CCRN Pediatric Prac ce Exam Ques ons from AACN
With complete solu on Updated new!!
To promote effec ve grieving in a 6-year-old sibling following the death of an infant, the nurse
should:
A) Recommend that the sibling not a!end the infant's memorial service
B) Encourage the parents to minimize their expression of grief with the sibling
C) Explain to the sibling that the infant went to heaven
D) Explain to the sibling that thoughts and wishes did not cause the infant's death - Ans Answer:
D) Explain to the sibling that thoughts and wishes did not cause the infant's death: At age 6,
children may take words literally and because of their egocentrism, they believe that thoughts
are all-powerful. They may truly believe they caused the death of their sibling. A simple, honest
explana on of why the sibling died is indicated. This interven on is consistent with Caring
Processes.
A) Recommend that the sibling not a!end the infant's memorial service: This interven on is not
a solu on to the problem and will not promote effec ve grieving for the sibling. It is not
consistent with Caring Processes.
B) Encourage the parents to minimize their expression of grief with the sibling: This interven on
will lead to ineffec ve grieving for the sibling and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This interven on will not address the
sibling's problem
A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at four weeks
of age is admi!ed with increased somnolence, decreased appe te, and increased complaints of
headache. This morning the child vomited twice. The nurse should an cipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) the pa ent having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilan n) or fosphenytoin (Cerebyx) - Ans Answer: B) The pa ent
having a CT scan followed by possible shunt revision: This pa ent is demonstra ng signs of
increased intracranial pressure. The most likely e ology is malfunc on of the VP shunt as a
,result of blockage or disconnec on, which is par cularly likely over me as the child grows. The
defini ve diagnosis is made by a CT scan and a shunt series. Surgical interven on for a shunt
revision would be indicated.
A) The physician ordering lumbar puncture and blood and urine cultures: These interven ons
will not address the most likely primary problem, which is suspected VP shunt malfunc on.
Addi onally, lumbar puncture is contraindicated in the presence of increased intracranial
pressure, because downward hernia on of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medica on are indicated for the medical
management of increased intracranial pressure, of which this pa ent has symptoms. However,
they will not address the most likely primary problem, which is suspected VP shunt malfunc on.
D) Administering phenytoin (Dilan n) or fosphenytoin (Cerebyx): These medica ons are
indicated for seizure management and would not address the pa ent's most likely primary
problem, which is suspected increased intracranial pressure as a result of VP shunt malfunc on
An adolescent trauma pa ent is complaining of le3 upper quadrant abdominal pain radia ng to
the le3 shoulder. Blood pressure has dropped to 80/50. Which condi on is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Lacera on
D) Pulmonary Embolism - Ans Answer: C) Splenic lacera on: Kehr's sign, which is referred pain
to the le3 shoulder during compression of the le3 upper abdominal quadrant, is an indica on of
splenic injury. Addi onal symptoms include tachycardia, hypotension, and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include progressive abdominal distension,
not referred le3 shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain, arrhythmias, and other
indicators of myocardial dysfunc on, such as elevated cardiac isoenzymes. Upper quadrant
abdominal pain with radia on to the le3 shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include chest pain and dyspnea on
exer on, not le3 shoulder pain
An infant has been admi!ed with encephali s. The nurse should first assess the pa ent's:
,A) Pupillary response
B) Blood glucose level
C) Level of consciousness
D) Airway Patency - Ans Answer: D) Airway Patency: The first priority a3er admi>ng an infant
with encephali s is to assess the pa ent's ability to maintain airway patency. Such pa ents can
develop rapid neurologic deteriora on, and the nurse must be prepared to support the airway,
oxygena on, and ven la on as needed.
A) Pupillary Response: The infant with encephali s should be monitored for changes in
neurologic status, including pupillary response. However, assessing the pa ent;s ability to
maintain airway patency is the first priority.
B) Blood Glucose Level: The infant with encephali s will need blood glucose levels monitored,
especially if unable to maintain adequate oral intake. However, assessing the pa ent's ability to
maintain airway patency is the first priority.
C) Level of consciousness: The infant with encephali s should be monitored for changes in
neurologic status, including assessment of the level of consciousness. However, assessing the
pa ent's ability to maintain airway patency is the first priority.
The pediatric pa ent with suspected asphyxia from smoke inhala on will typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - Ans Answer: C) Confusion: The pa ent with asphyxia from smoke inhala on
will experience cerebral hypoxemia and demonstrate symptoms of neurologic dysfunc on,
including confusion
A) Tachypnea: While the pa ent with smoke inhala on may experience tachypnea as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the pa ent with smoke inhala on may experience cyanosis as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the pa ent with smoke inhala on and a burn injury may demonstrate
hypotension from fluid shi3s, this symptoms is not specific to asphyxia
, An acutely ill infant is born to a Vietnamese family. The father asks few ques ons about the
infant's condi on, and the mother asks none. Both parents appear to be proficient in English.
Which of the following is the most useful resource for a nurse caring for this infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
C) Informa on about the cultural backgrounds represented in the community
D) Ongoing classes addressing the cultural needs of the community - Ans Answer: B) An
interpreter who is proficient in the parents' language: This interven on is consistent with
Response to Diversity. Providing an interpreter may facilitate communica on by the parents.
Trained interpreters can improve outcomes by helping to ensure effec ve communica on
between the healthcare team and the pa ent/family
A) Classes conducted by the primary nurse as the need arises: This interven on is not consistent
with Response to Diversity. It will not help in this situa on. While addressing needs as they arise
is important, the parents are not communica ng these needs at present.
C) Informa on about the cultural backgrounds represented in the community: This interven on
will not help in this situa on. Cultural backgrounds in the community will not address the
parents' needs during this stressful me.
D) Ongoing classes addressing the cultural needs of the community: This interven on will not
help in this situa on. Cultural backgrounds in the community will not address the parents;
needs during this stressful me.
A toddler with a history of unrepaired tetralogy of Fallot begins to cry while intravenous access
is a!empted. Cyanosis, diaphoresis and tachypnea are noted. The most appropriate nursing
interven on would be to:
A) Administer A pre-medica on before a!emp ng the IV
B) Apply a face mask with oxygen
C) Transfuse red blood cells
D) Place the child in knee-chest posi on - Ans Answer: D) Place the child in knee-chest posi on:
This maneuver aids blood return to the heart, thus allevia ng cyano c spells
With complete solu on Updated new!!
To promote effec ve grieving in a 6-year-old sibling following the death of an infant, the nurse
should:
A) Recommend that the sibling not a!end the infant's memorial service
B) Encourage the parents to minimize their expression of grief with the sibling
C) Explain to the sibling that the infant went to heaven
D) Explain to the sibling that thoughts and wishes did not cause the infant's death - Ans Answer:
D) Explain to the sibling that thoughts and wishes did not cause the infant's death: At age 6,
children may take words literally and because of their egocentrism, they believe that thoughts
are all-powerful. They may truly believe they caused the death of their sibling. A simple, honest
explana on of why the sibling died is indicated. This interven on is consistent with Caring
Processes.
A) Recommend that the sibling not a!end the infant's memorial service: This interven on is not
a solu on to the problem and will not promote effec ve grieving for the sibling. It is not
consistent with Caring Processes.
B) Encourage the parents to minimize their expression of grief with the sibling: This interven on
will lead to ineffec ve grieving for the sibling and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This interven on will not address the
sibling's problem
A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at four weeks
of age is admi!ed with increased somnolence, decreased appe te, and increased complaints of
headache. This morning the child vomited twice. The nurse should an cipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) the pa ent having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilan n) or fosphenytoin (Cerebyx) - Ans Answer: B) The pa ent
having a CT scan followed by possible shunt revision: This pa ent is demonstra ng signs of
increased intracranial pressure. The most likely e ology is malfunc on of the VP shunt as a
,result of blockage or disconnec on, which is par cularly likely over me as the child grows. The
defini ve diagnosis is made by a CT scan and a shunt series. Surgical interven on for a shunt
revision would be indicated.
A) The physician ordering lumbar puncture and blood and urine cultures: These interven ons
will not address the most likely primary problem, which is suspected VP shunt malfunc on.
Addi onally, lumbar puncture is contraindicated in the presence of increased intracranial
pressure, because downward hernia on of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medica on are indicated for the medical
management of increased intracranial pressure, of which this pa ent has symptoms. However,
they will not address the most likely primary problem, which is suspected VP shunt malfunc on.
D) Administering phenytoin (Dilan n) or fosphenytoin (Cerebyx): These medica ons are
indicated for seizure management and would not address the pa ent's most likely primary
problem, which is suspected increased intracranial pressure as a result of VP shunt malfunc on
An adolescent trauma pa ent is complaining of le3 upper quadrant abdominal pain radia ng to
the le3 shoulder. Blood pressure has dropped to 80/50. Which condi on is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Lacera on
D) Pulmonary Embolism - Ans Answer: C) Splenic lacera on: Kehr's sign, which is referred pain
to the le3 shoulder during compression of the le3 upper abdominal quadrant, is an indica on of
splenic injury. Addi onal symptoms include tachycardia, hypotension, and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include progressive abdominal distension,
not referred le3 shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain, arrhythmias, and other
indicators of myocardial dysfunc on, such as elevated cardiac isoenzymes. Upper quadrant
abdominal pain with radia on to the le3 shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include chest pain and dyspnea on
exer on, not le3 shoulder pain
An infant has been admi!ed with encephali s. The nurse should first assess the pa ent's:
,A) Pupillary response
B) Blood glucose level
C) Level of consciousness
D) Airway Patency - Ans Answer: D) Airway Patency: The first priority a3er admi>ng an infant
with encephali s is to assess the pa ent's ability to maintain airway patency. Such pa ents can
develop rapid neurologic deteriora on, and the nurse must be prepared to support the airway,
oxygena on, and ven la on as needed.
A) Pupillary Response: The infant with encephali s should be monitored for changes in
neurologic status, including pupillary response. However, assessing the pa ent;s ability to
maintain airway patency is the first priority.
B) Blood Glucose Level: The infant with encephali s will need blood glucose levels monitored,
especially if unable to maintain adequate oral intake. However, assessing the pa ent's ability to
maintain airway patency is the first priority.
C) Level of consciousness: The infant with encephali s should be monitored for changes in
neurologic status, including assessment of the level of consciousness. However, assessing the
pa ent's ability to maintain airway patency is the first priority.
The pediatric pa ent with suspected asphyxia from smoke inhala on will typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - Ans Answer: C) Confusion: The pa ent with asphyxia from smoke inhala on
will experience cerebral hypoxemia and demonstrate symptoms of neurologic dysfunc on,
including confusion
A) Tachypnea: While the pa ent with smoke inhala on may experience tachypnea as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the pa ent with smoke inhala on may experience cyanosis as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the pa ent with smoke inhala on and a burn injury may demonstrate
hypotension from fluid shi3s, this symptoms is not specific to asphyxia
, An acutely ill infant is born to a Vietnamese family. The father asks few ques ons about the
infant's condi on, and the mother asks none. Both parents appear to be proficient in English.
Which of the following is the most useful resource for a nurse caring for this infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
C) Informa on about the cultural backgrounds represented in the community
D) Ongoing classes addressing the cultural needs of the community - Ans Answer: B) An
interpreter who is proficient in the parents' language: This interven on is consistent with
Response to Diversity. Providing an interpreter may facilitate communica on by the parents.
Trained interpreters can improve outcomes by helping to ensure effec ve communica on
between the healthcare team and the pa ent/family
A) Classes conducted by the primary nurse as the need arises: This interven on is not consistent
with Response to Diversity. It will not help in this situa on. While addressing needs as they arise
is important, the parents are not communica ng these needs at present.
C) Informa on about the cultural backgrounds represented in the community: This interven on
will not help in this situa on. Cultural backgrounds in the community will not address the
parents' needs during this stressful me.
D) Ongoing classes addressing the cultural needs of the community: This interven on will not
help in this situa on. Cultural backgrounds in the community will not address the parents;
needs during this stressful me.
A toddler with a history of unrepaired tetralogy of Fallot begins to cry while intravenous access
is a!empted. Cyanosis, diaphoresis and tachypnea are noted. The most appropriate nursing
interven on would be to:
A) Administer A pre-medica on before a!emp ng the IV
B) Apply a face mask with oxygen
C) Transfuse red blood cells
D) Place the child in knee-chest posi on - Ans Answer: D) Place the child in knee-chest posi on:
This maneuver aids blood return to the heart, thus allevia ng cyano c spells
