ENPC 5th edition (Answered) QUESTIONS AND
ANSWERS
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. Ans - 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?
Ensuring all firearms in the home are locked in a safe place with no access
by the patient.
Promoting 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. Ans -
You are discharging a patient to home with a history of depression.
Discharge teaching should include which of the following?
Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions.
Ans - A 2-year old has uniformly demarcated burns to bilateral lower
extremities, approximately 30% of the childs 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?
Draw and send a metabolic panel and venous blood gas, administer a fluid
bolus, and obtain a point of care glucose
Electrolyte imbalances need to be identified and treated to prevent another
seizure. Ans - A 7-year-old arrives via ambulance. The patient's mother
reports witnessing a seizure at home. The patient has no seizure history.
Upon examination, 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 mother states the burns accidentally occurred 3 days ago,
but she was afraid to bring patient in due to an ongoing child welfare
investigation. Which of the following are the MOST appropriate immediate
interventions?
, ventilation to address hypoxia is the priority intervention. Ans - What is
the priority intervention for symptomatic bradycardia in a four-year-old
child?
Commotio cordis
Comotio Cordis "occurs when chest is struck during the refractory period of
the cardiac conduction cycle. This type of injury usually occurs in
recreational sports such as baseball or ice hockey." Ans - 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?
Focused Assessment: Vital Signs: "As the patient compensates for altered
tissue perfusion, the pulse pressure narrows and the heart rate increases" -
(need to rewrite either the question or the answers)
Widening Pulse pressure - not correct (suppose to be narrow pulse pressure)
Bradycardia - not correct
Decreasing diastolic blood pressure - late sign
Weak peripheral pulses - late sign Ans - A 5-year-old child presents to the
emergency department after being hit by a car. She 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?
Increasing heart rate
Pathophysiology: Cardiac Output. In pediatric patients, cardiac out is
primarily regulate by increasing heart rate Ans - 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?
Bruising to the left ear of a newborn from sleeping on his side
Pg 10- Any bruises in a non exploratory location (especially torso ears, neck)
in children younger than 4
Pg 11Any bruising in a child younger than 4 months. Ans - Which of the
following patient presentations should increase suspicion of potential child
maltreatment?
Fifth Disease at 6 months
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