ENPC EXAM 2 LATEST VERSIONS (VERSION A & B) ALL 300 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

ENPC EXAM 2 LATEST VERSIONS 2023-2024 (VERSION A &

B) ALL 300 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

VERSION A

What is the priority intervention for symptomatic bradycardia in a four-year-old

child?

A.Administer intravenous atropine

B.Administer intravenous epinephrine

C.Initiate bag-mask ventilation

D.Initiate transcutaneous pacing - ANSWER- C

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Identifying and treating other causes, chest compressions, and epinephrine

are interventions for pediatric bradycardia with signs of poor perfusion that

are not improved by adequate oxygenation and ventilation. Atropine and

pacing may be considered if there is no response to the other interventions.

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?

A.Widening pulse pressure

B.Bradycardia

C.Decreasing diastolic blood pressure

D.Weak peripheral pulses - ANSWER- D

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 child is compensating by shunting blood to their core.

Which of the following patients should be evaluated first?

A.A 3-year-old with a dislodged gastrostomy tube

B.An 18-month-old with bilious emesis

C.A 12-year-old with vomiting after a handlebar injury

D.A 3-month-old with periods of inconsolable crying - ANSWER- B

The presence of bilious emesis is especially concerning because it may be

indicative of an immediately life-threatening bowel obstruction. A dislodged

gastrostomy tube should be reinserted within 4-6 hours to prevent stoma closure.

Vomiting following a handlebar injury may be indicative of many possible

injuries, but does not take precedence unless other 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.

inconsolable crying - ANSWER- rule of 3s:

crying more than 3 hours per day, more than three days per week, for longer than

three weeks

A three-year-old is rescued after being submerged in a pool for several minutes.

On arrival the patient is responsive to painful stimuli with shallow respirations,

diminished breath sounds, and an occasional cough. Which of the following

interventions is the initial management priority?

A.Initiation of abdominal thrusts to remove fluid from the lungs

B.Insertion of orogastric to remove of water and debris from stomach

C.Endotracheal intubation to provide positive pressure ventilation

D.Removal of wet clothing to prevent hypothermia - ANSWER- C

The primary survey assessment and treatment of deficits are the priority.

Airway control and positive pressure ventilation while preparing for

intubation of a child who meets intubation criteria (GCS < 8>

performed while also maintaining cervical spine stabilization. The child is

responsive only to painful stimuli, has shallow respirations, and diminished

breath sounds. All of these are breathing problems and must be addressed

immediately. Removing wet clothing is necessary, but is not the main priority

initially. With intubation an orogastric tube will be placed and abdominal

thrusts are not necessary to remove fluid from the abdomen.

A 3-month-old is brought to the emergency department with new onset of fever.

You note the child to be pale, tachypneic, and tachycardic, with weak distal pulses.

Which intervention is the priority for this patient?

A.Administer an appropriate dose of an antipyretic

B.Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid

C.Prepare a broad spectrum antibiotic infusion

D.Administer a vasoactive medication - ANSWER- B

This patient most likely has septic shock. An immediate goal is to reverse

shock and restore tissue perfusion with fluids. An antipyretic may be needed

based on the temperature and patient symptoms. An antibiotic should be

started within an hour, and vasoactive medications may not be needed if fluid

resuscitation is successfu

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 concern for this child?

A.Cystic fibrosis

B.Bronchopulmonary dysplasia

C.Pneumonitis

D.Down syndrome - ANSWER- A

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 with respiratory issues but fatty stools would not

normally be seen.

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?

A.Applying a topical lidocaine-based cream

B.Elevating the extremity to the level of the heart

C.Placing warm compresses on the affected extremity

D.Applying a splint to the affected extremity - ANSWER- D

Splinting is an effective non-pharmacologic intervention to reduce pain associated

with fractures. This will also help to minimize complications. Topical creams and

elevation of the 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.

Which of the following is a known cause of pediatric seizures?

A.Benzodiazepine overdose