1
PEDIATRIC CRITICAL CARE NURSING EXAM –
RESPIRATORY & CARDIAC EMERGENCIES
2026-27 LATEST VERSION
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (Single Best Answer)
• Level: University / RN–BSN / Pediatric Critical Care specialization
• Time: 120–150 minutes
Introduction
This exam evaluates nursing knowledge and decision-making in critically ill pediatric patients with respiratory and
cardiac emergencies. It focuses on:
• Assessment of critically ill children – airway, breathing, circulation, vital signs
• Respiratory emergencies – asthma exacerbation, bronchiolitis, respiratory failure, intubation, ventilator
management
• Cardiac emergencies – congenital heart disease, arrhythmias, shock, cardiac arrest
• Hemodynamic support – IV fluids, vasoactive medications, monitoring perfusion
• Emergency interventions – rapid response, pediatric resuscitation (PALS), stabilization protocols
• Family-centered care – communication, education, psychosocial support
The exam uses scenario-based questions to evaluate critical thinking, prioritization, and adherence to evidence-
based pediatric critical care protocols.
Question & Answer Format
• Four options (A–D)
• One correct answer per question
• Each question includes a rationale referencing PALS guidelines, pediatric respiratory and cardiac care
standards .
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SECTION I: ASSESSMENT & RESPIRATORY EMERGENCIES (Q1–
30)
Q1.
A 5-year-old child presents with sudden onset wheezing,
dyspnea, and accessory muscle use. What is the priority
nursing assessment?
A. Airway patency, oxygen saturation, and respiratory rate
B. Height and weight
C. Oral intake
D. Skin turgor
Correct Answer: A
Rationale: In pediatric respiratory distress, airway and
oxygenation are always the first priority.
Q2.
A child with asthma exacerbation has a PEF <50% of predicted.
Appropriate nursing action:
A. Administer rescue bronchodilator and oxygen
B. Observe only
C. Provide IV fluids only
D. Feed orally
,3
Correct Answer: A
Rationale: Severe asthma exacerbation requires prompt
bronchodilator therapy and oxygen to prevent hypoxemia.
Q3.
A pediatric patient shows grunting, nasal flaring, and
retractions. Most likely diagnosis:
A. Respiratory distress syndrome or acute respiratory failure
B. Dehydration
C. Hyperbilirubinemia
D. Seizure
Correct Answer: A
Rationale: Classic signs of increased work of breathing in
pediatric respiratory distress.
Q4.
A child with bronchiolitis requires oxygen. Nursing goal:
A. Maintain oxygen saturation >92% while monitoring
respiratory effort
B. Feed immediately
C. Swaddle only
D. Observe
, 4
Correct Answer: A
Rationale: Hypoxemia is common in bronchiolitis; careful
oxygen titration prevents complications.
Q5.
A 2-year-old with foreign body aspiration develops sudden
coughing and cyanosis. Priority intervention:
A. Perform Heimlich maneuver or appropriate airway
clearance
B. Observe only
C. Feed immediately
D. Administer bronchodilator
Correct Answer: A
Rationale: Airway obstruction is life-threatening; immediate
intervention is critical.
Q6.
A pediatric patient with respiratory failure is intubated. Nursing
responsibility includes:
A. Monitor ventilator settings, oxygenation, and end-tidal CO₂
B. Feed only
C. Swaddle
D. Observe
PEDIATRIC CRITICAL CARE NURSING EXAM –
RESPIRATORY & CARDIAC EMERGENCIES
2026-27 LATEST VERSION
Exam Structure
• Total Questions: 100
• Format: Multiple Choice (Single Best Answer)
• Level: University / RN–BSN / Pediatric Critical Care specialization
• Time: 120–150 minutes
Introduction
This exam evaluates nursing knowledge and decision-making in critically ill pediatric patients with respiratory and
cardiac emergencies. It focuses on:
• Assessment of critically ill children – airway, breathing, circulation, vital signs
• Respiratory emergencies – asthma exacerbation, bronchiolitis, respiratory failure, intubation, ventilator
management
• Cardiac emergencies – congenital heart disease, arrhythmias, shock, cardiac arrest
• Hemodynamic support – IV fluids, vasoactive medications, monitoring perfusion
• Emergency interventions – rapid response, pediatric resuscitation (PALS), stabilization protocols
• Family-centered care – communication, education, psychosocial support
The exam uses scenario-based questions to evaluate critical thinking, prioritization, and adherence to evidence-
based pediatric critical care protocols.
Question & Answer Format
• Four options (A–D)
• One correct answer per question
• Each question includes a rationale referencing PALS guidelines, pediatric respiratory and cardiac care
standards .
,2
SECTION I: ASSESSMENT & RESPIRATORY EMERGENCIES (Q1–
30)
Q1.
A 5-year-old child presents with sudden onset wheezing,
dyspnea, and accessory muscle use. What is the priority
nursing assessment?
A. Airway patency, oxygen saturation, and respiratory rate
B. Height and weight
C. Oral intake
D. Skin turgor
Correct Answer: A
Rationale: In pediatric respiratory distress, airway and
oxygenation are always the first priority.
Q2.
A child with asthma exacerbation has a PEF <50% of predicted.
Appropriate nursing action:
A. Administer rescue bronchodilator and oxygen
B. Observe only
C. Provide IV fluids only
D. Feed orally
,3
Correct Answer: A
Rationale: Severe asthma exacerbation requires prompt
bronchodilator therapy and oxygen to prevent hypoxemia.
Q3.
A pediatric patient shows grunting, nasal flaring, and
retractions. Most likely diagnosis:
A. Respiratory distress syndrome or acute respiratory failure
B. Dehydration
C. Hyperbilirubinemia
D. Seizure
Correct Answer: A
Rationale: Classic signs of increased work of breathing in
pediatric respiratory distress.
Q4.
A child with bronchiolitis requires oxygen. Nursing goal:
A. Maintain oxygen saturation >92% while monitoring
respiratory effort
B. Feed immediately
C. Swaddle only
D. Observe
, 4
Correct Answer: A
Rationale: Hypoxemia is common in bronchiolitis; careful
oxygen titration prevents complications.
Q5.
A 2-year-old with foreign body aspiration develops sudden
coughing and cyanosis. Priority intervention:
A. Perform Heimlich maneuver or appropriate airway
clearance
B. Observe only
C. Feed immediately
D. Administer bronchodilator
Correct Answer: A
Rationale: Airway obstruction is life-threatening; immediate
intervention is critical.
Q6.
A pediatric patient with respiratory failure is intubated. Nursing
responsibility includes:
A. Monitor ventilator settings, oxygenation, and end-tidal CO₂
B. Feed only
C. Swaddle
D. Observe
