ENPC Exam 6th ed Latest Update 2024-2025
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A 10-year-old arrives at the ED post motor vehicle crash. The following assessment is
noted: hypotension, tachycardia, absent breath sounds from the left chest with an
increased respiratory rate, pain on palpation of the pelvis, tinge of blood noted at the
urinary meatus, moderate active 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?
A. Insert urinary catheter
B. Prepare for intubation
C. Assist with chest tube insertion
D. Place orogastric tube - CORRECT ANSWER: A. Insert urinary catheter
A 12-year-old involved in a house fire has full thickness, circumferential burns to
bilateral lower extremities. Fluid resuscitation is in progress on arrival at the ED. On
assessment the left pedal and posterior tibialis pulses are absent, with delayed capillary
refill. Which of the following is the priority intervention?
A. Application of compression dressings
B. Elevation of left lower extremity
C. Assist with escharotomy
D. Preparation for thrombectomy - CORRECT ANSWER: C. Assist with escharotomy
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of
the following intravenous medication orders should the nurse question?
A. Morphine
B. Acetaminophen
C. Hydromorphone
D. Ketorolac - CORRECT ANSWER: D. Ketorolac
, 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?
A. Practice yawning three to four times a day
B. Resume eating a regular diet later today
C. Apply hot packs to the joint area for pain control
D. Use a nonsteroidal anti-inflammatory for pain control - CORRECT ANSWER: D. Use
a nonsteroidal anti-inflammatory for pain control
A 14-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
patient?
A. Lumbar spine magnetic resonance imaging
B. Complete neurologic exam
C. Urinalysis by straight catheterization
D. Cervical spine radiographs - CORRECT ANSWER: D. Cervical spine radiographs
A 15-year-old presents alone requesting care. Which of the following chief complaints
would most likely be considered legal or appropriate to treat without parental consent?
A. Lower back pain
B. Itching rash to arms
C. Possible pregnancy
D. Dental pain - CORRECT ANSWER: C. Possible pregnancy
A 2-year-old arrives at the ED in hypovolemic shock and needs fluids immediately. After
several attempts, your team has been unsuccessful at establishing vascular access. Of
the following, which is the next best option for establishing access quickly?
A. Intraosseous in the patient's medial tibia.
B. Peripherally inserted central catheter
C. Assisting with central line placement.
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