ENPC 6TH EDITION COURSE EXAMS NEWEST

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ENPC 6TH EDITION COURSE EXAMS NEWEST

UPDATE TEST BANK| 4

VERSIONS (VERSIONS A, B, C & D) EACH VERSION

CONTAINS 50 QUESTIONS AND CORRECT DETAILED

ANSWERS (VERIFIED ANSWERS) ALREADY GRADED

A+ (BRAND NEW!!)

VERSION A

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

• Benzodiazepine overdose
• Supraventricular tachycardia
• Overdiluted formula
• Congenital heart disease - Correct Answer - C

Water overload is a well-documented etiology of hyponatremia in infants, which can be caused by excess dilution of formula. Hyponatremia is a known cause of seizures. Benzodiazepine overdose is more likely to result is respiratory depression and coma. CHD and SVT are not readily known to cause seizures.

For the infant, what duration of time is consider apneic?A.10 seconds B.20 seconds C.5 seconds D.15 seconds - Correct Answer - B

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pg. 2 The respiratory rate, depth, and regularity all continue to change the first year of life, making respiratory assessments different than those of older children. Infants breathe faster and less regularly, with apnea not considered as such until 20 seconds without a breath or associated with other physiologic effects such as bradycardia.

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?

• Assess the oropharynx
• Assess endotracheal tube placement
• Insert an orogastric tube
• Insert a second intravenous access - Correct Answer - B

If a patient arrives with an artificial airway (endotracheal tube or tracheostomy) in place, assess its placement, patency, and the oral airway (in that order) before moving to the next step of the primary survey. The oropharynx should be checked for fluids or objects such as broken teeth. Inserting a gastric tube in an intubated patient and starting a second large caliber IV line should also be done, but they don't take priority over airway.

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?

• Begin chest compressions
• Suction the oropharynx with a catheter
• Obtain vascular access
• Initiate positive pressure ventilation - Correct Answer - D 2 / 4

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pg. 3 Immediately after delivery all neonates should be warmed, stimulated, and have their mouth then nose suctioned using a bulb syringe. Following this, if the neonate is not breathing or is gasping and/or has a heart rate of less than 100 beats per minute positive pressure ventilation at 21% FiO2 at a rate of 40-60 breaths per minute should be immediately initiated. The heart rate should be assessed after 15 seconds of PPV and if not improving additional measures should be taken (MRSOPA). Vascular access is not always needed but can be worked on by another team member while airway and breathing interventions are being completed.

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?

• Ask about any new bed-wetting or sleep disturbances
• Discharge to home and follow-up with their primary care physician
• Repeat a head-to-toe exam to identify any missed traumatic injuries
• Consult cardiology for appropriate follow-up - Correct Answer - A

Physical complaints are not uncommon in children following a traumatic event.Once any physical injuries or illnesses have been ruled out, assessment for any other behavioral symptoms to facilitate appropriate care and follow-up would be indicated. The incident occurred a week ago so the likelihood any an severe medical issues is pretty low.

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

• Closed greenstick wrist fracture in a 4-year-old child who fell off his bicycle
• Bruises in various stages of healing to the lower extremities of a 2-year-old

child

• Right radial spiral fracture in a 10 year old practicing martial arts 3 / 4

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• Bruising to the left ear of a newborn from sleeping on his side - Correct Answer
• D

Any bruises in a non-exploratory location (especially torso, ears, and neck) in children younger than 4 years old and ANY bruising in a child younger than 4 months old is suspicious for child maltreatment. Bruises to the lower extremities of a 2-year-old who is learning to walk on their own is not uncommon. Greenstick fractures are a more common fracture is children due to the immaturity of their bone structure. Martial arts includes many moves that could produce a spiral fracture.

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?

• Obtain a history including immunization status
• Suction nasal passages using a bulb syringe
• Administer oxygen by nasal cannula with patient in caregiver's arms
• Respiratory assessment is completed so move to circulatory - Correct Answer -

B

Infants up to four months old are obligate nose breathers and can have respiratory distress when nares are occluded. Mucous can be gently suctioned using a bulb syringe or suction catheter. A good, thorough history should always include immunization status for pediatric patients. The nose needs to be clear before applying oxygen via nasal cannula. Respiratory assessment includes interventions to improve breathing so you would not move to move to circulation until that is accomplished.

You need to draw blood from a 2-year-old. Which of the following is the best approach for this patient?

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