind and clump (agglutinate) the donated cells The aorta recives the full force of blood exiting the heart during ventricular systole. Which if the following statements best describes the adaptive anatomy ifthe aorta? Elastic fibers are extensive in the tunica media of the aorta and dampen the pulsepressure generated by the heart Normal heart sounds are casued by which of the following events Closure of the heart valves Permitting the exchange of nutrients and gases between the blood and tissue cells is the primary function of Capillaries Dues to the branching of arteries the type of arteries that would be most numerous would be? Arterioles The left ventricular wall of the heart is thicker than the right wall in order to Pump blood with greaters pressure Hemolytic disease of the newborn will not be possible in which of the following situations listed below
If the father is Rh- Which blood type is the universal donor Blood type O Which tunic of an artery is most responsible for maintaining blood pressure and continuous blood circulation? Tunica media Compared to skeletal muscle, cardiac muscle Has gap junctions that allow it ti act as functional syncytium Select the correct statement about the heart valves The atrioventricular (AV) valves prevent backflow of blood into the atria during ventricular contraction Which statement best describes arteries All carry blood away from the heart Reducation in the contraction of albumin in blood plasma would alter capillary exchange by decreasing colloid osmotic pressure and edema will occur factors that aid venous return include all except urinary output Which of the following in not a structural characteristic that contributes to erythrocyte gas transport functions Mitotically active What organ in the body regulates erythrocyte production? Kidney
they are nucleated Blood within the pulmonary vein returns to the left atrium If the vagel nerves to the heart were cut, the result would be that the heart rate would increase by about 25 beats per minuet In general it is expected that hydrostatic pressure will drop as blood moves away from the arteriole end of the capillary bed Which of the following would NOT be classified as a lymphoid organ? pancreas Which of the following statements regarding the thymus is FALSE? It has follicles similar to those in the spleen Lymph involves all of the following EXCEPT Smooth muscle contraction in the lymph capillary walls Which lymphatic structure drains lymph from the right upper limb and the right side of the head and thorax? Right lymphatic duct Which of the following is NOT a part of the lymphatic system? Erythrocytes Antibodies that act against a particular foreign substance are released by Plasma cells
Lymph leaves a lymph node via Efferent lymphatic vessels Which cells are the main "warriors" of the immune system? Lymphocytes Select the correct statement about lymphocytes B cells produce plasma cells, which secrete antibodies into the blood Lymphoid tissue that appears as a swelling of the mucosa in the oral cavity is called a(n) Tonsil Which of the following does NOT contain a mucosa associated lymphatic tissue?-thymus Peyer's patches are found in the distal portion of the small intestine Lymphatic capillaries are present in Digestive organs The thymus is the only lymphoid organ that does NOT directly fight antigens Large clusters of lymph nodes occur in all of the following locations EXCEPT Lower extremities Which of the following is NOT a normal component of lymph? Red blood cells Which lymphoid organ atrophies as we age? Thymus Which of the following is NOT a function of the lymphatic system?
