Latest AACN CCRN-Pediatric Exam questions and answers

DumpTorrent CCRN-Pediatric Exam Practice Test Questions (Updated 152 Questions)

NEW QUESTION # 16
Barbie had a Arteriovenous fistula access and starts hemodialysis as treatment for a renal failure. Which of the following statement made by the mother would indicate further teaching:

• A. "I will take blood pressure in the arm with fistula everyday"
• B. "I will check the pulse at the wrist of the arm with fistula everyday"
• C. "I will need to call the clinic once my child develops diarrhea"
• D. "I will ensure that my child drinks enough fluid if weather is warm"

Answer: A

Explanation:
Explanation: Inflating a blood pressure cuff in the arm with fistula is contraindicated because it disrupts the integrity of the fistula.

NEW QUESTION # 17
Immediately following a heart transplant, a patient has two P waves followed by one QRS segment each cardiac cycle. What is the nurse's next step?

• A. Obtain an echocardiogram
• B. Continue to monitor
• C. Request isoproterenol
• D. Start temporary pacing

Answer: B

Explanation:
After aheart transplant, the native atrial tissue may continue to generateP waves, even though the donor heart generates its own rhythm. This results in the appearance oftwo P waveson ECG - one from the native sinoatrial node and one from the donor atrium. This is anormal findingpost-transplant and doesnot require intervention.
"Dual P waves seen post-transplant are common due to retained native atrial activity. The QRS response from donor conduction confirms proper graft function." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Post-Transplant Electrophysiology Monitoring)

NEW QUESTION # 18
Systemic Inflammatory Response Syndrome (SIRS) is characterized by:

• A. Vasodilation and increased capillary permeability
• B. Vasodilation and decreased capillary permeability
• C. Vasoconstriction and increased capillary permeability
• D. Vasoconstriction and decreased capillary permeability

Answer: A

Explanation:
SIRS leads towidespread vasodilation and increased capillary permeability, which causesfluid shifting, hypotension, and potential multi-organ dysfunction. This systemic response is part of the pathophysiology of sepsis and MODS.
"SIRS involves a cytokine-mediated vasodilatory response with increased capillary permeability, leading to third-spacing, hypoperfusion, and potential organ dysfunction." (Referenced from CCRN Pediatric - Direct Care: Multisystem, Inflammatory Cascade in Sepsis)

NEW QUESTION # 19
A 4-year old child with cerebral palsy is admitted for a surgery. At the time of admission, the nurse should have told the mother that:

• A. there's a limit in visiting hours the child
• B. the hospital will provide her a pureed diet.
• C. the therapy used at home will be utilized in the hospital.
• D. the child needs to be in a private room.

Answer: C

Explanation:
Explanation: The therapy program that was utilized at home will be incorporated in the plan of care at the hospital in order to maintain continuity. The client needs to socialize and interact. Parents are encouraged to actively participate in caring for the chills. Diet is regular and should be appropriate for the age.

NEW QUESTION # 20
An adolescent with type 1 diabetes has been admitted due to ketoacidosis. The nurse expects that the child will exhibit:

• A. Fever
• B. Bradycardia
• C. Hypercapnia
• D. Hypertension

Answer: C

Explanation:
Explanation: Hypercpnia is an attempt by the respiratory system to eliminate too much carbon dioxide.
It is a compensatory mechanism associated with metabolic acidosis.

NEW QUESTION # 21
Hillary is a 6 year old who has meningitis. The nurse at the unit noticed that she assumes an opisthotonic position. The nurse should place her in :

• A. side-lying position
• B. high fowler's position
• C. knee-chest position
• D. semi-fowler's position

Answer: A

Explanation:
Explanation: In meningitis, side-lying position is for maximum safety and comfort because the child with meningitis has hyperextended neck and back.

NEW QUESTION # 22
An infant with Myelomeningocoele underwent a surgical repair. Suddenly, the client developed metabolic acidosis, notable decreased urinary output and diarrhe a. The nurse at the unit anticipates that the doctor will order:

• A. Sodium Lactate
• B. Isotonic saline
• C. Hypertonic saline
• D. Potassium chloride

Answer: A

Explanation:
Explanation: T o correct the sodium deficit and metabolic acidosis, the client needs Sodium Lactate.
Sodium Lactate is converted to sodium bicarbonate. Saline intensifies acidosis. Potassium will only be given once kidney function was restored.

NEW QUESTION # 23
A mother brought her child to the clinic with nose bleeding. The nurse showed the mother the most appropriate position for the child which is:

• A. moderate back rest
• B. Lying semi flat
• C. Sitting up
• D. low back rest

Answer: C

Explanation:
Explanation: This position will minimize the amount of blood pressure in nasal vessels and keep blood moving forward not back into the nasopharynx, which will have the choking sensation and increase risk of aspiration. Other options are inappropriate because they can cause blood to enter the nasopharynx.

NEW QUESTION # 24
An infant has hypovolemic shock from severe diarrhea. Which of the following assessments demonstrates adequate tissue perfusion following fluid resuscitation?
Capillary Refill
Urine Output
CVP
BP
a. 2 sec
0.5 ml/kg/hr
2 mm Hg
84/50
b. 3 sec
0.5 ml/kg/hr
6 mm Hg
72/44
c. 3 sec
1.2 ml/kg/hr
4 mm Hg
72/48
d. 2 sec
1.2 ml/kg/hr
8 mm Hg
80/54

• A. Option B
• B. Option C
• C. Option A
• D. Option D

Answer: D

Explanation:
Indicators ofadequate tissue perfusionfollowing fluid resuscitation include:
* Capillary refill #2 seconds
* Urine output #1 mL/kg/hr
* Normal CVP(4-10 mm Hg in infants)
* Age-appropriate blood pressure
Option D is the only one whereall parameters are within normal ranges, reflecting effective volume resuscitation and adequate perfusion.
"Capillary refill <2 sec, urine output >1 mL/kg/hr, and CVP in the normal range indicate improved perfusion in shock management." (Referenced from CCRN Pediatric - Direct Care: Multisystem, Shock States and Resuscitation Targets)

NEW QUESTION # 25
What explanation would a nurse give to a parent of a pediatric client who will undergo a cardiac catheterization:

• A. it will identify specific location of the defect.
• B. it will establish the presence of heart muscle hypertrophy.
• C. it will confirm if there is a pansystolic murmur.
• D. it will determine the degree of heart muscle problem

Answer: A

Explanation:
Explanation: The procedure will identify the exact location of ventricular septal defect and also assess pulmonary pressure. Other options can be identified by using ECG and stethoscope.

NEW QUESTION # 26
Measles vaccine should be given among infant between:

• A. 12 and 15 months
• B. 9 and 11 months
• C. 1 and 3 months
• D. 6 and 9 months

Answer: A

Explanation:
Explanation: Measles vaccine should be given immediately after the first birthday between 12 and 15 months. Maternal antibodies to measles are no longer present to block the formation of the Child's own antibodies. Other options has questionable efficacy of the vaccine because maternal antibodies are still present at those times.

NEW QUESTION # 27
For acute otitis media, the treatment is prompt antibiotic therapy. Delayed treatment may result in complications of:

• A. Tonsillitis
• B. Brain damage
• C. Eardrum Problems
• D. Diabetes mellitus

Answer: B

Explanation:
Explanation: One of the complications of recurring acute otitis media is risk for having Meningitis, thereby causing possible brain damage. That is why patient must follow a complete treatment regimen and follow up care.

NEW QUESTION # 28
A 3-month-old infant was brought back to the unit after a surgery for hypertrophic pyloric stenosis. The mother was very good in caring for the client but is reluctant with regard to feeding. Probably the mother is:

• A. not aware that her baby is allowed to resume feedings.
• B. afraid that her baby will vomit again.
• C. in doubt about the safety of the special nipple.
• D. uncertain if her baby can tolerate the thickened formula.

Answer: B

Explanation:
Explanation: Past experiences with projectile vomiting are frightening. It is the responsibility of the nurse to explain that it will not happen again. No special nipple is needed in this situation.

NEW QUESTION # 29
What nursing action should be done in an infant who receives IVF via a scalp vein:

• A. assess the pupils every 1 hour for any untoward reaction.
• B. explain to the parents that they cant hold the client while the IV therapy is ongoing.
• C. assess for signs of infiltration behind the occiput
• D. restrain the extremities when there's no one to see the child.

Answer: D

Explanation:
Explanation: Extremities need to be restrained as infants use them to dislodge the needle. Pupillary reaction and assessing at the occiput do not relate to scalp vein and IV therapy.

NEW QUESTION # 30
A nurse just completed their first-year evaluation and indicates a long-term goal to be a Chief Nursing Officer (CNO). The mentor should recommend the nurse:

• A. Apply for the open charge nurse position
• B. Identify a leader to serve as a role model
• C. Enroll in a nurse manager training course
• D. Email the current CNO to request a meeting

Answer: B

Explanation:
Early in career development,identifying a mentor or role modelprovides foundational support for leadership growth. This allows the nurse to observe effective leadership behaviors, gain guidance, anddevelop long- term goals through structured exposure.
"Mentorship is essential in leadership development. New nurses with administrative goals should be encouraged to identify and learn from respected leaders to develop the skills and behaviors required for advanced roles." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: Leadership Development and Mentorship)

NEW QUESTION # 31
A mother brings her 18-month-old child to the clinic because the child "eats ashes, crayons, and paper." Which of the following information would be most important to obtain first about this toddler?

• A. experiencing a growth spurt
• B. currently cutting large teeth
• C. eating a soft, low-roughage diet
• D. experiencing changes in the home environment

Answer: D

Explanation:
Explanation: It is important to determine if the child is experiencing any change in the home environment that could cause anxiety that is relieved through oral gratification. A craving to eat nonfood substances is known Aspica.

NEW QUESTION # 32
A nurse is caring for a Daniel, a 7 year-old client, who receives chest physiotherapy (CPT). Which of the following action by the nurse would be appropriate?

• A. Teach the child not to cough during the treatment
• B. percuss on to the rib cage area
• C. Schedule the therapy thirty minutes after meals
• D. Place the child in a prone position for the therapy

Answer: B

Explanation:
Explanation: Percussion (clapping) should only be done in the area of the rib cage.

NEW QUESTION # 33
Upon assessing a child, the nurse notes white patches on the child's tongue and determines that it may be an indicative of candidiasis (oral thrush). The nurse understands that the white patches of oral thrush:

• A. sticks on the tongue even when scraped
• B. only appears on the tongue
• C. produces red circle at the center of white lesion
• D. causes tongue to bleed

Answer: A

Explanation:
Explanation: Candidiasis, a fungal infection, adheres firmly to the tongue or mucous membranes of the mouth and throat.

NEW QUESTION # 34
Following a traumatic brain injury, an intubated 2-year-old patient requires an infusion of cisatracurium (Nimbex) to assist with intracranial pressure. On day 3, the ventilator's mean airway pressure begins to alarm frequently and suctioning needs have increased. The patient's vital signs are:
* BP: 99/58
* HR: 148
* RR: 20
* T: 102.2°F (39°C)
* ICP: 19
* CPP: 53
* WBC: 22,000
* Na#: 153 mEq/L
A nurse should anticipate the patient will require:

• A. A head CT
• B. A sputum culture
• C. Albuterol (Proventil) treatment
• D. Mannitol (Osmitrol) 2 g/kg

Answer: B

Explanation:
The elevated WBC count, fever, rising airway pressures, and increased secretions are consistent with a developing ventilator-associated pneumonia (VAP). Asputum cultureis needed to identify the infectious agent and guide antibiotic therapy.
"Signs of VAP include increased airway secretions, elevated temperature, and rising ventilator pressures.
Diagnostic workup includes obtaining sputum culture to guide treatment." (Referenced from CCRN Pediatric - Direct Care: Pulmonary, Ventilator Complications and Infection)

NEW QUESTION # 35
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