EMERGENCY MEDICAL CONSULTANTS INC. Florida’s Premier Provider Of Quality Medical Training Programs

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Since 1988

ENPC Emergency Nursing Pediatric Course

Preparation Packet and Pre-Test

Please Note: This course is sanctioned and overseen by the ENA. Reviewing the textbook, completing the

online lectures, and taking the pre-test in this packet are mandatory prior to entering the class. If you do not

have the 4th

edition textbook, you will not be allowed to attend the class.

All information and directions are contained within this packet and the 4th

edition text.

We want your experience to be low stress and educational. We have found it takes most people several weeks to

prepare prior to entering the course. Following lectures, practice, and skills stations-both written and scenario

assessment are evaluated.

Please note you must complete the online lectures and pre-test

2017B

* Phone (772) 878-3085 * Fax (772) 878-7909 * E-mail: info@medicaltraining.cc

597 SE Port St. Lucie Blvd * Port St Lucie, Florida 34984

Visit Our Website at EMCmedicaltraining.com

To: 4th Edition ENPC Provider Course Participant

ENPC  is  a  two-­‐day  course  consisting  of  lectures,  practice  stations  and  testing  stations.    In  

addition,  each  participant  is  encouraged   to  review  certain  lectures  online   prior  to   the  course.  

Please   see  attached   directions   to   access   these   lectures   on  the  ENA  website.  

 

In   addition   to  viewing  these  lectures,   it   is  imperative   that  you   read   and   study  your  provider  

manual  prior  to  the  course.    Pay  particular  attention  to  the  chapter  on      the  Management  of  the  

Critically  Ill  or  Injured  Pediatric  Patient  station,  pages  389-­‐393  you  will  also  find  attached   a  

practice   test  with  answers.  This  test  will  give  you  an  idea  of  the  type  of  questions  asked  on  the  

50-­‐question  exam.  

 

Special  Notes:  

 

Cancellation  Policy:  Due  to  the  stringent  ratios,  once  registered,  cancellations  greater  than  5  business  days  are  

eligible  for  a  refund  minus  a  $100.00  administrative  fee.    Cancellations  within  3-­‐  5  business  days  of  the  course  

are  eligible  for  a  refund  minus  a  50%  of  course  fee.    If  cancellation  is  received  2  business  days  before  the  course,  

entire  fee  is  forfeited.    

 

Rescheduling  Policy:    Rescheduling  between  3-­‐5  business  days  prior  to  the  course  will  incur  a  $100.00  

administrative  fee.  Rescheduling  2  business  days  before  the  course  will  incur  a  50%  fee  of  the  course  fee.  

 

Participants  who  are  “No  Shows”  or  those  who  call  to  cancel  or  change  the  night  before  or  morning  of  a  

course  will  forfeit  all  registration  fees.    

 

You  will  need  to  bring  to  class  a  copy  of  your  nursing  license  and  a  copy  of  your  ENA  membership  card  if  you  are  

asking  for  an  ENA  membership  discount.    

 

If you have any questions please call Emergency Medical Consultants at (772)-878-3085 or the ENA at 800-900-9659

®

EMERG ENCY N U RSES ASSOC IATIO N

S,\H P R ACT I CE, SMf- (AIU

EMERGENCY NURSING PEOIATRIC COUP.SE

An II IHJ"course

To Access the 4th edition ENPC Provider Pre-Course Online Modules:

1. Go  to  ENA.org  select  the  Education  tab  and  click  on  ENA  LEARN.  Scroll  down  and  select  Find  a  Course.  2. Log  in  to  the  ENA  website  or  create  an  account.  3. Select  the  category  button  named  ENPC.    Scroll  down  to  find  ENPC  Provider  Course  Online  Modules  and  

add  to  your  shopping  cart.    4. Enter  the  discount  code  ENPCENA4  and  click  on  apply.  There  will  be  no  cost  to  you.  The  discount  code  

will  bring  the  cost  to  zero.  Do  not  use  a  credit  card  for  payment.  Payments  will  not  be  credited  or  refunded.  

5. DO  NOT  proceed  until  the  discount  code  is  applied.  Click  on  the  Check-­‐Out  button,  and  complete  the  checkout  process.  

6. To access your course, select the Go to Your Online Courses button at the bottom of the confirmation page.

7. Select Click here to Proceed to your Courses.

8. Under Online Courses, select ENPC Provider Course Modules.

To Return to the Modules:

You  may  log  out  of  the  online  modules  and  return  to  them  as  often  as  necessary.    Should you need to return to the

modules again follow the steps below:

1. Go  to  ENA.org  select  the  Education  tab  and  click  on  Go  to  Your  Online  Courses.  2. Log  in  to  the  ENA  website.  3. Select  Click  Here  to  Proceed  to  Your  Courses.  

 

To record completion select the Submit Contact Hours button in the course profile. You will complete a course

evaluation at this time. The certificate for contact hours will be provided to you by your Course Director. While

not required, you may print a certificate of completion for your records.

It  is  encouraged  that  all  students  complete  the  modules  as  well  as  read  the  provider  manual.  The  online  modules,  

in  person  class  and  the  provider  manual  are  meant  to  supplement  each  other  to  provide  a  more  robust  learning  

experience  focused  on  retention  and  to  provide  for  more  hands-­‐on  skill  training  in  the  classroom  setting.  

If  you  have  questions  or  are  experiencing  technical  difficulties  please  contact  elearning@ena.org  or  the  

education  department  at  847-­‐460-­‐4123.

Continued

®

EMERG ENCY N U RSES ASSOC

IATIO N

S,\H P R ACT I CE, SMf-

(AIU

EMERGENCY NURSING PEOIATRIC COUP.SE

An II IHJ"course

To Return to the Modules again:

Should you need to return to these modules again you can access the online modules from the same

location on the ENA web site by following the steps below

1. Visit www.ena.org/ENPC and skip to #6 OR

2. Go to the ena.org web site

3. Click on the purple 'Education' tab to reveal the dropdown menu

4. Click on ENPC/TNCC

5. Click on the ENPC link towards the top of the center screen

6. Click on the link towards the top of the ENPC page called 'Access ENPC Provider Course Online Modules'

7. Once you click on this link, you will be taken to a web site separate from the ENA web site to access

the online modules:

o Returning Users: Enter your Username and Password in the login area in the top center of

the screen

o Click on the Launch button to access any of the 4 online learning modules.

• To open any of the online modules, click on the module name. You can view the modules in any

order. When finished watching each module, close out of the module window and click on

Take Module Assessment located in the upper right corner, answer the question to verify

completion of that individual module.

• Students can log out of the online modules and return to them as often as they need to.

As a reminder: This is not the ENA web site that you are logging in to, so the username and password is

relevant only for the ENPC online modules.

There is not a contact hour certificate produced upon completion of the online modules. The contact hours

associated with the online modules are to be included in the total contact hours given at the completion of

the course.

Please note: It is encouraged that all students complete the modules as well as read the provider manual. The

online modules, in person class and the provider manual are meant to supplement each other to provide a more

robust learning experience focused on retention and to provide for more hands-on skill training in the classroom

setting.

If you have any questions or issues with the login process, or technical difficulties with the online modules,

please contact ENA Educational Services at 847-460-4123.

ENPC 4th Edition: Practice Test

Revised April 2014 1 Copyr ight© 2014 Emergency Nursing Association

2

2

1. A preschooler has a small laceration that required 2 stitches. The nurse covers the wound with a bandage

knowing that it will comfort the child to have it covered. What is the developmental reason for this

intervention?

a. Preschoolers are magical thinkers and imagine bandages keep their insides from coming out

b. Preschoolers fear physical disability and believe a bandage will prevent disability

c. Preschoolers explore orally and will likely chew or suck on the stitches if left uncovered

d. Preschoolers are concerned with body image and don't want to appear different than peers

2. A 7-month-old presents to the emergency department with a complaint of fever. Assessment reveals a pa

tent airway and slight cyanosis around his lips and nail beds. He is alert and interactive. His vital

signs are 38.5° C (101.3° F), HR 134, RR 32, BP 78/54 mm Hg, and Sp02 84%. The nurse notes a healed

surgical scar on his chest. Based on this assessment, what is the nurse’s priority?

a. Administer ibuprofen to treat the fever b.

Begin oxygen via a nonrebreather mask

c. Obtain a surgical history

d. Ask if the Sp0 is normal for him

3. An 11-year-old presents to the emergency department with a complaint of hitting his head while playing

soccer. The nurse enters the room and performs an across-the-room assessment. He is staring at the

wall. He has no increased work of breathing, and his color is pink. Using the pediatric assessment

triangle (PAT), what classification will the nurse assign?

a. Well

b. Sick

c. Sicker

d. Sickest

4. The pediatric prioritization process components include the focused assessment, focused history, acuity

rating decision and:

a. the pediatric assessment triangle (PAT).

b. developmental characteristics.

c. head-to-toe assessment.

d. life-saving interventions.

5. A 2-yea r-old is brought to the emergency department by her father when he found her face down in

the pool. She remains unresponsive and is breathing shallowly and slowly. Her color is pale. What is the

priority?

a. Administer 100% oxygen

b. Immobilize the cervical spine

c. Begin bag-mask ventilation

d. Insert an oral airway

6. A 2-year-old has a suspected cervical spinal injury. In order to ensure neutral spinal alignment, padding

should be placed under which area?

a. Shoulders

b. Head

c. Neck

d. Waist

Revised April 2014 2 Copyr ight© 2014 Emergency Nursing Association

;)'

ENPC 4th Edition: Practice Test

7. The nurse is preparing to administer a feeding through a nasogastric feeding tube. The tube position

was verified by radiograph after insertion 2 hours ago. What is the best way to verify placement before

feeding?

a. Instill air and listen over the epigastrium

b. Test the pH of the gastric contents

c. Observe color of a gastric aspirate sample

d. Repeat the radiograph

8. What is the best method to rapidly administer a 20 mL/kg bolus of 0.9% normal saline to a pediatric

patient weighing 8 kg?

a. A 20-mL syringe with a stopcock

b. A syringe pump

c. A rapid infuser

d. A pressure bag

9. Immediately after intraosseous insertion the nurse assesses the infusion and notes that the fluid is not

dripping. How should the nurse respond?

a. Use an infusion pump to deliver the fluids

b. Remove the device and insert in another site

c. Advance the device and reassess the flow

d. Attempt to aspirate bone marrow

10. A 13-month-old presents to the emergency department with a 2-day history of a low-grade fever,

increased work of breathing, and tonight developed a barking cough and inspiratory stridor. What

condition does the nurse suspect?

a. Epiglottitis

b. Foreign body aspiration

c. Tracheomalacia

d. Croup

11. In providing education to a family regarding obtaining baseline peak airway flow for a child with

asthma, the nurse will recommend what time of day?

a. At bedtime

b. Before exercise

c. In the morning

d. After meals

12. The nurse is planning to begin oral rehydration therapy for a 9-month-old with mild dehydration. She

provides the caregivers with a glucose and sodium solution and instructs them to administer small

amounts:

a. Every 2 to 5 minutes

b. Every 10 to 12 minutes

c. Every 15 minutes

d. Every 30 minutes

Revised April 2014 3 Copyr ight© 2014 Emergency Nursing Association

ENPC 4th Edition: Practice Test

13. Caregivers bring in their 3-week-old neonate and describe nonbilious vomiting after every feeding that is

becoming more forceful over the past 24 hours. The last time he vomited the vomitus hit a chair 2 feet

away. They say he cries, roots, and sucks vigorously on his pacifier right after vomiting as though still

hu ngry. He is not experiencing any diarrhea. What condition is the most likely cause of these signs and

symptoms?

a. Intussusception

b. Vol vulus

c. Gastroenteritis

d. Pyloric stenosis

14. A neonate is delivered in the emergency department and placed on a radiant warmer. There is no

staining of the amniotic fluid. What is the first step in neonatal resuscitation?

a. . Dry and warm the neonate

b. . Suction the mouth and nose

c. Assess for effective breathing

d . Palpate a central pulse rate

15. I n discussing the legal care of the adolescent patient, what is a mature minor?

a. A minor who lives independently and is legally able to make health decisions

b. A minor who is able to make decisions regarding his or her own sexual or mental health

c. A minor who is able to make decisions regarding healthcare as a parent of his or her own child

d. A minor who lives with a parent or guardian but legally is able to make health decisions

16. Which of the following screening statements/questions is most appropriate in assessing an adolescent for

dating violence?

a. "Wbat triggers for violence have you experienced from your partner?"

b. "Does your partner feel entitled to sex even if you say 'no'?"

c. "Tell me about a time when you've felt unsafe in your relationship."

d. "Do you feel if you tried harder to please, your partner will not become violent?"

17. Which sign distinguishes compensated shock from decompensated shock in the pediatric

patient?

a. Peripheral pulses

b. Blood pressure

c. Capillary refill

d. Level of consciousness

18. A 5-year-old arrives to the emergency department unconscious with a heart rate of 32 beats/minute,

weak, thready pulses, and pale, mottled skin. The team has begun bag-mask ventilation with 100%

oxygen and chest compressions with no improvement in the heart rate. An intraosseous line is in place.

Which of the following interventions is the priority?

a. Administration of atropine

b. Transcutaneous pacing

c. Administration of epinephrine

d. Attempt vagal stimulation

Revised April 2014 4 Copyr ight© 2014 Emergency Nursing Association

ENPC 4th Edition: Practice Test

2

19. A 9-month-old infant pulled himself up onto the hearth of a fireplace. While doing so, he fell forward

onto t he hot glass doors and sustained deep partial thickness burns to the bilateral palmar aspects of both

hands. What is the approximate percentage of total body surface area burned?

a. 1% b. 2% c. 4% d. 5%

20. An ambulance arrives with a 13-year-old pedestrian hit by a car. Identified injuries reported by

paramedics include multiple abrasions to the head and face, a large, actively bleeding laceration to the

forehead, hip pain with the leg externally rotated, and bruising across the chest and abdomen. The patient is

in full spinal immobilization and has two intravenous catheters and a nonrebreather oxygen mask in

place. Vital signs are BP 110/70 m m Hg, HR 118 beats/minute, RR 24 breaths/minute, and Sp02 96%. The

Glasgow coma scale score

is 15. What is the priority?

a. Computed tomography

b. Immobilize the femur

c. A pressure dressing to the forehead

d. Focused assessment with sonography for trauma (FAST)

21. A 15-year-old with a history of schizophrenia is taking risperidone (Risperdal) and lithiu m (Eskalith).

She presents with dystonia, akinesia, a shuffling gait, muscle rigidity, and tremors. What does the

nurse suspect is the cause of these signs and symptoms?

a. Extrapyramida l symptoms

b. Tardive dyskinesia

c. Neuroleptic malignant syndrome

d. Serotonin syndrome

22. Which of the following bu rn injury patterns and history indicates suspected child maltreatment?

a. A 5-cm (2-inch) linear, superficial partial-thickness burn with irregular edges on the leg of a preschooler,

reportedly from touching a curling iron left on a low table

b. A deep partial-thickness, sharply demarcated bum on the buttocks of a toddler, reportedly from the child turning

on the hot water while in the bath

c. A 2-cm (0.75 inch) linear partial-thickness burn on the arm of toddler, reportedly from walking and bumping i n t o

a lighted cigarette

d. A partial-thickness bum with irregular edges and splash pattern on the chest and right hand of a 7-year-old

reportedly spilling a bowl of soup from the microwave

23. A mother presents to the emergency department with a 6-week-old infant with no medical issues after a

normal delivery, until yesterday. Mom states he has been eating poorly, vomiting, and that "he's ha rd

to wake up."

The infant is responsive only to painful stimuli. The anterior fontanel is bulging. He is mildly tachycardic,

but otherwise vital signs are normal. What diagnostic evaluation will the nurse expect for this i n f a n t ?

a. Upper gastrointestinal (GI) series

b. Skeletal survey

c. Lumbar puncture

d. Blood gas analysis

Revised April 2014 5 Copyr ight© 2014 Emergency Nursing Association

ENPC 4th Edition: Practice Test

24. A malfunctioning oxygen tank explodes near a child's bed in the emergency department, resulting in an

extensive burn injury to the child. Four nurses participate in the child's immediate care. Which nurse

requires intervention after this critical incident?

a. One who refuses to participate in critical incident stress debriefing

b. One who readily talks about the incident and how he reacted

c. One who admits experiencing burnout and asks for a week leave of absence

d. One who is not sleeping because of dreams of the incident

25. Two ambulances collide in front of the hospital. The victims include three pediatric victims. Using the

J umpSTART triage system, which category assignment will the nurse give to a 2-yea r-old who is lying

on the ground, alert and crying with spontaneous respirations of 36 breaths/minute and present

peripheral pulses?

a. Green

b. Yellow

c. Red

d. Black

1.A

2.D

3.C

4.A

5.B

6.A

7.B

8.A

9.A

10. D 11. C

12. A

13. D

14. A

15.D

16. C 17. D 18. C 19. B

20. C

21. A

22. B

23. B

24. D

25. B

ENPC 4th EDITION PRACTICE TEST

ANSWER KEY