ENPC exam questions with correct answers latest complete solution, Exams of Nursing

Download ENPC exam questions with correct answers latest complete solution and more Exams Nursing in PDF only on Docsity! ENPC exam questions with correct answers latest complete solution | 1. Which of the following would be an abnormal finding in a patient with glomerulonephritis? Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. Decreased energy Hypertension Nausea, vomiting 2. A 3-year-old is brought to the emergency department with a 2-day history of a runny nose, low- grade fever, and a "barky" cough at night. The caregiver tells the emergency department nurse the coughing is getting worse. The child is awake and alert, with stridor. The nurse should anticipate which of the following? Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. Delivery of humidified oxygen Bag-valve-mask ventilations Suctioning secretions from the oropharynx 3. The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? Allow the extended to family members to serve as interpreters during the procedure. Dedicate a healthcare team member to be with the family during the procedure. Allowing caregivers to remain with the pediatric patient is more supportive in this situation. Allow family members to serve as interpreters during the procedure Provide access to nondenominational clergy in a quiet area 4. Which of the following patient presentations should increase suspicion of potential child maltreatment? Right radial spiral fracture in a 10-year-old practicing martial arts Bruising to the left ear of a newborn from sleeping on his side Any bruise in a non- exploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse. Closed greenstick wrist fracture in a 4 year old who fell off his bicycle Bruises in various stages of healing to the lower extremities of a 2-year-old 5. 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? Aortic Dissection Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey. Pericardial Tamponade Physical and psychological safety Create an environment where patients feel safe, both physically and psychologically. Increase awareness of the patient’s interpersonal interactions with others to screen for risk of harm. Prioritize the patient being in a safe location. Peer support Trustworthiness and transparency 11.A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes? Cystic Fibrosis Pancreatic insufficiency leads to fat malabsorption, which results in the fatty stools seen with cystic fibrosis. Bronchopulmonary Dysplasia Pneumonitis Reactive Airway Disease 12.The emergency nurse is caring for a patient with significant facial trauma and a suspected globe rupture. Which of the following medication orders would the nurse question? Ondansetron Midzaolam Succinylcholine Succinylcholine may increase intraocular pressure and should be avoided. Vancomycin 13.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? Administer lorazepam and a fluid bolus and place on seizure precautions Draw and send a metabolic panel, administer a fluid bolus, and obtain a point of care glucose Significant burns can cause electrolyte imbalances. Electrolyte imbalances may be the cause of the patient's seizure. Electrolyte imbalances need to be identified and treated. Administer intravenous analgesics, a fluid bolus, and obtain a point of care glucose Call police and child welfare authorities and have security detain parent 14. In which of the following primary survey components can assessment of the fontanel provide the most useful information? Circulation and disability A sunken fontanel may indicate dehydration; a bulging fontanel can indicate increased intracranial pressure. Breathing and circulation Disability and exposure Circulation and exposure 15.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? Decreasing preload Decreasing contractility Increasing afterload Increasing heart rate In pediatric patients, tachycardia is the primary compensatory mechanism to increase cardiac output. 16.A toddler has a chemical eye injury. Which of the following is the priority intervention? Consult with ophthalmology within 24 hours Copious eye irrigation with an isotonic solution Normal saline or Ringer's lactate solution are both acceptable for irrigation. Irrigate until the pH of the eye returns to normal. The pH of Ringer's lactate is closer to that of human tears and may be more comfortable than normal saline. Elevate the head of the bed to 30 to 45 degrees. Administration of an ocular antibiotic 17.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? Discharge to home with follow-up instructions to contact their primary care physician Handing the family a list of potential behavioral health facilities to call for follow-up. Emphasizing to the family to come back to the hospital for any escalation in behavior rather than calling authorities. Ensuring all firearms in the home are locked in a safe place with no access by the patient. Promote 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. Discussion with the family on the importance of keeping all medications stored on the top shelf of a closet. 23.A 3-year-old is injured in a motor vehicle collision. Upon arrival at the emergency department, the child has a diminished level of consciousness, equal bilateral breath sounds, and cool, pale skin. Vital signs are HR 140 beats/minute, RR 36 breaths/minute, and BP 70/40 mm Hg. The child is most likely in which of the following shock states? Hypovolemic shock The mechanism and presentation lead to a suspicion of blood loss. Obstructive shock Cardiogenic shock Distributive shock 24.Which of the following is the priority intervention for a pediatric patient with diabetic ketoacidosis? Subcutaneous insulin Intramuscular insulin Insulin infusion A continuous infusion of insulin at 0.05–0.1 unit/kg/hr should be used to decrease blood glucose. Insulin bolus 25.Which of the following describes a neonate’s normal position? Extension with extremities close to the body Flexion with extremities away from the body Extension with extremities away from the body Flexion with extremities close to the body A neonate’s normal position is flexion with extremities close to the body. 26.The emergency nurse is caring for a 14-year-old patient who sustained a displaced fracture of the radius and ulna after falling from a bicycle. Which of the following pain interventions is most likely to result in improvement in symptoms? Topical application of lidocaine-based cream Application of warm compresses to the affected extremity Placing the extremity at the level of the heart Application of a splint to the affected extremity Splinting is an effective non- pharmacologic intervention to reduce pain associated with fractures. 27.The type of vascular access is appropriate in all of the patient situations given EXCEPT for which of the following? Intraosseous device insertion for a cardiac emergency Scalp IV for a neonate with a fever Peripherally inserted central catheter line for one time fluid bolus This vascular access is most appropriate for long term medication administration and multiple blood draws. Peripheral IV in the forearm pre-surgically in a child 28.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? Widening pulse pressure Narrowing pulse pressure and increasing heart rate are early indications of ongoing blood loss. Bradycardia Decreasing diastolic blood pressure Weak peripheral pulses 29.A 15-year-old patient has attempted suicide by overdosing on amitriptyline. The emergency nurse should expect which of the following symptoms? Primary survey, vital signs, pain management, and effectiveness of therapeuticinterv ntions The additional components of the reevaluation in the tertiary survey include the primary survey, vital signs, pain management, and effectiveness of therapeutic interventions. 34.Which of the following interventions would the nurse anticipate for a pediatric patient with a fever and a history of a hematologic or oncologic condition? Oral ibuprofen Placement in a negative pressure room Rectal acetaminophen Intravenous antibiotics This patient population is at risk for life-threatening sepsis, and treatment with intravenous antibiotics is indicated. 35.Prioritizing pediatric patients presenting with fever is often difficult. Which of the following patients is at greatest risk of serious illness? A 13-year-old female who reports feeling "run down" for 4 days with an oral temperature of 38.2°C (100.8°F) A 7-year old boy with a history of sickle cell anemia and an oral temperature of 38.3°C (101°F) Children with chronic illnesses such as sickle cell disease are at greatest risk for life-threatening fever-related illnesses. A 3-month old with no abnormalities based on the Pediatric Assessment Triangle and a rectal temperature of 37.6°C (99.7°F) A 6-month old boy who is alert and pulling at his ear with a rectal temperature of 39.4°C (103°F) 36.Which of the following indicates the need for additional parent/guardian education regarding a UTI? I should encourage my child to drink fluids My child will grow out of their frequent urinary tract infections UTIs are not a normal occurrence in children and may require additional investigation and follow up. I should encourage my child to use the bathroom when they feel they need to My child should complete all of their antibiotics 37.A 4-day-old who is brought to the emergency department with the parental complaint of "not acting right" is found to be hypoglycemic. The appropriate glucose concentration to administer to this neonate is which of the following? D10 D10 is the preferred concentration for neonates to protect their fragile vasculature. D25 D50 D5 38.Which of the following actions by the nurse promotes pediatric patient safety? Silencing alarms on IV pump to promote patient resting Overriding medication guardrails to accommodate pediatric medication doses Securing and covering the IV site to ensure patency and decrease anxiety Preparing medications in a distraction-free area To decrease errors, the nurse should befocused and systematic in verifying patient identification, medication order, route, time, and dose. 39.A 16-year-old trauma patient is noted to have external rotation and shortening of the left lower extremity and pain with palpation of the pelvis after being ejected from a motorcycle. Which of the following assessment findings is most concerning for a potentially life-threatening condition? Diminished tactile sensation to the left lower extremity Tenderness to palpation of left iliac crest Open wound to left lower extremity with no active bleeding Bony crepitus and instability with gentle anteroposterior compression of the iliac crests Bony crepitus and instability to palpation of the pelvis are common findings in patients with unstable pelvic fractures. Unstable pelvic fractures may be associated with injury to major blood vessels and contribute to hypovolemic shock. 40.A 10-year-old patient was recently diagnosed with Marfan syndrome. The emergency nurse understands that this patient may be at risk for developing which of the following conditions? Myocarditis Aortic Aneurism Cardiovascular defects associated with Marfan syndrome are mitral valve prolapse, heart failure, and aortic dissection/aneurysm. Rheumatic heart disease Pericarditis My child cannot get influenza if they wash their hands. 46.A fertilizer silo exploded during a school tour of a working farm. The children are able to manage their own secretions but are all incontinent and salivating with excess tearing. Which of the followiing is the priority intervention? Rapid administration of atropine Establishing patient identification Removal of clothing and decontamination Decontamination of nerve agents requires removal of clothing and flushing the skin with copious amounts of soap and water. Providing supportive treatment 47.A 2-year old has uniformly demarcated burns to bilateral lower extremities, approximately 30% of the child’s 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? Cover burns with moist sterile sheets Contact child welfare to report suspicious burn Calculate and administer resuscitation and maintenance fluids. Obtain vascular access for analgesic and fluid administration Rapid vascular access and fluid administration are the priority interventions. 48.Which of the following findings would be most concerning for a secondary headache? Pain described as throbbing and severe Pain with flexion of the neck Nuchal rigidity is associated with meningeal irritation and meningitis, which would be considered a more serious secondary headache condition. Nausea and vomiting Unilateral headache with aura 49.A 6 year-old child presents to the emergency department with caregivers who report a cough with nasal congestion and “pink-eye” that started 2 days ago. They have been treating with an over-the-counter medicine without relief. Today they noticed a raised red rash on the face and papules in the mouth. You suspect which of the following? Varicella Rubeola Rubeola presents with a cough, nasal inflammation (coryza), and non-purulent conjunctivitis. A rash begins as erythematous macules and papules on the hairline and face that spreads downward. Erythema Infectiosum Hand, foot, and mouth disease 50.According to the American Academy of Pedatrics guidelines, which of the following describes how a neonate riding in a car should be positioned? Forward facing in a convertible car seat Rear facing in a convertible car seat until at least the age of 2 Rear facing in a high back booster with a five point restraint system Rear facing in a convertible car seat until the age of 1 The safest mode of transport for the neonate is rear facing until the age of 2 when the neck ligaments are stronger to support the head.