CCRN Pediatric Practice Exam Questions
and Answers from AACN
To promote effective grieving in a 6-year-old sibling following the death
of an infant, the nurse should:
A) Recommend that the sibling not attend 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 - Correct Answer -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 explanation of why the sibling
died is indicated. This intervention is consistent with Caring Processes.
A) Recommend that the sibling not attend the infant's memorial service:
This intervention is not a solution to the problem and will not promote
effective 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 intervention will lead to ineffective grieving for the sibling
and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This intervention
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 admitted with increased somnolence,
decreased appetite, and increased complaints of headache. This
morning the child vomited twice. The nurse should anticipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) The patient having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilantin) or fosphenytoin (Hereby) - Correct
Answer -Answer: B) The patient having a CT scan followed by possible
shunt revision: This patient is demonstrating signs of increased
intracranial pressure. The most likely etiology is malfunction of the VP
shunt as a result of blockage or disconnection, which is particularly likely
over time as the child grows. The definitive diagnosis is made by a CT
,scan and a shunt series. Surgical intervention for a shunt revision would
be indicated.
A) The physician ordering lumbar puncture and blood and urine cultures:
These interventions will not address the most likely primary problem,
which is suspected VP shunt malfunction. Additionally, lumbar puncture
is contraindicated in the presence of increased intracranial pressure,
because downward herniation of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medication are
indicated for the medical management of increased intracranial
pressure, of which this patient has symptoms. However, they will not
address the most likely primary problem, which is suspected VP shunt
malfunction.
D) Administering phenytoin (Dilantin) or fosphenytoin (Hereby): These
medications are indicated for seizure management and would not
address the patient's most likely primary problem, which is suspected
increased intracranial pressure as a result of VP shunt malfunction
An adolescent trauma patient is complaining of left upper quadrant
abdominal pain radiating to the left shoulder. Blood pressure has
dropped to 80/50. Which condition is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Laceration
D) Pulmonary Embolism - Correct Answer -Answer: C) Splenic
laceration: Ker’s sign, which is referred pain to the left shoulder during
compression of the left upper abdominal quadrant, is an indication of
splenic injury. Additional symptoms include tachycardia, hypotension,
and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include
progressive abdominal distension, not referred left shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain,
arrhythmias, and other indicators of myocardial dysfunction, such as
elevated cardiac is enzymes. Upper quadrant abdominal pain with
radiation to the left shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include
chest pain and dyspnea on exertion, not left shoulder pain
An infant has been admitted with encephalitis. The nurse should first
assess the patient's:
A) Pupillary response
B) Blood glucose level
C) Level of consciousness
, D) Airway Patency - Correct Answer -Answer: D) Airway Patency: The
first priority after admitting an infant with encephalitis is to assess the
patient's ability to maintain airway patency. Such patients can develop
rapid neurologic deterioration, and the nurse must be prepared to
support the airway, oxygenation, and ventilation as needed.
A) Pupillary Response: The infant with encephalitis should be monitored
for changes in neurologic status, including pupillary response. However,
assessing the patient’s ability to maintain airway patency is the first
priority.
B) Blood Glucose Level: The infant with encephalitis will need blood
glucose levels monitored, especially if unable to maintain adequate oral
intake. However, assessing the patient's ability to maintain airway
patency is the first priority.
C) Level of consciousness: The infant with encephalitis should be
monitored for changes in neurologic status, including assessment of the
level of consciousness. However, assessing the patient's ability to
maintain airway patency is the first priority.
The pediatric patient with suspected asphyxia from smoke inhalation will
typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - Correct Answer -Answer: C) Confusion: The patient
with asphyxia from smoke inhalation will experience cerebral hypoxemia
and demonstrate symptoms of neurologic dysfunction, including
confusion
A) Tachypnea: While the patient with smoke inhalation may experience
tachypnea as a result of damage to the lung parenchyma, this symptoms
is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience
cyanosis as a result of damage to the lung parenchyma, this symptoms
is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn
injury may demonstrate hypotension from fluid shifts, this symptoms is
not specific to asphyxia
An acutely ill infant is born to a Vietnamese family. The father asks few
questions about the infant's condition, 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
and Answers from AACN
To promote effective grieving in a 6-year-old sibling following the death
of an infant, the nurse should:
A) Recommend that the sibling not attend 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 - Correct Answer -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 explanation of why the sibling
died is indicated. This intervention is consistent with Caring Processes.
A) Recommend that the sibling not attend the infant's memorial service:
This intervention is not a solution to the problem and will not promote
effective 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 intervention will lead to ineffective grieving for the sibling
and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This intervention
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 admitted with increased somnolence,
decreased appetite, and increased complaints of headache. This
morning the child vomited twice. The nurse should anticipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) The patient having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilantin) or fosphenytoin (Hereby) - Correct
Answer -Answer: B) The patient having a CT scan followed by possible
shunt revision: This patient is demonstrating signs of increased
intracranial pressure. The most likely etiology is malfunction of the VP
shunt as a result of blockage or disconnection, which is particularly likely
over time as the child grows. The definitive diagnosis is made by a CT
,scan and a shunt series. Surgical intervention for a shunt revision would
be indicated.
A) The physician ordering lumbar puncture and blood and urine cultures:
These interventions will not address the most likely primary problem,
which is suspected VP shunt malfunction. Additionally, lumbar puncture
is contraindicated in the presence of increased intracranial pressure,
because downward herniation of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medication are
indicated for the medical management of increased intracranial
pressure, of which this patient has symptoms. However, they will not
address the most likely primary problem, which is suspected VP shunt
malfunction.
D) Administering phenytoin (Dilantin) or fosphenytoin (Hereby): These
medications are indicated for seizure management and would not
address the patient's most likely primary problem, which is suspected
increased intracranial pressure as a result of VP shunt malfunction
An adolescent trauma patient is complaining of left upper quadrant
abdominal pain radiating to the left shoulder. Blood pressure has
dropped to 80/50. Which condition is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Laceration
D) Pulmonary Embolism - Correct Answer -Answer: C) Splenic
laceration: Ker’s sign, which is referred pain to the left shoulder during
compression of the left upper abdominal quadrant, is an indication of
splenic injury. Additional symptoms include tachycardia, hypotension,
and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include
progressive abdominal distension, not referred left shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain,
arrhythmias, and other indicators of myocardial dysfunction, such as
elevated cardiac is enzymes. Upper quadrant abdominal pain with
radiation to the left shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include
chest pain and dyspnea on exertion, not left shoulder pain
An infant has been admitted with encephalitis. The nurse should first
assess the patient's:
A) Pupillary response
B) Blood glucose level
C) Level of consciousness
, D) Airway Patency - Correct Answer -Answer: D) Airway Patency: The
first priority after admitting an infant with encephalitis is to assess the
patient's ability to maintain airway patency. Such patients can develop
rapid neurologic deterioration, and the nurse must be prepared to
support the airway, oxygenation, and ventilation as needed.
A) Pupillary Response: The infant with encephalitis should be monitored
for changes in neurologic status, including pupillary response. However,
assessing the patient’s ability to maintain airway patency is the first
priority.
B) Blood Glucose Level: The infant with encephalitis will need blood
glucose levels monitored, especially if unable to maintain adequate oral
intake. However, assessing the patient's ability to maintain airway
patency is the first priority.
C) Level of consciousness: The infant with encephalitis should be
monitored for changes in neurologic status, including assessment of the
level of consciousness. However, assessing the patient's ability to
maintain airway patency is the first priority.
The pediatric patient with suspected asphyxia from smoke inhalation will
typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - Correct Answer -Answer: C) Confusion: The patient
with asphyxia from smoke inhalation will experience cerebral hypoxemia
and demonstrate symptoms of neurologic dysfunction, including
confusion
A) Tachypnea: While the patient with smoke inhalation may experience
tachypnea as a result of damage to the lung parenchyma, this symptoms
is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience
cyanosis as a result of damage to the lung parenchyma, this symptoms
is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn
injury may demonstrate hypotension from fluid shifts, this symptoms is
not specific to asphyxia
An acutely ill infant is born to a Vietnamese family. The father asks few
questions about the infant's condition, 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
