ENPC ENPC Respiratory Emergencies 1 — Questions and Answers
Question 1: A child presents with inspiratory stridor, a barking cough, and low-grade fever. Which condition is most likely?
- Epiglottitis
- Croup (laryngotracheobronchitis) (Correct answer)
- Foreign body aspiration
- Bacterial tracheitis
Correct answer: Croup (laryngotracheobronchitis)
Croup is characterized by the classic barking cough, inspiratory stridor, and low-grade fever in young children.
Question 2: A 4-year-old presents with sudden onset of choking, unilateral wheezing, and decreased breath sounds on the right. What is the priority intervention?
- Administer nebulized albuterol
- Obtain a chest X-ray
- Prepare for bronchoscopy (Correct answer)
- Administer racemic epinephrine
Correct answer: Prepare for bronchoscopy
Sudden unilateral wheezing with decreased breath sounds strongly suggests foreign body aspiration, requiring bronchoscopy for removal.
Question 3: Which oxygen delivery method provides the highest inspired oxygen concentration for a spontaneously breathing, critically ill pediatric patient?
- Nasal cannula
- Simple face mask
- Non-rebreather mask (Correct answer)
- Venturi mask
Correct answer: Non-rebreather mask
A non-rebreather mask with a reservoir bag and one-way valves can deliver up to 90–95% oxygen concentration.
Question 4: A 2-year-old with asthma presents with moderate respiratory distress and SpO2 of 91% after initial albuterol. Which adjunct treatment is MOST appropriate?
- IV magnesium sulfate only
- Ipratropium bromide plus systemic corticosteroids (Correct answer)
- Heliox therapy
- Ketamine infusion
Correct answer: Ipratropium bromide plus systemic corticosteroids
Ipratropium bromide combined with systemic corticosteroids is standard adjunct therapy for moderate asthma exacerbations not resolved by albuterol alone.
Question 5: Which assessment finding BEST indicates impending respiratory failure in a pediatric patient?
- Respiratory rate of 30 breaths/min in a 3-year-old
- Altered mental status with decreasing respiratory effort (Correct answer)
- Mild intercostal retractions with clear breath sounds
- SpO2 of 95% on room air
Correct answer: Altered mental status with decreasing respiratory effort
Altered mental status combined with decreasing respiratory effort signals impending respiratory failure and requires immediate airway intervention.
Question 6: When selecting an endotracheal tube for pediatric intubation, current ENPC guidelines recommend which approach?
- Use the formula age/4 + 4 for uncuffed tubes only
- Use a length-based resuscitation tape and consider cuffed tubes for all ages (Correct answer)
- Select tube size based solely on the child's weight
- Always use uncuffed tubes in children under 8 years
Correct answer: Use a length-based resuscitation tape and consider cuffed tubes for all ages
Length-based resuscitation tapes provide accurate sizing, and cuffed ETTs are now acceptable for all pediatric age groups per current guidelines.
ENPC ENPC Respiratory Emergencies 1
A child presents with inspiratory stridor, a barking cough, and low-grade fever.
Which condition is most likely?