ENPC Study Guide with Questions and Answers
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,...
ENPC Study Guide with Questions and
Answers
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 definitive treatment for the suspected
diagnosis? ANSWER Bronchoscopy
A child with an injury to the lower cervical spine with spinal cord involvment would most
likely demonstrate which of the following findings during assessment? ANSWER Decreased
respiratory effort
Caregivers state an 18-month-old child had a harsh, barky cough, low-grade fever, and
irritability throughout the night. On assessment this morning, the child appears alert, is
interactive, their present cough is quiet, and their temperature is 98.8°F (37.1°C) axillary.
Which of the following diagnoses is the highest probablity for this child? ANSWER Croup
A 5-year-old presents with decreased level of consciousness and a wide complex and rapid
rate on the electrocardiogram. Which of the following characteristics would indicate
ventricular tachycardia as opposed to other tachydysrhythmias? ANSWER Heart rate
between 120 and 200 beats/minute
A school-aged child arrives in the emergency department with a 2-day history of vomiting.
The child is cool and pale, with weak pulses, elevated heart rate, and capillary refill of 4 to 5
seconds. Which of the following is the priority intervention for the child? ANSWER Initiate
fluid bolus
, 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, SaO2 97% without 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? ANSWER Temperature 37.7C (99.9F)
During your primary assessment of a 3-year-old, the child is pale, with a respiratory rate of
70 breaths/minute, costal retractions, poor air movement, and a pulse oximetry reading of
89%. What is the priority intervention for this patient? ANSWER wrong? Prepare for
intubation
Patients with severe respiratory distress as evidenced by marked tachycardia and tachypnea,
prolonged capillary refill, severe nasal flaring, and low pulse oximetry readings should
receive oxygen per protocol first. Getting a provider in the room and preparing for intubation
would come next.
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? ANSWER Providing
frequent updates and re-educating them on the care that is being provided
A teenager presents to the ED for evaluation of pain with deep inspiration. The pain was a
sudden onset after running track at school. While obtaining the history, the patient states that
they have Marfan Syndrome. What would be a priority triage question based on this
information? ANSWER "Have you ever had a pneumothorax?"
Which of the following physiological changes in an infant increase the chances of drowning?
ANSWER weak neck muscles
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