PEDIATRIC CCRN AACN MAIN EXAMINATION TEST
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔A patient who does not speak or understand English is admitted.
Guidelines for using a translator may include
A. having the translator ask questions that you don't feel comfortable asking.
B. standing next to the translator and as close to the patient as possible.
C. providing all of the information, then allowing for translation and asking of
questions.
D. allowing time for the translator to decode the medical jargon used in the
teaching. - ✔✔standing next to the translator and as close to the patient as possible
✔✔An infant post cardiac surgery is displaying signs of hypovolemia. The
nurse suspects there is an increased insensible fluid loss due to
A. decreased activity.
B. hypothermia.
C. the radiant warmer.
D. sedation. - ✔✔the radiant warmer
✔✔The primary objective in the treatment of an infant with persistent
pulmonary hypertension is to
A. maintain the pH level at less than 7.40.
B. dilate the pulmonary vascular bed.
C. dilate the systemic vascular bed.
D. constrict the pulmonary vascular bed. - ✔✔dilate the pulmonary vascular bed
✔✔31. A 26-week-gestation infant with multiple congenital abnormalities dies
shortly after admission to the NICU. The parents saw the infant briefly in
the delivery room, but decline to come to the NICU. The nurse should first
A. Take the infant to the parents.
B. Refer the parents to a genetic counselor.
C. Prepare a memory box for the parents.
D. Take an instant photo of the infant to the parents. - ✔✔Take an instant photo of the
infant to the parents.
✔✔For an acetaminophen level of 140 mcg/mL, the treatment choice is
A. activated charcoal.
B. N-acetylcysteine (Acetadote).
C. deferoxamine (Desferal).
D. pralidoxime chloride (Protopam). - ✔✔N-acetylcysteine (Acetadote).
,✔✔33. Which of the following actions would be appropriate after the administration of
desmopressin (DDAVP) to a patient with diabetes insipidus?
A. Decreasing IV fluid rate
B. Maintaining current fluid rate
C. Increasing sodium intake
D. Decreasing glucose intake - ✔✔Decreasing IV fluid rate
✔✔34. A 15-year-old with acute myelogenous leukemia has undergone multiple rounds
of chemotherapy. One night, the patient tells the nurse, "I'm tired of all the chemo and I
want to stop." The nurse should
A. Explain the adolescent patients cannot legally make healthcare decisions
B. Encourage the patient to, "express these feelings to your parents."
C. Arrange for the patient to discuss the treatment plan with the physicians
D. Ask the patient, "Do you realize you could die if you stop chemotherapy?" -
✔✔Encourage the patient to, "express these feelings to your parents."
✔✔35. A 9-year-old presents with recurrent episodes of intermittent palpitations
associated with weakness. Physical examination is unremarkable. An ECG reveals a
heart rate of 125 beats per minute, a shortened PR interval and a slurred upstroke prior
to each widened QRS complex. This slurred upstroke (Delta wave) can be explained by
A. Atrial pre-excitation
B. Atrial depolarization
C. Ventricular repolarization
D. Ventricular pre-excitation - ✔✔Ventricular pre-excitation
✔✔36. A patient with end-stage liver failure secondary to Hepatitis C virus has been
declared brain dead. The parents decide to discontinue feedings and donate their
daughter's organs. In response to the parents' request, the most appropriate action by
the nurse would be to
A. Contact the organ procurement agency
B. Convene a multidisciplinary care conference
C. Tell the parents that their daughter's condition precludes organ donation
D. Discontinue feedings per the parents' request - ✔✔Contact the organ procurement
agency
✔✔37. Which of the following tests will confirm brain death in a 6-month-old?
A. Absence of spontaneous breathing when PaCO2 goes above 60 mmHg
B. Eyes deviate toward the right when ice water is injected into the ears
C. Radionuclide scan shows cerebral arterial blood flow into the brain stem
, D. Low voltage amplitude observed on electroencephalogram (EEG) - ✔✔Absence of
spontaneous breathing when PaCO2 goes above 60 mmHg
✔✔38. The acute treatment of esophageal varices includes
A. Placement of a large NGT to low intermittent suction
B. Immediate surgical intervention
C. Administration of vasopressin (Pitressin) or octreotide (Sandostatin)
D. Placement of a central venous line for hyperalimentation (TPN) - ✔✔Administration
of vasopressin (Pitressin) or octreotide (Sandostatin)
✔✔39. A 1-year-old who in ventilator dependent has been hospitalized since birth. He is
now being discharged home with a tracheostomy and a gastrostomy. In order to
determine the discharge needs of the patient, the should arrange for
A. Home nursing care for the first few days following discharge
B. A social worker to meet with the family and assess the adequacy of the home
environment
C. An outreach educator to determine the learning needs of the family
D. A multidisciplinary care conference prior to discharge - ✔✔A multidisciplinary care
conference prior to discharge
✔✔40. A 10-year old patient is intubated due to a sudden deterioration in respiratory
status. ABGs post intubation are as follows:
pH 7.31
pCO2 50
pO2 80
HCO3 22
O2 Sat 95%
The blood gases reflect
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis - ✔✔Respiratory acidosis
✔✔41. A 4-year-old has been admitted following repair of coarctation of the aorta. The
child's vital signs are:
HR 80
BP 150/80
RR 20
CVP 10
The arterial blood gas results are:
pH 7.32
pCO2 42
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔A patient who does not speak or understand English is admitted.
Guidelines for using a translator may include
A. having the translator ask questions that you don't feel comfortable asking.
B. standing next to the translator and as close to the patient as possible.
C. providing all of the information, then allowing for translation and asking of
questions.
D. allowing time for the translator to decode the medical jargon used in the
teaching. - ✔✔standing next to the translator and as close to the patient as possible
✔✔An infant post cardiac surgery is displaying signs of hypovolemia. The
nurse suspects there is an increased insensible fluid loss due to
A. decreased activity.
B. hypothermia.
C. the radiant warmer.
D. sedation. - ✔✔the radiant warmer
✔✔The primary objective in the treatment of an infant with persistent
pulmonary hypertension is to
A. maintain the pH level at less than 7.40.
B. dilate the pulmonary vascular bed.
C. dilate the systemic vascular bed.
D. constrict the pulmonary vascular bed. - ✔✔dilate the pulmonary vascular bed
✔✔31. A 26-week-gestation infant with multiple congenital abnormalities dies
shortly after admission to the NICU. The parents saw the infant briefly in
the delivery room, but decline to come to the NICU. The nurse should first
A. Take the infant to the parents.
B. Refer the parents to a genetic counselor.
C. Prepare a memory box for the parents.
D. Take an instant photo of the infant to the parents. - ✔✔Take an instant photo of the
infant to the parents.
✔✔For an acetaminophen level of 140 mcg/mL, the treatment choice is
A. activated charcoal.
B. N-acetylcysteine (Acetadote).
C. deferoxamine (Desferal).
D. pralidoxime chloride (Protopam). - ✔✔N-acetylcysteine (Acetadote).
,✔✔33. Which of the following actions would be appropriate after the administration of
desmopressin (DDAVP) to a patient with diabetes insipidus?
A. Decreasing IV fluid rate
B. Maintaining current fluid rate
C. Increasing sodium intake
D. Decreasing glucose intake - ✔✔Decreasing IV fluid rate
✔✔34. A 15-year-old with acute myelogenous leukemia has undergone multiple rounds
of chemotherapy. One night, the patient tells the nurse, "I'm tired of all the chemo and I
want to stop." The nurse should
A. Explain the adolescent patients cannot legally make healthcare decisions
B. Encourage the patient to, "express these feelings to your parents."
C. Arrange for the patient to discuss the treatment plan with the physicians
D. Ask the patient, "Do you realize you could die if you stop chemotherapy?" -
✔✔Encourage the patient to, "express these feelings to your parents."
✔✔35. A 9-year-old presents with recurrent episodes of intermittent palpitations
associated with weakness. Physical examination is unremarkable. An ECG reveals a
heart rate of 125 beats per minute, a shortened PR interval and a slurred upstroke prior
to each widened QRS complex. This slurred upstroke (Delta wave) can be explained by
A. Atrial pre-excitation
B. Atrial depolarization
C. Ventricular repolarization
D. Ventricular pre-excitation - ✔✔Ventricular pre-excitation
✔✔36. A patient with end-stage liver failure secondary to Hepatitis C virus has been
declared brain dead. The parents decide to discontinue feedings and donate their
daughter's organs. In response to the parents' request, the most appropriate action by
the nurse would be to
A. Contact the organ procurement agency
B. Convene a multidisciplinary care conference
C. Tell the parents that their daughter's condition precludes organ donation
D. Discontinue feedings per the parents' request - ✔✔Contact the organ procurement
agency
✔✔37. Which of the following tests will confirm brain death in a 6-month-old?
A. Absence of spontaneous breathing when PaCO2 goes above 60 mmHg
B. Eyes deviate toward the right when ice water is injected into the ears
C. Radionuclide scan shows cerebral arterial blood flow into the brain stem
, D. Low voltage amplitude observed on electroencephalogram (EEG) - ✔✔Absence of
spontaneous breathing when PaCO2 goes above 60 mmHg
✔✔38. The acute treatment of esophageal varices includes
A. Placement of a large NGT to low intermittent suction
B. Immediate surgical intervention
C. Administration of vasopressin (Pitressin) or octreotide (Sandostatin)
D. Placement of a central venous line for hyperalimentation (TPN) - ✔✔Administration
of vasopressin (Pitressin) or octreotide (Sandostatin)
✔✔39. A 1-year-old who in ventilator dependent has been hospitalized since birth. He is
now being discharged home with a tracheostomy and a gastrostomy. In order to
determine the discharge needs of the patient, the should arrange for
A. Home nursing care for the first few days following discharge
B. A social worker to meet with the family and assess the adequacy of the home
environment
C. An outreach educator to determine the learning needs of the family
D. A multidisciplinary care conference prior to discharge - ✔✔A multidisciplinary care
conference prior to discharge
✔✔40. A 10-year old patient is intubated due to a sudden deterioration in respiratory
status. ABGs post intubation are as follows:
pH 7.31
pCO2 50
pO2 80
HCO3 22
O2 Sat 95%
The blood gases reflect
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis - ✔✔Respiratory acidosis
✔✔41. A 4-year-old has been admitted following repair of coarctation of the aorta. The
child's vital signs are:
HR 80
BP 150/80
RR 20
CVP 10
The arterial blood gas results are:
pH 7.32
pCO2 42
