CCRN PEDIATRIC TEST
1. Which of the following is a common side effect of valproic acid?
a. Hirsutism
b. Excitability
c. Hyperglycemia
d. Increased seizure activity: c. Hyperglycemia
2. The nurse is caring for a 1 week old who has experienced a CVA. Which ofthe following
manifestations would the nurse not expect to see in the infant?
a. Hypotonia
b. seizures
c. Resp distress
d. Hemiplegia: d. Hemiplegia Due to developmental immaturity
3. The nurse is caring for a 6yr with seizure disorder. At change of shift, the nurse describes
the child's seizure to the oncoming nurse. Which of thefollowing best describes the clonic
phase?
a. "She was staring straight ahead and seemed to be daydreaming"
b. "She said that she tasted metal"
c. "She was very stiff and rigid"
d. "She experienced rhythmic contractions and relaxation of her arms and legs": d The clonic
phase of a seizure occurs when the muscle groups experiencealternating contractions and
relaxation.
4. A child is admitted to the PICU in status epilepticus. Which of the followingwould the
nurse anticipate administering first?
a. Phenytoin
b. Benzodiazepines
c. Barbiturates
d. Vecuronium: b Benzodiazepines are usually the first line drug for SE as they aretypically
effective for immediate management of seizures.
5. When caring for a toddler with meningitis, the nurse notes that there is resistance when
the child's lower legs are extended. She also cried when her legs are raised to change her
diaper. The nurse documents which of thefollowing?
a. Kernig's
b. Brudinski's
c. Nuchal rigidity
d. Battle's sign: a Kernig's Sign
(Brudinski's - hips and knees flex with neck flexion)
,6. After obtaining an LP on a child, the diagnosis of bacterial meningitis is made. Which of
the following would likely had been seen in the child's CSF?
a. Increased WBC with mostly lymphocytes
b. Decreased protein levels
c. Decreased glucose levels
d. Negative gram stain: c Decreased glucose levels
7. Which of the following statements concerning brain tumors is true?
a. They are the most common malignancy in children
b. 80% of children with a brain tumor will live more than 5 years
c. Non-malignant tissue does not lead to mortality
d. Both malignant and nonmalignant tumors can cause compression or ero- sion of brain
tissue: d. Both malignant and nonmalignant tumors can cause com-pression or erosion of brain
tissue
8. Which of the following manifestations is not typically seen in a child witha brain tumor?
a. Seizures
b. Changes in vision
c. Headache upon waking
d. Extreme nausea followed by vomiting: d. Extreme nausea followed by vomiting
9. Which of the following is a manifestation of Reye syndrome?
a. Decreased LFTs
b. Decreased ammonia
c. Cerebral edema
d. Increased glucose: c. Cerebral edema
Increased LFTs, ammonia, decreased glucose and cerebral edema are commonsigns
10. An adolescent is scheduled for a spinal fusion to correct scoliosis. Thenurse knows that
the child most likely has a curvature of greater than
a. 10 degrees
b. 20 degrees
c. 30 degrees
d. 40 degrees: d 40 degrees
11. A neonate is born with a sac containing spinal cord elements bulging through a defect in
her lower back. Upon exam, the neonate moves upper and lower extremities spontaneously
and withdraws her leg to painful stimuli.Which defect is present?
a. Meningocele
b. Myelomeningocele
c. Anencephaly
,d. spina bifida occulta: a Meningocele
A meningocele does not contain nerve routes - allowing infant spontaneous move-ment and
sensation
12. The nurse is providing education to a family of a newly adopted 4yo with
myelomeningocele. Which of the following is most important to include in theteaching plan?
a. "If she develops a fever, it is important to manage it with Tylenol and notallow it to get too
high"
b. If she complains of tingling in her legs, it is important to get her evaluated"
c. :"If she complains of a headache, she needs to be evaluated in the emergency room"
d. "Although it is difficult, do not be overprotective with her. She should be able to
participate in the same activities as her peer group": c "If she complainsof a headache, she
needs to be evaluated in the emergency room"
Most children have hydrocephalus and a shunt - HA can indicate malfunction.
13. Which of the following is true concerning Duchenne Muscular Dystrophy?
a. Children with MD tend to have over reactive reflexes
b. It is a degenerative disease of the muscle due to inflammation within themyocytes
c. Muscle fiber degeneration occurs from proximal to distal
d. Central nerve abnormalities are usually present within 1-2yrs of diagnosis: cMuscle fiber
degeneration occurs from proximal to distal
Duchenne's MD is an inherited noninflammatory muscle disorder where the de- generation
occurs proximal to distal. The children are hypo-reflexive. No central orperipheral nerve
abnormalities.
14. Which of the following is true concerning GBS?
a. Paralysis occurs due to demyelination
b. Paralysis is usually asymmetrical
c. Paralysis usually begins in the trunk and progresses to the extremities
d. It is not associated with a recent viral infection: a Paralysis occurs due todemyelination
GBS causes ascending symmetrical paralysis due to demyelination.
15. A 6yo with GBS is having slurred speech and is not able to swallow. Whichof the following
is a priority intervention?
a. Ensure that the child is getting adequate IV fluids and do not allow himanything by mouth
as he is at risk for aspiration
b. Prepare to intubate
c. Prepare to admin IVIG
, d. Encourage deep breathing and coughing to clear his airway: b. Prepare tointubate
16. Which of the following is not true of Myasthenia Gravis?
a. If asked to smile the child may snarl instead
b. There is enhanced cholinergic nerve conduction
c. It is an autoimmune disease where antibodies attack acetylcholine receptorsites
d. There is progressively reduced muscle strength that worsens with fatigue: b.There is enhanced
cholinergic nerve conduction
MG is an autoimmune disease of the periphral nervous system where there is im- paired
cholinergic nerve conduction. In this disorder, antibodies attack acetylcholinereceptor sites
causing progressively reduced muscle strength that is worse with fatigue. Instead of smiling
weakened facial muscles often produce a snarl
17. A 16yo who was involved in gang violence has experienced a penetratinginjury to his
back. He is currently awake and alert. The nurse notes that he cannot feel pain to his left side
and is unable to move his right side. This is known as:
a. Anterior cord syndrome
b. Brown-Sequard syndrome
c. Central cord syndrome
d. Neurogenic shock: b. Brown-Sequard syndrome
This is a rare injury that is caused by penetrating trauma to the spine. It causesipsilateral
hemiplegia and contralateral sensation deficits
18. Which of the following is true of GBS?
a. It is more likely to affect the highly myelinated nerves
b. It is more liekly to affect the less myelinated nerves
c. It is more likely to affect the nerves responsible for pain and temp sensation
d. There is no pattern with what type of nerves are specifically affected: a. It ismore likely to
affect the highly myelinated nerves
e.g. (motor nerve fibers)
19. Which of the following is true concerning the autonomic nervous system?
a. The sympathetic ns(SNS) consciously regulates both smooth and cardiacmuscles
b. The vagal response is an example of SNS activation
c. Since the parasympathetic and sympathetic branches of the autonomic nseach control
different organs, the body is maintained in balance
d. Increased peristalsis occurs when the parasympathetic ns is activated: d.Increased
peristalsis occurs when the parasympathetic ns is activated
1. Which of the following is a common side effect of valproic acid?
a. Hirsutism
b. Excitability
c. Hyperglycemia
d. Increased seizure activity: c. Hyperglycemia
2. The nurse is caring for a 1 week old who has experienced a CVA. Which ofthe following
manifestations would the nurse not expect to see in the infant?
a. Hypotonia
b. seizures
c. Resp distress
d. Hemiplegia: d. Hemiplegia Due to developmental immaturity
3. The nurse is caring for a 6yr with seizure disorder. At change of shift, the nurse describes
the child's seizure to the oncoming nurse. Which of thefollowing best describes the clonic
phase?
a. "She was staring straight ahead and seemed to be daydreaming"
b. "She said that she tasted metal"
c. "She was very stiff and rigid"
d. "She experienced rhythmic contractions and relaxation of her arms and legs": d The clonic
phase of a seizure occurs when the muscle groups experiencealternating contractions and
relaxation.
4. A child is admitted to the PICU in status epilepticus. Which of the followingwould the
nurse anticipate administering first?
a. Phenytoin
b. Benzodiazepines
c. Barbiturates
d. Vecuronium: b Benzodiazepines are usually the first line drug for SE as they aretypically
effective for immediate management of seizures.
5. When caring for a toddler with meningitis, the nurse notes that there is resistance when
the child's lower legs are extended. She also cried when her legs are raised to change her
diaper. The nurse documents which of thefollowing?
a. Kernig's
b. Brudinski's
c. Nuchal rigidity
d. Battle's sign: a Kernig's Sign
(Brudinski's - hips and knees flex with neck flexion)
,6. After obtaining an LP on a child, the diagnosis of bacterial meningitis is made. Which of
the following would likely had been seen in the child's CSF?
a. Increased WBC with mostly lymphocytes
b. Decreased protein levels
c. Decreased glucose levels
d. Negative gram stain: c Decreased glucose levels
7. Which of the following statements concerning brain tumors is true?
a. They are the most common malignancy in children
b. 80% of children with a brain tumor will live more than 5 years
c. Non-malignant tissue does not lead to mortality
d. Both malignant and nonmalignant tumors can cause compression or ero- sion of brain
tissue: d. Both malignant and nonmalignant tumors can cause com-pression or erosion of brain
tissue
8. Which of the following manifestations is not typically seen in a child witha brain tumor?
a. Seizures
b. Changes in vision
c. Headache upon waking
d. Extreme nausea followed by vomiting: d. Extreme nausea followed by vomiting
9. Which of the following is a manifestation of Reye syndrome?
a. Decreased LFTs
b. Decreased ammonia
c. Cerebral edema
d. Increased glucose: c. Cerebral edema
Increased LFTs, ammonia, decreased glucose and cerebral edema are commonsigns
10. An adolescent is scheduled for a spinal fusion to correct scoliosis. Thenurse knows that
the child most likely has a curvature of greater than
a. 10 degrees
b. 20 degrees
c. 30 degrees
d. 40 degrees: d 40 degrees
11. A neonate is born with a sac containing spinal cord elements bulging through a defect in
her lower back. Upon exam, the neonate moves upper and lower extremities spontaneously
and withdraws her leg to painful stimuli.Which defect is present?
a. Meningocele
b. Myelomeningocele
c. Anencephaly
,d. spina bifida occulta: a Meningocele
A meningocele does not contain nerve routes - allowing infant spontaneous move-ment and
sensation
12. The nurse is providing education to a family of a newly adopted 4yo with
myelomeningocele. Which of the following is most important to include in theteaching plan?
a. "If she develops a fever, it is important to manage it with Tylenol and notallow it to get too
high"
b. If she complains of tingling in her legs, it is important to get her evaluated"
c. :"If she complains of a headache, she needs to be evaluated in the emergency room"
d. "Although it is difficult, do not be overprotective with her. She should be able to
participate in the same activities as her peer group": c "If she complainsof a headache, she
needs to be evaluated in the emergency room"
Most children have hydrocephalus and a shunt - HA can indicate malfunction.
13. Which of the following is true concerning Duchenne Muscular Dystrophy?
a. Children with MD tend to have over reactive reflexes
b. It is a degenerative disease of the muscle due to inflammation within themyocytes
c. Muscle fiber degeneration occurs from proximal to distal
d. Central nerve abnormalities are usually present within 1-2yrs of diagnosis: cMuscle fiber
degeneration occurs from proximal to distal
Duchenne's MD is an inherited noninflammatory muscle disorder where the de- generation
occurs proximal to distal. The children are hypo-reflexive. No central orperipheral nerve
abnormalities.
14. Which of the following is true concerning GBS?
a. Paralysis occurs due to demyelination
b. Paralysis is usually asymmetrical
c. Paralysis usually begins in the trunk and progresses to the extremities
d. It is not associated with a recent viral infection: a Paralysis occurs due todemyelination
GBS causes ascending symmetrical paralysis due to demyelination.
15. A 6yo with GBS is having slurred speech and is not able to swallow. Whichof the following
is a priority intervention?
a. Ensure that the child is getting adequate IV fluids and do not allow himanything by mouth
as he is at risk for aspiration
b. Prepare to intubate
c. Prepare to admin IVIG
, d. Encourage deep breathing and coughing to clear his airway: b. Prepare tointubate
16. Which of the following is not true of Myasthenia Gravis?
a. If asked to smile the child may snarl instead
b. There is enhanced cholinergic nerve conduction
c. It is an autoimmune disease where antibodies attack acetylcholine receptorsites
d. There is progressively reduced muscle strength that worsens with fatigue: b.There is enhanced
cholinergic nerve conduction
MG is an autoimmune disease of the periphral nervous system where there is im- paired
cholinergic nerve conduction. In this disorder, antibodies attack acetylcholinereceptor sites
causing progressively reduced muscle strength that is worse with fatigue. Instead of smiling
weakened facial muscles often produce a snarl
17. A 16yo who was involved in gang violence has experienced a penetratinginjury to his
back. He is currently awake and alert. The nurse notes that he cannot feel pain to his left side
and is unable to move his right side. This is known as:
a. Anterior cord syndrome
b. Brown-Sequard syndrome
c. Central cord syndrome
d. Neurogenic shock: b. Brown-Sequard syndrome
This is a rare injury that is caused by penetrating trauma to the spine. It causesipsilateral
hemiplegia and contralateral sensation deficits
18. Which of the following is true of GBS?
a. It is more likely to affect the highly myelinated nerves
b. It is more liekly to affect the less myelinated nerves
c. It is more likely to affect the nerves responsible for pain and temp sensation
d. There is no pattern with what type of nerves are specifically affected: a. It ismore likely to
affect the highly myelinated nerves
e.g. (motor nerve fibers)
19. Which of the following is true concerning the autonomic nervous system?
a. The sympathetic ns(SNS) consciously regulates both smooth and cardiacmuscles
b. The vagal response is an example of SNS activation
c. Since the parasympathetic and sympathetic branches of the autonomic nseach control
different organs, the body is maintained in balance
d. Increased peristalsis occurs when the parasympathetic ns is activated: d.Increased
peristalsis occurs when the parasympathetic ns is activated
