ULTIMATE ENPC
1. A 4-year-old presents with vomiting, lethargy, frequent urination, weight loss, and dry
mucous membranes.Vital signs reveal deep respirations at 44breaths 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?: Hypoglycemia (wrong)
Remediation feedback:
Children can present with new onset diabetes in diabetic ketoacidosis. Manifesta- tions
include signs of dehydration ( dry mucous membranes, hypotension, tachycar-dia),
incontinence (polyuria), vomiting, abdominal pain, Kussmaul respirations (to counter the
acidosis), polydipsia, anorexia, and weight loss. Expected laboratory values would reveal an
acidotic state with a pH level below 7.3, an elevated serumbIcarbonate level, and an elevated
blood glucose level > 200 mg.dL.
2. An 18-month-old isseen for fever,slight circumoral cyanosis, and wheezingnoted on
auscultation in the right upper lobe of the lung field after a chokingevent 4 days ago.The white
blood cell count is elevated and the patient notedto 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 retrievethe suspected foreign body
instead of diagnostic tests to locate the foreign body itself.
3. 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 priorityintervention?: Establishing a secure
airway
4. Parents report their 3-year-old child has developed noisy breathing. On assessment,highpitched wheezes are audible and auscultated on inspirationand expiration.What medication
would be appropriate to administer first?: ini-tial medication intervention includes an inhaled
short-acting beta agonist.
5. 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
6. A 12-year-old is being prepped for surgical intervention of acute appendici-tis.Which of the
following intravenous medication orders should the nurse
question?: Ketorolac