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AACN CCRN-Pediatric Exam is a credentialing program designed to evaluate the clinical knowledge and skills of pediatric critical care nurses. CCRN-Pediatric examination focuses on the theoretical and practical understanding of pediatric critical care nursing, assessing the ability of candidates to provide competent and safe care to critically ill infants, children, and adolescents. It is a valuable tool for nurses who wish to improve their career opportunities and advance their skills in critical care specialties.
NEW QUESTION # 90
A 15-year-old patient with a history of anxiety is experiencing palpitations, dizziness, nausea, diaphoresis, and tachypnea. This is most likely:
- A. Supraventricular tachycardia
- B. Due to caffeine consumption
- C. An asthma exacerbation
- D. A panic attack
Answer: D
Explanation:
Panic attacksare common in adolescents and present withsympathetic overdrivesymptoms-palpitations, dyspnea, dizziness, chest discomfort, nausea, and diaphoresis. A history of anxiety strongly supports this diagnosis, especially in the absence of objective cardiac or respiratory findings.
"Panic attacks in adolescents can mimic cardiopulmonary emergencies. The presence of a prior anxiety disorder and resolution of symptoms without intervention support the diagnosis." (Referenced from CCRN Pediatric - Direct Care: Psychosocial, Mental Health Emergencies)
NEW QUESTION # 91
After a cleft lip repair, it is important to preserve the integrity of suture line. What is the best position for an infant who had this type of surgery:
- A. mother's shoulder
- B. on his abdomen
- C. side-lying
- D. on his back
Answer: D
Explanation:
Explanation: This position prevents incisional contact with the mattress. This is also the best position for infants who are not able to turn.
NEW QUESTION # 92
The relationship between the family of a long-term patient and ICU healthcare providers has become strained. A nurse should first:
- A. Discuss the issue with the physician
- B. Rotate assignments among staff members
- C. Suggest the family discuss their concerns with the nurse manager
- D. Arrange a patient care conference with the family
Answer: D
Explanation:
When communication and relationships become strained, themost appropriate first action is to initiate a care conference. This collaborative approach provides a forum for the family and healthcare team to align goals, express concerns, andrebuild trustthrough structured, clear communication.
"Care conferences serve as a critical strategy to address and resolve family-staff conflict, particularly in long- term ICU stays where emotional fatigue and communication breakdowns are common." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: Family-Centered Communication and Collaboration)
NEW QUESTION # 93
A child has a fever, moderate hypertension, petechiae, decreased urinary output, and bloody diarrhea.
A nurse should suspect:
- A. Nephrotic syndrome
- B. Hepatorenal syndrome
- C. Hemolytic uremic syndrome
- D. Acute glomerulonephritis
Answer: C
Explanation:
Hemolytic uremic syndrome (HUS)is commonly preceded by a diarrheal illness, often caused byE. coli O157:H7. Classic triad:microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury
-often with petechiae, hypertension, and decreased urine output.
"HUS presents in children as a post-infectious complication, typically following bloody diarrhea. It manifests with renal failure, anemia, thrombocytopenia, and neurologic or hypertensive symptoms." (Referenced from CCRN Pediatric - Direct Care: Renal Dysfunction and Hematologic Disorders)
NEW QUESTION # 94
An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:
- A. Pericarditis
- B. Kawasaki disease
- C. Rheumatic heart disease
- D. Hypertrophic cardiomyopathy
Answer: B
Explanation:
Kawasaki disease is an acute vasculitis that primarily affects children under 5 and presents with classic signs:
fever, rash, conjunctivitis, strawberry tongue, and extremity changes. It may also causecoronary artery aneurysmsandconduction abnormalities, such as PR prolongation.
"Kawasaki disease presents with mucocutaneous inflammation, and cardiac complications may include myocarditis and conduction delays, such as first-degree AV block." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Inflammatory Heart Disease)
NEW QUESTION # 95
A medical team recommends a tracheostomy for an infant with spinal muscular atrophy. The parent states, "I just want to make sure my child has the best life." The nurse should:
- A. Provide education about the procedure
- B. Obtain a palliative care consult
- C. Notify the medical team
- D. Offer reassurance to the parent
Answer: B
Explanation:
This statement reflectsemotional and existential distressrather than a purely educational need. Apalliative care consultis appropriate to provideholistic support,clarify goals of care, and ensure that the family's values and quality-of-life concerns are addressed within a multidisciplinary approach.
"Palliative care is appropriate when families face complex, life-altering decisions. It supports communication, decision-making, and emotional well-being alongside curative or life-sustaining treatments." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: Palliative Care and Family- Centered Decision-Making)
NEW QUESTION # 96
The primary pulmonary pathophysiological change leading to respiratory distress syndrome (RDS) is:
- A. Thinning of alveolar membrane
- B. Increased surfactant production
- C. Pulmonary vascular hypertension
- D. Increased alveolar-capillary membrane permeability
Answer: D
Explanation:
Neonatal Respiratory Distress Syndrome (RDS) is primarily caused by surfactant deficiency, which results in alveolar collapse and increased permeability of the alveolar-capillary membrane. This leads to pulmonary edema, impaired gas exchange, and hypoxemia.
"The hallmark of RDS is increased permeability of the alveolar-capillary membrane, which allows fluid to leak into alveoli, contributing to atelectasis and reduced oxygenation. Surfactant deficiency is the initiating factor." (Referenced from CCRN Pediatric - Direct Care: Pulmonary, Neonatal RDS Pathophysiology) Increased surfactant production would be protective, not pathological. Pulmonary vascular hypertension can occur secondarily but is not the initiating pathophysiology.
NEW QUESTION # 97
What is the most appropriate toy that a nurse should give to a 12-week-old infant?
- A. Balls made of safe plastic
- B. Metallic mirror
- C. Colorful stuffed toy
- D. Rattle
Answer: B
Explanation:
Explanation: Metallic mirror is the best among the choices because a 3-month-old infant is more interested in self-recognition and playing with the "baby" in the mirror. The infant is old enough for a rattle and still too young for stuffed toys and plastic balls.
NEW QUESTION # 98
What medication instruction would a nurse give to a parent whose child will receive prednisone as a home medication for Asthma:
- A. avoid halting the medication abruptly
- B. it can cause early growth spurt
- C. it protects the child against infection
- D. it causes moon-shaped face
Answer: A
Explanation:
Explanation: During Asthma, it is necessary to wean the child gradually to prevent adrenal insufficiency or adrenal crisis.
NEW QUESTION # 99
Nurse Cathy is assigned for a 2 and half year-old who is being treated with Chelation Therapy, calcium disodium edetate, due to poisoning. Cathy should be alerted for which of the following side effect?
- A. Neurotoxicity
- B. Hepatomegaly
- C. Ototoxicity
- D. Nephrotoxicity
Answer: D
Explanation:
Explanation: Nephrotoxicity is a common side effect of calcium disodium edentate
NEW QUESTION # 100
A 2 year old was brought to the pediatric clinic for a routine check up. When assessing the child's relationship with other children, the nurse would expect to observe.
- A. cooperative play
- B. team play
- C. initiative play
- D. parallel play
Answer: D
Explanation:
Explanation: Parallel play is typical of the toddler age group. They have not yet learned to interact with other toddler in a social situation. Initiative play does not identify any age group; moreover, it is not a recognized term for social play.
NEW QUESTION # 101
Victor, a 4 year old child, is at the clinic for a routine clinic visit. In assessing Victor's growth and development, the nurse is guided by principles of growth and development. Which is not included:
- A. All individual follow standard growth rate
- B. All individuals follow cephalo-caudal and proximo-distal
- C. Rate and pattern of growth can be modified
- D. Different parts of the body grows at different rate
Answer: C
Explanation:
Explanation: Growth and development occurs in cephalo-caudal meaning development occurs through out the body's axis. Ex: the child must be able to lift the head before he is able to lift his chest. Proximo- distal is development that progresses from center of the body to the extremities.
Ex: a child first develops arm movement before fine-finger movement. Different parts of the body grows at different range because some body tissue mature faster than the other such as the neurologic tissues peaks its growth during the first years of life while the genital tissue doesn't till puberty. Also G&D is predictable in the sequence which a child normally precedes such as motor skills and behavior. G&D can never be modified.
NEW QUESTION # 102
A 9-year-old child is attending a new school in Manitoba. Her teachers assess her behavior over 6 months and then reported it to the school nurse. The nurse suspects that the child shows behaviors related to ADHD. This adaptation would include:
- A. increased mental ability
- B. good peer relationship
- C. hatred and hostility
- D. restlessness and impulsivity
Answer: D
Explanation:
Explanation: Maladaptive behavior for at least 6 months duration characterized by inattention, impulsiveness, and over activity are the criteria for attention deficit hyperactivity disorder.
NEW QUESTION # 103
A 6-year-old patient with ARDS has been mechanically ventilated for 10 days. The patient is being assessed for readiness to wean. The patient will open his eyes spontaneously but not to command. The pupils are equal and reactive but the patient is restless, sleeping only for short intervals. A nurse suspects the patient is demonstrating signs of:
- A. Withdrawal
- B. Hypoxic-ischemic injury
- C. Neuroleptic syndrome
- D. Delirium
Answer: D
Explanation:
Pediatric ICU delirium is a common but underdiagnosed condition in critically ill children, especially those on prolonged ventilation. Hallmarks includedisorientation, sleep disturbance, agitation, and altered attention.
"Delirium should be suspected in pediatric ICU patients showing new or worsening behavioral symptoms, altered sleep-wake cycles, and fluctuating mental status. Prolonged sedation and critical illness are risk factors." (Referenced from CCRN Pediatric - Direct Care: Neurologic Dysfunction and ICU Delirium)
NEW QUESTION # 104
The mother of a 16-month-old child who is coughing and having trouble breathing calls the clinic to ask advice because she suspects that her child has croup. Which of the following instructions would be most appropriate?
- A. Give over-the-counter cough syrup every 6 hours
- B. Administer acetaminophen (Tylenol) every 4 hours
- C. Take the child into the bathroom and run the hot water
- D. Get the child to take as much fluid as possible
Answer: C
Explanation:
Explanation: For a child with croup who is coughing and having difficulty breathing, the child should be taken into the shower where hot water is running to make the bathroom steamy. Steam helps to loosen secretion and relieve some of the respiratory distress. Giving acetaminophen is helpful but will not ease difficult breathing. Giving over-the-counter cough syrup is inappropriate because the underlying problem is airway inflammation and subsequent mucus accumulation and bronchoconstriction. Getting the child to take as much fluid as possible is important but it will not be effective in easing difficult breathing.
NEW QUESTION # 105
A 6-month-old patient presents with bronchiolitis and respiratory distress. Upon admission, the patient has mild retractions, scattered crackles, copious secretions, diarrhea with significant diaper dermatitis, and weight/height/head circumference less than the 5th percentile. The patient's vital signs are:
* BP: 80/45
* HR: 150
* RR: 42
* Temp: 98.8°F (37.1°C)
* SpO#: 96% on 4L heated high flow nasal cannula
A nurse should consider that the patient:
- A. Needs an arterial blood gas
- B. Requires a wound care consult
- C. Needs CPAP
- D. Requires a nutrition assessment
Answer: D
Explanation:
This patient demonstratesfailure to thrive(FTT) as evidenced by growth parameters below the 5th percentile and signs of malabsorption (diarrhea, dermatitis). While respiratory issues are present, theGI/nutritional status is a critical concernthat must be addressed for recovery and long-term health.
"Patients with chronic illness, diarrhea, and poor weight gain should receive early and comprehensive nutritional assessments. Malnutrition exacerbates respiratory disease and delays recovery." (Referenced from CCRN Pediatric - Direct Care: Gastrointestinal and Nutritional Considerations)
NEW QUESTION # 106
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 need to call the clinic once my child develops diarrhea"
- C. "I will ensure that my child drinks enough fluid if weather is warm"
- D. "I will check the pulse at the wrist of the arm with fistula everyday"
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 # 107
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