Pediatric CCRN AACN Question
1. An acutely ill infant is born to a Vietnamese family. The father asks a few questions about the infant's condition, and the mother asks none.
Both parents appear to be proficient in English. Which is the MOST USEFUL resource for a nurse caring for this infant?
A. ongoing classes addressing the cultural needs of the community
B. classes conducted but the primary nurse as the need arises
C. information about the cultural backgrounds represented in the community
D. an interpreter who is proficient in the parents' language: D
2. A neonate is admitted with gastroschisis. The mother did not receive prenatal care and admits to recreational drug use. During the first unit
visit, the mother expresses concern that she is at fault for her infant's birth defect. The nurse should:
A. offer a counseling session with the social worker
B. refer the mother to the pediatric surgeon for further information
C. offer information regarding drug treatment programs
D. explain the anatomical basis for gastroschisis development: D
3. When caring for a 4 year old child with an acute case of idopathic thrombocytopenic purpura (ITP) who presented with a low PLT count
(20,000/mm3), the nurse should expect initial orders to include:
A. child life specialist consult and physical therapy to support increased mobility and activity
B. placement of an IV for administration of anti-D antibody therapy after premedication with acetaminophen (Tylenol)
C. alternation acetaminophen (Tylenol) with ibuprofen (Advil) every 4 hours for pain.
D. placement of an IV for administration of one unit cross match leuko-reduced platelets: B
4. A patient is admitted to the unit after a witnessed episode of seizure and vomiting. Initial assessment reveals increased work of breathing,
tachypnea, diminished breath sounds, and increased O2 requirement. CXR report has evidence of bilateral pulmonary edema. What should the
nurse expect? A. congestive heart failure
B. sepsis C. ARDS
D. foreign body aspiration: C
,5. A 2 month old born with spina bifida is admitted with dehydration and sepsis. Before the patient was discharged from the hospital a month
ago, the parents were instructed on the proper technique and important of performing cateterization every 6 hours. While interviewing the
parents, the nurse learns this was not done consistently for the past 2 weeks. Interventions at this point should include:
A. eliminating parental visitation
B. involving social services
C. notifying law enforcement
D. demonstrating the catherization technique: B
6. According to recommendations based on research findings, pain assessment should occur:
A. only when the presence of pain can be vaildated
B. only when the patient's movements indicate the patient is seeking attention
C. based on changes in vital signs
D. routinely, regardless of physical findings: D
7. Which of the following should be the INITIAL intervention when a toxicologic emergency is suspected?
A. obtain a list of drugs and chemicals in the environment
B. conduct lab studies and diagnostic imaging
C. reverse the effects of the toxin (if possible)
D. detect life-threatening manifestations of the poisoning: D
8. Junctional rhythms are caused by a dysfunction of the sinoatrial (SA) node and typically cause: A. shortened PR interval
B. irregular ventricular rhythm
C. widened QRS complex
D. prolonged QT interval: A
9. A child is admitted for colitis. 8 hours after admission the patient develops respiratory distress, abdominal distention and capillary refill time
greater than 4 seconds. The nurse should suspect:
A. splenic rupture
B. intussusception
,C. malrotation with volvulus
D. bowel perforation: D
10. Which action is BEST to help reduce the anxiety of a patient who has been hospitalized for suspected peptic ulcer disease?
A. assign the patient to a room with a talkative, optimistic roommate
B. explain to the patient what to expect during hospitalization
C. ask all members of the team to reassure the patient about the quality of care provided by the staff
D. visit the patient frequently and encourage discussion about pleasant future plans: B
11. A patient on mechanical ventilation remains hypoxic despite increased oxygen delivery. The nurse has assessed endotracheal tube
placement and the equipment. The nurse anticipates the following ventilator changes:
A. increasing the PEEP
B. switching to volume control ventilation
C. increasing the tidal volume
D. using continuous posituive airway pressure: A
12. A patient being treated for DKA is severely hyperglycemic. The serum glucose level decrease within the last hour by 150 mg/dL. The
patient is receiving an infusion of insulin at 0.05 units/kg/hr, along with an infusion of normal saline solution. Which of the following changes
to the patient's management should the nurse anticipate?
A. reduction in the insulin infusion rate
B. addition of 5% dextrose infusion
C. infusion of sodium bicarbonate
D. increase in the insulin infusion rate: B
13. A patient is admitted to the unit with nausea, vomiting and diarrhea. The nurse should call the provider immediately with which of the
following venous lab results?
A. 132 Na+, 5.4 K+, 100 Cl-
B. 125 Na+, 6.5 K+, 95 Cl-
C. 145 Na+, 3.5 K+, 92 Cl- D. 160 Na+, 3.0 K+, 90 Cl-: B
, 14. An infant is admitted two days ago after being in a MVC with a L femur fracture. Initial assessment reveals a unilateral hip spica cast. The
nurse notes the following on the infant's LLE: 3+ pitting edema, pallor, pulselessness, paresthesia, and some paralysis. Data are:
BP 104/65
HR 190
RR 58
T 37.2C
SpO2 90%
The BEST action for the nurse would be to:
A. call the provider immediately for a new pain medication order
B. ice and elevate the extremity
C. conduct a bedside Doppler ultrasound exam
D. call the provider immediately with the findings: D
15. A newborn with hypothermia and hypoglycemia has an absolute neutrophil count and an immature/total neutrophil count ration of 0.30.
Based on the findings the nurse prepares to:
A. administer IV fluids
B. obtain a blood culture
C. administer antibiotics
D. repeat a CBC in 4 hours: C
16. A nurse notices that there seems to be an increase in medication errors when medication infusions are started. The nurse's BEST course of
action would be to:
A. keep a list of all nurses who have made errors, and give to the nurse manager
B. be more careful when hanging and checking medication infusions
C. ask the nurse manager to remind all staff to be careful when hanging and checking medication infusions
D. review the medication error rate, then offer to help revise the unit policy for checking medication drips: D
17. A 9 month old born at 26 weeks has grunting, tachypnea and cool extremities. The following ABG findings are obtained on room air: pH
7.07, pCO2 80, pO2 50, HCO3 7.
These ABG results indicate:
1. An acutely ill infant is born to a Vietnamese family. The father asks a few questions about the infant's condition, and the mother asks none.
Both parents appear to be proficient in English. Which is the MOST USEFUL resource for a nurse caring for this infant?
A. ongoing classes addressing the cultural needs of the community
B. classes conducted but the primary nurse as the need arises
C. information about the cultural backgrounds represented in the community
D. an interpreter who is proficient in the parents' language: D
2. A neonate is admitted with gastroschisis. The mother did not receive prenatal care and admits to recreational drug use. During the first unit
visit, the mother expresses concern that she is at fault for her infant's birth defect. The nurse should:
A. offer a counseling session with the social worker
B. refer the mother to the pediatric surgeon for further information
C. offer information regarding drug treatment programs
D. explain the anatomical basis for gastroschisis development: D
3. When caring for a 4 year old child with an acute case of idopathic thrombocytopenic purpura (ITP) who presented with a low PLT count
(20,000/mm3), the nurse should expect initial orders to include:
A. child life specialist consult and physical therapy to support increased mobility and activity
B. placement of an IV for administration of anti-D antibody therapy after premedication with acetaminophen (Tylenol)
C. alternation acetaminophen (Tylenol) with ibuprofen (Advil) every 4 hours for pain.
D. placement of an IV for administration of one unit cross match leuko-reduced platelets: B
4. A patient is admitted to the unit after a witnessed episode of seizure and vomiting. Initial assessment reveals increased work of breathing,
tachypnea, diminished breath sounds, and increased O2 requirement. CXR report has evidence of bilateral pulmonary edema. What should the
nurse expect? A. congestive heart failure
B. sepsis C. ARDS
D. foreign body aspiration: C
,5. A 2 month old born with spina bifida is admitted with dehydration and sepsis. Before the patient was discharged from the hospital a month
ago, the parents were instructed on the proper technique and important of performing cateterization every 6 hours. While interviewing the
parents, the nurse learns this was not done consistently for the past 2 weeks. Interventions at this point should include:
A. eliminating parental visitation
B. involving social services
C. notifying law enforcement
D. demonstrating the catherization technique: B
6. According to recommendations based on research findings, pain assessment should occur:
A. only when the presence of pain can be vaildated
B. only when the patient's movements indicate the patient is seeking attention
C. based on changes in vital signs
D. routinely, regardless of physical findings: D
7. Which of the following should be the INITIAL intervention when a toxicologic emergency is suspected?
A. obtain a list of drugs and chemicals in the environment
B. conduct lab studies and diagnostic imaging
C. reverse the effects of the toxin (if possible)
D. detect life-threatening manifestations of the poisoning: D
8. Junctional rhythms are caused by a dysfunction of the sinoatrial (SA) node and typically cause: A. shortened PR interval
B. irregular ventricular rhythm
C. widened QRS complex
D. prolonged QT interval: A
9. A child is admitted for colitis. 8 hours after admission the patient develops respiratory distress, abdominal distention and capillary refill time
greater than 4 seconds. The nurse should suspect:
A. splenic rupture
B. intussusception
,C. malrotation with volvulus
D. bowel perforation: D
10. Which action is BEST to help reduce the anxiety of a patient who has been hospitalized for suspected peptic ulcer disease?
A. assign the patient to a room with a talkative, optimistic roommate
B. explain to the patient what to expect during hospitalization
C. ask all members of the team to reassure the patient about the quality of care provided by the staff
D. visit the patient frequently and encourage discussion about pleasant future plans: B
11. A patient on mechanical ventilation remains hypoxic despite increased oxygen delivery. The nurse has assessed endotracheal tube
placement and the equipment. The nurse anticipates the following ventilator changes:
A. increasing the PEEP
B. switching to volume control ventilation
C. increasing the tidal volume
D. using continuous posituive airway pressure: A
12. A patient being treated for DKA is severely hyperglycemic. The serum glucose level decrease within the last hour by 150 mg/dL. The
patient is receiving an infusion of insulin at 0.05 units/kg/hr, along with an infusion of normal saline solution. Which of the following changes
to the patient's management should the nurse anticipate?
A. reduction in the insulin infusion rate
B. addition of 5% dextrose infusion
C. infusion of sodium bicarbonate
D. increase in the insulin infusion rate: B
13. A patient is admitted to the unit with nausea, vomiting and diarrhea. The nurse should call the provider immediately with which of the
following venous lab results?
A. 132 Na+, 5.4 K+, 100 Cl-
B. 125 Na+, 6.5 K+, 95 Cl-
C. 145 Na+, 3.5 K+, 92 Cl- D. 160 Na+, 3.0 K+, 90 Cl-: B
, 14. An infant is admitted two days ago after being in a MVC with a L femur fracture. Initial assessment reveals a unilateral hip spica cast. The
nurse notes the following on the infant's LLE: 3+ pitting edema, pallor, pulselessness, paresthesia, and some paralysis. Data are:
BP 104/65
HR 190
RR 58
T 37.2C
SpO2 90%
The BEST action for the nurse would be to:
A. call the provider immediately for a new pain medication order
B. ice and elevate the extremity
C. conduct a bedside Doppler ultrasound exam
D. call the provider immediately with the findings: D
15. A newborn with hypothermia and hypoglycemia has an absolute neutrophil count and an immature/total neutrophil count ration of 0.30.
Based on the findings the nurse prepares to:
A. administer IV fluids
B. obtain a blood culture
C. administer antibiotics
D. repeat a CBC in 4 hours: C
16. A nurse notices that there seems to be an increase in medication errors when medication infusions are started. The nurse's BEST course of
action would be to:
A. keep a list of all nurses who have made errors, and give to the nurse manager
B. be more careful when hanging and checking medication infusions
C. ask the nurse manager to remind all staff to be careful when hanging and checking medication infusions
D. review the medication error rate, then offer to help revise the unit policy for checking medication drips: D
17. A 9 month old born at 26 weeks has grunting, tachypnea and cool extremities. The following ABG findings are obtained on room air: pH
7.07, pCO2 80, pO2 50, HCO3 7.
These ABG results indicate:
