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A 45-year-old male presents to the emergency department with a chief complaint of chest pain. He describes the pain as a squeezing sensation that radiates to his left arm. He is diaphoretic and short of breath. What is the most appropriate initial action?
A
B
C
D
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Sample ENP-C Practice Exam Practice Questions
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1A 45-year-old male presents to the emergency department with a chief complaint of chest pain. He describes the pain as a squeezing sensation that radiates to his left arm. He is diaphoretic and short of breath. What is the most appropriate initial action?
A.Administer nitroglycerin
B.Obtain a 12-lead ECG
C.Draw blood for cardiac enzymes
D.Administer aspirin
Explanation: The most appropriate initial action for a patient with suspected myocardial infarction is to obtain a 12-lead ECG. This will help to determine if the patient is experiencing an ST-elevation myocardial infarction (STEMI), which requires immediate reperfusion therapy. While the other actions are also important, the ECG is the most time-sensitive intervention.
2A 6-year-old child is brought to the emergency department with a 2-day history of fever, cough, and runny nose. The child is alert and playful, with a respiratory rate of 24 breaths/minute and an oxygen saturation of 98% on room air. According to the Emergency Severity Index (ESI), what is the most appropriate triage level for this child?
A.Level 1
B.Level 2
C.Level 3
D.Level 4
Explanation: This child is stable and does not require immediate life-saving interventions. The ESI level is determined by the number of resources the patient is expected to consume. A child with a simple viral illness is likely to require only one or two resources, such as a prescription or a single diagnostic test.
3A 65-year-old female with a history of hypertension presents with a sudden onset of tearing chest pain that radiates to her back. Her blood pressure is 220/120 mmHg in the right arm and 180/100 mmHg in the left arm. A chest X-ray reveals a widened mediastinum. What is the most likely diagnosis?
A.Myocardial infarction
B.Pulmonary embolism
C.Aortic dissection
D.Pericarditis
Explanation: The classic presentation of aortic dissection is the sudden onset of tearing chest pain that radiates to the back. A discrepancy in blood pressure between the arms and a widened mediastinum on chest X-ray are also highly suggestive of this diagnosis.
4A 2-year-old child is brought to the emergency department after ingesting an unknown amount of their grandmother's diltiazem. The child is lethargic, with a heart rate of 50 beats/minute and a blood pressure of 70/40 mmHg. What is the most appropriate initial treatment?
A.Atropine
B.Glucagon
C.Calcium gluconate
D.Naloxone
Explanation: Calcium channel blocker overdose can cause profound bradycardia and hypotension. Calcium gluconate is the first-line treatment, as it directly antagonizes the effects of calcium channel blockers at the cellular level.
5A 16-year-old female presents to the emergency department requesting treatment for a sexually transmitted infection. She asks that her parents not be informed. What is the most appropriate action for the nurse practitioner?
A.Refuse to treat the patient without parental consent.
B.Inform the parents of the patient's request.
C.Treat the patient without parental consent.
D.Contact child protective services.
Explanation: In most states, minors can consent to treatment for sexually transmitted infections without parental notification. The nurse practitioner should respect the patient's confidentiality and provide treatment.
6A 70-year-old male with a history of atrial fibrillation presents with the sudden onset of right-sided weakness and aphasia. His symptoms began 2 hours ago. A non-contrast head CT is negative for hemorrhage. What is the most appropriate next step in management?
A.Administer aspirin
B.Administer intravenous tissue plasminogen activator (tPA)
C.Perform a carotid endarterectomy
D.Observe the patient for 24 hours
Explanation: The patient is presenting with an acute ischemic stroke within the 3- to 4.5-hour window for thrombolytic therapy. A non-contrast head CT has ruled out hemorrhage, so the patient is a candidate for intravenous tPA.
7A 25-year-old female presents with a 1-day history of right lower quadrant abdominal pain, nausea, and vomiting. On physical examination, she has tenderness at McBurney's point. What is the most likely diagnosis?
A.Ovarian torsion
B.Ectopic pregnancy
C.Appendicitis
D.Diverticulitis
Explanation: The classic presentation of appendicitis is periumbilical pain that migrates to the right lower quadrant, nausea, vomiting, and tenderness at McBurney's point.
8A 5-year-old child is brought to the emergency department with a 3-day history of a barking cough and inspiratory stridor. The child is afebrile and has a steeple sign on neck X-ray. What is the most likely diagnosis?
A.Epiglottitis
B.Bacterial tracheitis
C.Croup
D.Foreign body aspiration
Explanation: Croup, or laryngotracheobronchitis, is a viral infection that causes inflammation of the upper airway. The classic presentation is a barking cough and inspiratory stridor. The steeple sign on neck X-ray is pathognomonic for croup.
9A 30-year-old female with a history of type 1 diabetes presents with nausea, vomiting, and abdominal pain. Her blood glucose is 450 mg/dL, and her arterial blood gas shows a pH of 7.25, a pCO2 of 25 mmHg, and a bicarbonate of 10 mEq/L. What is the most likely diagnosis?
A.Hyperosmolar hyperglycemic state (HHS)
B.Diabetic ketoacidosis (DKA)
C.Hypoglycemia
D.Lactic acidosis
Explanation: The patient is presenting with the classic signs and symptoms of DKA, including hyperglycemia, metabolic acidosis with an anion gap, and ketonemia. The anion gap is calculated as follows: (Na+) - [(Cl-) + (HCO3-)] = (140) - [(100) + (10)] = 30. A normal anion gap is 8-12 mEq/L.
10A 45-year-old male presents with a painful, swollen, and red great toe. He denies any recent trauma. Aspiration of the joint reveals needle-shaped, negatively birefringent crystals. What is the most likely diagnosis?
A.Septic arthritis
B.Gout
C.Pseudogout
D.Rheumatoid arthritis
Explanation: The classic presentation of gout is the sudden onset of a monoarticular arthritis, most commonly affecting the great toe (podagra). The diagnosis is confirmed by the presence of needle-shaped, negatively birefringent monosodium urate crystals in the synovial fluid.
About the ENP-C Practice Exam Exam
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ENP-C Practice Exam Exam Content Outline
About the ENP-C Exam
<p>The Emergency Nurse Practitioner (ENP-C) certification is offered by the American Academy of Nurse Practitioners Certification Board (AANPCB). It is designed for certified Family Nurse Practitioners who have specialized in emergency care.</p><p>The exam consists of 150 multiple-choice questions, and you will have 3 hours to complete it. The content covers a wide range of topics, including medical screening, patient management, and various patient conditions.</p>
How to Pass the ENP-C Practice Exam Exam
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- Complete 500+ practice questions
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Frequently Asked Questions
How many questions are on the ENP-C exam?
The ENP-C exam has 150 multiple-choice questions.
What is the time limit for the ENP-C exam?
You will have 3 hours (180 minutes) to complete the ENP-C exam.
What is the passing score for the ENP-C exam?
The passing score for the ENP-C exam is determined by the AANPCB, but is generally around 70%.