ENPC 5th Edition
1. A 5 year-old with no health problems presentsto the Emergency Departmentwith 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?
Answer: Ask about any new bed-wetting orsleep disturbances
Pediatric patients with anxiety and PTSD may present with physical complaints. Assess for
other behavioral symptoms to facilitate appropriate care and follow-up.
2. You are discharging a patient to home with a history of depression. Dis- charge teaching
should include which of the following?
Answer: Ensuring all firearmsin 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.
3. A 2-year old has uniformly demarcated burns to bilateral lower extremities,approximately
30% of the child total body surface area. The father states hebriefly 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?
Answer: Obtain vascular access for rapid fluid administration
Rapid vascular access and fluid administration are the priority interventions.
4. A 7-year-old arrives via ambulance.The patient's mother reports witnessinga seizure at
home. The patient has no seizure history. Upon examination, thepatient is post-ictal with a heart
rate of 142 beats per minute,respiratory rate of36 breaths per minute, and blood pressure of
86/72 mm Hg. Significant burnsare 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?
Answer: Draw and send a metabolic paneland venous blood gas, administer a fluid bolus, and
obtain a point of care glucose