ENPC 6th Edition Course Exam

ENPC 6th Edition Course Exam

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ENPC 6th Edition Course Exam

• 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?

Answer: Hypoglycemia (wrong)

Remediation feedback:

Children can present with new onset diabetes in diabetic ketoacidosis. Manifestations include signs of dehydration ( dry mucous membranes, hypotension, tachycardia), 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 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?

Answer: Computed tomography (wrong)

Remediation feedback:

Manifestations of a lower airway foreign body include a choking incident with subsequent failure to improve on antibiotics. Wheezing or decreased lung sounds in one area of the pulmonary system is a high indicator for a foreign body along with signs of hypoxia such as cyanosis, tachypnea, tachycardia, increased respiratory effort, agitation or lethargy, and elevated white blood cell counts indicating an infectious process. 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?

Answer: Establishing a secure airway

• 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?

Answer: - Humidified oxygen (wrong)

Remediation feedback:

Wheezing is most often identified with asthma in the pediatric population. Initial medication

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