ENPC 6th Edition Test Answers

The Emergency Nursing Pediatric Course (ENPC) is a comprehensive, internationally recognized program designed specifically for the unique needs of pediatric patients in emergency situations. As an initiative of the Emergency Nurses Association (ENA), the course provides nurses with the tools to effectively assess and respond to critical situations involving children.

The primary purpose of the ENPC is to prepare emergency nurses and other emergency care providers to recognize a pediatric patient who is experiencing a life- or limb-threatening illness or injury and to provide appropriate interventions and care.

The course offers a holistic approach to pediatric emergency care, covering the crucial medical knowledge needed for quick and accurate assessment and incorporating aspects of family-centered care.

Moreover, the ENPC also prepares nurses to care for any pediatric patient who presents to an emergency department, urgent care, or clinic. Its comprehensive nature ensures that medical professionals have the knowledge and skills to provide high-quality, effective care in pediatric emergencies, regardless of the case’s specific circumstances.

Read Also: ENPC 5th Edition Test Answers.

By fostering a robust understanding of the complexities of pediatric emergency care, the ENPC plays a critical role in enhancing the quality of care delivered to pediatric patients in emergency settings. It empowers nurses with the expertise needed to make a significant difference in the outcomes of their youngest patients​.

ENPC 6th Edition Exam Answers

Question	Answer
Parents report their 3-year-old child has developed noisy breathing. On assessment, high-pitched wheezes are audible and auscultated on inspiration and expiration. What medication would be appropriate to administer first?	Initial medication intervention includes an inhaled short-acting beta agonist.
A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry mucous membranes. Vital signs reveal deep respirations at 44 breaths per minute, BP of 70/44 mm Hg, and HR of 144 beats per minute. Which of the following laboratory values would be most expected in this child?	Expected laboratory values would reveal an acidotic state with a pH level below 7.3, an elevated serum bIcarbonate level, and an elevated blood glucose level > 200 mg.dL.
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?	The definitive treatment would be a bronchoscopy in order to retrieve the suspected foreign body instead of diagnostic tests to locate the foreign body itself.
A child in cardiopulmonary arrest is receiving chest compressions and manual ventilations with a bag-mask device. Once return of spontaneous circulation has been confirmed, which of the following would be the priority intervention?	Establishing a secure airway
A 6-week-old is brought to the emergency department by the caregivers for poor feeding, listlessness, and fever. Assessment reveals a crying infant, HR 160 beats/minute, RR 52 breaths/minute, rectal temperature of 96.0 F (35.5 C), and a bulging anterior fontanel. Capillary refill is 4 seconds. Based on these findings what is the most likely diagnostic test the nurse should anticipate?	Lumbar puncture
A 12-year-old is being prepped for surgical intervention of acute appendicitis. Which of the following intravenous medication orders should the nurse question?	Ketorolac is an appropriate medication for moderate to severe pain, however, it should not be used pre-operatively due to its potential to increase the bleeding risk.
A 17-year-old female arrives in the ED with her boyfriend who states she is pregnant and having vaginal bleeding. The patient is unsure of the gestational age and has not had any prenatal treatment. The patient is quiet and lets her boyfriend answer most of the questions. Which of the following is the most appropriate action for the nurse to take at this point?	Have the boyfriend leave the room during the pelvic exam.
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?	Intraosseous in the patient’s medial tibia.
A child with an electrical injury is seen 1 hour post event. Which of the following types of specimen samples would provide visual information regarding a potential complication of this injury?	Electrical injuries, though they may appear to be small, can produce large amounts of damage internally, including muscle damage. Myoglobin is excreted in the urine and is evidenced by dark, red-tinged urine.
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?	Providing frequent updates and re-educating them on the care that is being provided
When taking vital signs on a stable infant, which of the following should be done first?	Respiratory rate
A laceration on a toddler’s arm is prepared for suturing. Which of the following preparations for topical anesthesia would be the best choice for this procedure?	LET (lidocaine/epinephrine/tetracaine)
Which of the following is appropriate administration of N-acetylcysteine (NAC) for an acetaminophen overdose?	A bolus infusion of 150 mg/kg NAC should be administered.
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?	Urinary catheters are contraindicated for placement if pelvic injury is suspected or blood is noted at the urinary meatus. Scrotal or perineal discolorations with edema to the areas is also a contraindication for this adjunct.
A 2-year-old is seen with a 3-day history of irritability, vomiting, and the presence of foul-smelling urine. The child is hypotensive and tachycardic. Which of the following methods for obtaining a urine sample is most appropriate in this circumstance?	Urinary catherization
A child with bipolar disorder is brought to the emergency department for increasing irritability, agitation, pressured speech, and a decreased need for sleep. What should be included in the plan of care for this child?	Performing a suicide risk assessment
You are discharging a patient home who has a history of depression. Discharge teaching should include which of the following?	Ensuring all firearms in the home are locked up with no access available by the patient.
A 5-year-old child presents with hives, swelling of the lips and face, and stridor that developed about an hour after eating lunch. The child has no known allergies. Which of the following is the priority intervention?	Administer intramuscular epinephrine
Which of the following pathologic processes would most likely be attributed to a primary diagnosis of cystic fibrosis?	Constipation
A 2-year-old arrives with a 2-day history of vomiting and diarrhea. The patient has a fever of 38.4oC (101.2°F), resting HR of 152 beats/minute, RR of 34 breaths/minute, and blood pressure of 94/ 56 mm Hg. Assessment reveals a capillary refill time of > 5 seconds. Which of the following would be most indicative of the need for intravenous rehydration therapy for this patient?	Capillary refill
Which of the following is a family-centered care concept ?	Cultural backgrounds are assessed and incorporated into the plan of care.
An 8-month-old arrives with a 12-hour history of intermittent abdominal pain, non-bilious vomiting, and a low grade fever. On assessment the child is intermittently inconsolable followed by periods of normal activity. A sausage-shaped mass is noted during palpation of the abdomen. The nurse should prepare for which of the following?	Enema with air
A caregiver presents to the emergency department with an 18-month-old and reports the child is not using their left arm after playing a game with an older sibling. The child is alert and curious, with regular, even respirations, and skin color is appropriate. Using the Pediatric Assessment Triangle (PAT), how would you categorize this patient?	Sick
A 13-year -old male presents to the triage desk complaining of nausea and vomiting. The patient looks distressed and pale. He complains of spasming pain in his right scrotum which has now become constant and more severe. Which of the following assessment findings would the nurse expect with this patient?	Elevated right testicle
An 8-year-old trauma patient suddenly develops increased respiratory distress with a rise in heart rate from 112 beats/minute to 142 beats/minute associated with an abrupt hypotensive event. Distention of the jugular veins is noted. Which of the following emergent interventions should be anticipated first?	Needle decompression is emergently necessary to release the air and allow expansion of the lung again.
An 8-year-old pedestrian is thrown onto the hood of a moving vehicle striking the windshield. On arrival to the ED. the patient is minimally responsive with active bleeding from the nose and mouth. The patient is vomiting. Which of the following interventions would most likely be considered?	Endotracheal intubation
The nurse is reevaluating the effectiveness of interventions for a 4-year-old child with a suspected tension pneumothorax. Which assessment finding indicates the interventions were effective?	Bilateral chest wall rise with assisted ventilations.
A 3-year-old is brought by caregivers with generalized tonic-clonic activity, unresponsiveness, and drooling that began 6 minutes prior to arrival. Which of the following interventions would be most appropriate for this event?	Administer intranasal midazolam
A 6-month-old arrives with swelling to the left thigh. Caregivers deny any traumatic event. Assessment findings include a patient who is active and alert, in the 10th percentile for length, and has blue-grey sclera. Radiographs reveal a midshaft fracture of the left femur. Which of the following is the most likely cause?	Osteogenesis imperfecta is a genetic disorder that includes short stature, blue-grey color to the sclera, discolored teeth, and laxity of the ligaments. Such patients are susceptible to fractures, especially of the midshaft of long bones. These patients are often mistaken for victims of child maltreatment.
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?	Patients with temporomandibular joint dislocation should avoid activities that involve extreme jaw joint opening. Cold or warm, not hot, compresses are recommended along with nonsteroidal anti-inflammatory medications for pain control.
A 5-year-old patient presents with severe dehydration and signs of shock due to viral gastroenteritis. Which of the following physiologic responses by this patient will have the greatest impact on improving their cardiac output?	Increased heart rate
An 8-year-old male presents to the emergency department with incoherent speech, hallucinations, and violent behavior. What is the priority in caring for this patient?	Ensure safety of the patient and staff
A 12-year-old presents to the emergency department with a severe headache. The mother reports that the child has been experiencing headaches and has had multiple seizures for the past several months. The child was seen by their primary doctor and prescribed an anti-seizure medication, but the prescription was not filled because “the doctor just wants money.” This is an example of what type of neglect?	Medical
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?	Cervical spine radiographs
The nurse is triaging an infant brought to the emergency department by their caregiver. Which finding by the nurse leads the infant to be placed in isolation?	The presence of a purpuric rash necessitates the infant to be placed in isolation immediately as this is a symptom of possible meningitis.
EMS is transporting a 12-year-old restrained passenger involved in a high-speed motor vehicle collision. The patient complains of increasing dyspnea. Breath sounds are clear and equal, and heart sounds are difficult to auscultate. Vitals include HR 132 beats/minute, RR 36 breaths/minute, and BP 80/55 mm Hg. Which of the following is the priority intervention?	Pericardiocentesis
A 3-year-old is assessed for the presence of increasing amounts of serosanguineous drainage from his left nares over the past 6 hours. Which of the following foreign bodies is the most likely etiology?	Button battery
An infant presents to the emergency department with difficulty breathing. The patient is pale and respirations appear rapid and shallow. Which location on the torso is the most effective site for assessing bilateral breath sounds?	Bilateral midaxillary
A child presents with a history of poor oral intake. The patient is pale, lethargic, and has shallow, rapid respirations. Central pulses are weak and capillary refill time is four seconds. Which of the following interventions has the highest priority?	Initiate an intravenous fluid bolus
A 5-year-old arrives in the ED with a 4 day history of vomiting. Vital signs: HR 136 beats/minute, RR 36 breaths/minute, BP 92/56 mm Hg, T 38oC (100.4oF), and pulse oximetry 93% on room air. The child is pale with warm, dry skin and a capillary refill of 3 seconds. A fluid bolus is completed. Which of the following reassessment findings indicate that a second fluid bolus is necessary?	Blood pressure of 92/78 mm Hg
A 3-week old is brought to the emergency department with a history of fussiness, spitting up, crying, and watery stools. Assessment reveals an alert child with moist mucous membranes. Which of the following should be the priority?	Identify the type of formula the caregiver uses
Which of the following is considered a “red flag” when triaging a pediatric patient?	Any temperature greater than 38°C (100.4°F) in a neonate is a significant red flag and should be treated as neonatal sepsis.
A neonate presents to the emergency department with irritability, weak cry, and hypotonia. Which of the following is a priority intervention?	Serum blood glucose
A 10-year-old playing baseball is hit in the chest with a ball. He immediately demonstrates loss of consciousness with no pulses. Which of the following is the priority intervention?	Utilize AED/defibrillator
A 12-year-old female patient arrives awake and alert with an acute onset of abdominal pain on the right side, nausea, vomiting, and vaginal spotting. On palpation, the pain is localized to the right side and there is tenderness to the breasts. Which of the following laboratory tests is the priority for this patient?	Human chorionic gonadotropin
Which of the following is a first-line treatment for atopic dermatitis?	Skin hydration therapy
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?	Temperature 37.7°C (99.9°F)
During a diaper change on a 4-month-old infant, the nurse measures the infant’s urinary output. After subtracting the weight of a dry diaper, the wet diaper weighs 22 grams. What is the infant’s estimated urinary output?	22 mL
A 3 year-old patient presents following frequent emesis and diarrhea over the past 12 hours. Which of the following assessment findings indicate that the patient’ body is compensating for the fluid loss?	In the early compensated phase of shock attributed to fluid volume loss, the diastolic pressure will increase due to vasoconstriction (increasing systemic vascular resistance) as a compensatory mechanism causing a narrowed pulse pressure. A normal systolic pressure is maintained during this phase. Other manifestations of early shock states are tachycardia, normal capillary refill, decreased urine output, mild irritability, tachypnea, and weak peripheral pulses.

ENPC 6th Edition Pre-Exam Answers

1. 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?
   • Answer: Applying a splint to the affected extremity
2. Assessment of the fontanelle provides the most useful information for which two primary survey components?
   • Answer: Circulation and disability
3. 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?
   • Answer: Cystic fibrosis
4. A 4-day-old who is brought to the emergency department with the parental complaint of “not acting right” is found to be hypoglycemic. What is the appropriate glucose concentration to administer to this neonate?
   • Answer: Dextrose 10%
5. Which of the following indicates the need for additional caregiver education regarding a urinary tract infection?
   • Answer: My child will grow out of their frequent urinary tract infections.
6. You need to draw blood from a 2-year-old. Which of the following is the best approach for this patient?
   • Answer: Have them watch a cartoon on an I-pad or cell phone
7. The caregiver of a 2-month-old infant states the patient has had trouble breathing for the past two days. Pediatric assessment triangle (PAT) reveals an age-appropriate general appearance, rapid breathing with mild distress, and pink skin. Mucous is noted in both nares. Which of the following is the best next step?
   • Answer: Suction nasal passages using a bulb syringe
8. An ambulance arrives with a 16-year-old male involved in a dirt bike crash who was intubated prior to arrival. Which of the following is the priority assessment or intervention?
   • Answer: Assess endotracheal tube placement
9. Which of the following patients should be evaluated first?
   • Answer: An 18-month-old with bilious emesis
10. A nurse providing trauma informed care to the family of a seriously ill child should be doing which of the following?

• Answer: Appointing one staff member to stay with the family

11. What is the priority intervention for symptomatic bradycardia in a four-year-old child?

• Answer: Initiate bag-mask ventilation

12. 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?

• Answer: Endotracheal intubation to provide positive pressure ventilation

13. 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?

• Answer: Weak peripheral pulses

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

• Answer: Overdiluted formula

15. For the infant, what duration of time is considered apneic?

• Answer: 20 seconds

16. For the infant, what duration of time is considered apneic?

• Answer: 20 seconds

17. A 9-month pregnant woman presents to the emergency department and delivers a term neonate vaginally. The neonate is dried and stimulated and the mouth and nose are suctioned using a bulb syringe. After repositioning the head, the neonate remains limp and apneic and the HR is 80 beats/minute. What is the priority intervention?

• Answer: Initiate positive pressure ventilation

18. 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 the best next step to take?

• Answer: Ask about any new bed-wetting or sleep disturbances

19. 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?

• Answer: Infuse a rapid 10-20 mL/kg bolus of an isotonic crystalloid

20. Which of the following patient presentations should increase suspicion of potential child maltreatment?

• Answer: Bruising to the left ear of a newborn from sleeping on his side

21. The caregiver of a 7-year old reports witnessing a seizure at home, but no seizure history. 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 caregiver states the burns accidentally occurred three days ago, but was afraid to bring the patient in due to an ongoing child welfare investigation. Which of the following groups of interventions are the priority for this patient?

• Answer: Draw a metabolic panel, point of care glucose, and administer a fluid bolus.

ENPC 6th Edition Make-Up Exam Answers

Question	Answer
A 2-year-old arrives with parents stating the child may have ingested a button battery. The patient initially choked and coughed and is now drooling with bloody sputum. Which of the following is the priority intervention?	Prepare the patient for hospitalization
Which of the following is the priority intervention for the nurse caring for an immunocompromised pediatric patient with a fever?	Placement in a negative pressure room
Which patient reflects an EMTALA compliant transfer?	An infant with respiratory difficulties being transferred to another hospital with the same level of pediatric care. Parents are not present, and records are copied. (wrong)
A fertilizer silo exploded during a school tour of a working farm. The children are able to manage their own secretions but all are incontinent and salivating, with excess tearing. Which of the following is the priority intervention?	Removal of clothing and decontamination
Which of the following is the highest priority intervention for a well-appearing 2-month-old with a fever?	Urine culture
An anxious 12-year-old child presents to the emergency department with a sudden onset of nausea, diarrhea, abdominal cramping, flushing, and hypotension. Symptoms started about 60 minutes after lunch. Which of the following conditions is the most likely cause of these symptoms?	Anaphylaxis
An adolescent is awaiting ICU admission for pneumonia. During reassessment, which of the following findings would be most indicative that respiratory failure is developing?	Extreme lethargy
A 4-week-old infant born prematurely is brought to the emergency department due to the rapid onset of abdominal distention, vomiting, bloody stools, and exhibiting signs of shock. Based on these findings, what condition should the nurse suspect?	Necrotizing enterocolitis
A child with an injury to the lower cervical spine with spinal cord involvement would most likely demonstrate which of the following findings during assessment?	Decreased respiratory effort
A caregiver states their 3-year-old child ate some marijuana gummies approximately 3 hours prior to arrival. The PAT reveals the child is pink, difficult to arouse, and work of breathing is normal. What is your initial intervention?	Obtain a full set of vital signs (wrong) Remediation feedback: When assessing patients with a toxic ingestion, if the ABCs are within normal limits you move to Disability. You should check blood sugar for any altered level of consciousness.
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a splenic rupture is suspected. Which of the following diagnoses should be suspected as a companion injury with these findings and associated mechanism of injury?	Subdural hematoma (wrong) Remediation feedback: A chance fracture (fracture of the lumbar spine) is often associated with belted passengers. Injuries associated with the “seatbelt sign” are small bowel, abdominal vasculature, ureteral, and splenic and liver injuries.
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a splenic rupture is suspected. Which of the following diagnoses should be suspected as a companion injury with these findings and associated mechanism of injury?	Subdural hematoma (wrong) Remediation feedback: A chanceContinuing with the flashcards.
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?	Initiate a fluid bolus
Which of the following is a first-line treatment for atopic dermatitis?	Skin hydration therapy
After an explosion at a school, you are helping triage patients. In your field triage room you find a 5-year-old patient who is not breathing. What is the appropriate initial intervention?	Open the airway and assess for breathing.
A parent presents to the emergency department carrying her 12-week-old infant. The PAT reveals an infant who is quiet and opens eyes with stimulation, whose breathing is regular and even, and whose skin is pale, with a scattered vesicular rash. What is the priority intervention for this infant?	Obtain a full set of vital signs (wrong) Remediation feedback: An abnormal PAT in the presence of a rash should be considered life-threatening until proven otherwise and the patient placed in isolation.
Immediately following birth, a full-term neonate is not breathing and has a heart rate of 45 beats/minute. The neonate has been warmed, dried, stimulated, and suctioned without improvement. What the next step in resuscitation?	Initiate positive-pressure ventilation with 21% oxygen at 40-60 breaths per minute.
Which of the following physiological changes in an infant increase the chances of drowning?	Weak neck muscles
Which of the following questions reflects the concept of the “teach-back” method?	“Would you repeat those instructions, so I can make sure I was clear?”
A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra-abdominal trauma?	Constant left shoulder pain
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?	Heart rate between 120 to 200 beats/minute
A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about?	The likelihood of the infant ingesting a harmful substance (wrong) Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula.
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?	Prepare for intubation
A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made?	Provide simple, straightforward information
A 3-year-old has a two-day history of runny nose, low-grade fever, and a “barky” cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child?	Administration of nebulized epinephrine
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?	Heart rate between 120 to 200 beats/minute
A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about?	The likelihood of the infant ingesting a harmful substance (wrong) In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula.
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?	Prepare for intubation
A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made?	Provide simple, straightforward information
A 3-year-old has a two-day history of runny nose, low-grade fever, and a “barky” cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. What is the initial intervention for this child?	Administration of nebulized epinephrine

Immediately following birth, a full-term neonate is not breathing and has a heart rate of 45 beats/minute. The neonate has been warmed, dried, stimulated, and suctioned without improvement. What the next step in resuscitation?		Initiate positive-pressure ventilation with 21% oxygen at 40-60 breaths per minute.
Which of the following physiological changes in an infant increase the chances of drowning?		Weak neck muscles
Which of the following questions reflects the concept of the “teach-back” method?		“Would you repeat those instructions, so I can make sure I was clear?”
A 6-year-old involved in a boating crash is awaiting admission for surgical repair of a fractured ankle. Which of the following manifestations during reassessments would cause the greatest concern for possible intra-abdominal trauma?		Constant left shoulder pain
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?		Heart rate between 120 to 200 beats/minute
A parent brings in a 4-month-old infant reporting seizure-like activity at home. The parent denies a fever and reports that the infant is otherwise healthy. Which of the following is most important for the nurse to inquire about?		The likelihood of the infant ingesting a harmful substance (wrong) Remediation feedback: In infants less than six months of age with an otherwise normal exam, hyponatremia is the leading cause of new-onset non-febrile seizures. The most common contributing factor is over-dilution of infant formula.
A parent brings in a 4-month-old infant reporting seizure-like activity at home.		False
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?		Prepare for intubation
A pediatric resuscitation has ended with the death of the child. Coroner notification has not been made yet. In dealing with the family of this child, how can the nurse facilitate their grieving process until legally required notification has been made?		Provide simple, straightforward information
A 3-year-old has a two-day history of runny nose, low-grade fever, and a “barky” cough at night. The child is awake and alert with noted stridor. Pulse oximetry is 96% on room air. Which of the following interventions would be the most appropriated for this child?		Administration of nebulized epinephrine
A term infant is delivered in the emergency department. Which assessment finding is most concerning?		Acrocyanosis (wrong) Remediation feedback: Normal findings for a newborn include a heart rate between 90-180 bpm, respiratory rate of 30-55 breaths/minute, and systolic blood pressure of 67-84 mm Hg. They may also exhibit acrocyanosis, particularly when in cool environments.
A child was found unresponsive under the monkey bars during recess and arrives with the following assessment: eyes open only with supraorbital pressure stimulus, no verbal response is elicited, and withdraws arms and legs when a swab is inserted in the nose. Which of the following is the priority intervention for this child?		Prepare for immediate intubation
Which of the following is the recommended method of insulin administration for a pediatric patient with diabetic ketoacidosis?		Insulin infusion
The triage nurse is assessing a 14-year-old male who was brought in by ambulance. The patient reports he was playing his video games at home when he had a sudden onset of groin pain that was so severe he became nauseated and vomited. Further assessment reveals a swollen scrotum. What is the priority intervention for this patient?		Preparing the patient for ultrasound
A 6-year-old child weighing 20 kg (44.1 lb) arrives in full arrest following an electrocution event. CPR is in progress after defibrillation for ventricular fibrillation. What is the intravenous dose of epinephrine for this patient?		0.01 mg (wrong) Remediation feedback: The pediatric dose of intravenous epinephrine during a cardiac arrest is 0.01 mg/kg.
A 12-year-old complains of a severe headache for the past 8 hours. Which of the following past history disease processes would be considered a “red flag” and warrant immediate evaluation for this patient?		Sickle cell disease
A six-week-old infant presents to the emergency department with seizures. The infant is afebrile with a normal glucose level, and caregivers report no signs of illness other than formula intolerance, which they treated by adding extra water to the formula. The nurse would expect to find which of the following laboratory abnormalities?		Hyponatremia
A 5-year-old presents with sudden onset nausea, vomiting, abdominal cramping, hives, and hypotension after eating lunch. Which of the following is the priority intervention?		Intramuscular epinephrine
During the assessment of a 16-year-old patient, the ED nurse identifies them as a potential sex trafficking victim. Which of the following trauma-informed care principles has the highest priority for this patient?		Physical and psychological safety
A parent presents to the emergency department carrying her 12-week-old infant. The PAT reveals an infant who is quiet and opens eyes with stimulation, whose breathing is regular and even, and whose skin is pale, with a scattered vesicular rash. What is the priority intervention for this infant?		Obtain a full set of vital signs (wrong) Remediation feedback: An abnormal PAT in the presence of a rash should be considered life-threatening until proven otherwise and the patient placed in isolation.
After an explosion at a school, you are helping triage patients. In your field triage room you find a 5-year-old patient who is not breathing. What is the appropriate initial intervention?		Open the airway and assess for breathing.
Which of the following is a first-line treatment for atopic dermatitis?		Skin hydration therapy
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?		Initiate a fluid bolus
A 12-year-old restrained, back -seat passenger involved in a motor vehicle crash is noted to have hypotension, tachycardia, and contusions and discoloration across the lap area. On exam a splenic rupture is suspected. Which of the following diagnoses should be suspected as a companion injury with these findings and associated mechanism of injury?		Subdural hematoma (wrong)