PEDIATRIC CCRN AACN CORE EXAMS SET 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔1. A 1-month-old infant presents with poor feeding, vomiting and diarrhea since
birth. The infant is lethargic and in mild respiratory distress. The mother reports having
another infant with the same symptoms who died at 2 months of age. Which finding
would cause the nurse to suspect an inborn error of metabolism?
A. micrognathia
B. microglossia
C. petite facial features
D. abnormal urine odor - ✔✔abnormal urine odor
✔✔2. Cardiac defects associated with increased pulmonary blood flow place the patient
at greatest risk for
A. heart failure.
B. systemic air emboli.
C. hypoxemia.
D. syncope. - ✔✔heart failure
✔✔3. Which ventilator parameters would be weaned first in a patient with
bronchopulmonary dysplasia (BPD)?
A. VT and FiO2
B. peak inspiratory pressure and IMV
C. FiO2 and IMV
D. FiO2 and peak inspiratory pressure - ✔✔FiO2 and peak inspiratory pressure
✔✔4. Amrinone lactate (Inocor) produces which of the following effects?
A. vasodilation
B. phospholipid inhibition
C. decreased myocardial contractility
D. antagonism to other catecholamines - ✔✔vasodilation
✔✔5. Which of the following procedures would be most valuable in aiding management
of a child requiring PEEP of 14 cm of water?
A. ECMO therapy
B. placement of a thoracostomy tube
C. placement of a pulmonary artery catheter
D. high-frequency ventilation - ✔✔high-frequency ventilation
,✔✔6. A 15-year-old patient underwent a classic Fontan repair of tricuspid atresia 12
hours ago. The patient is cool, diaphoretic, restless, mottled peripherally, with no pedal
pulses and faint femoral pulses.
Vital signs are:
HR 140
MAP 60 mm Hg
CVP 20 mm Hg
Cardiac Index 2.1 L/min/m2
SVR 2000 dynes/sec/cm-5
The nurse should suspect
A. a pulmonary embolus.
B. cardiac tamponade.
C. cardiogenic shock.
D. hypovolemic shock. - ✔✔cardiogenic shock.
✔✔7. The nurse is providing patient education for a family whose child has cerebral
palsy and will be receiving a Baclofen (Lioresal) pump to control spasticity. Which of the
following is most important for the nurse to include in the discussion?
A. The drug acts to inhibit the neurotransmitter gamma-amniobutyric acid (GABA).
B. Parents can be taught to regulate the dosage based on symptoms.
C. The child will have a normal gait after insertion of the pump.
D. Parents must bring the child back to the clinic to have the medicine
added to the pump. - ✔✔Parents must bring the child back to the clinic to have the
medicine
added to the pump.
✔✔8. A nurse is interested in including other disciplines in the educational process of
developmental care in the NICU. The best way to convince administration that this
venture is financially worthwhile is to
A. present a report summarizing research relating developmental care to
decreased length of stay.
B. request that the neonatologist present the plan.
C. present case studies demonstrating favorable outcomes to
developmental care.
D. invite members of administration to attend the classes. - ✔✔present a report
summarizing research relating developmental care to decreased length of stay.
✔✔9. PEEP is intended to do which of the following?
A. increase functional residual capacity
B. decrease functional residual capacity
C. increase venous return to the heart
D. increase cardiac output - ✔✔increase functional residual capacity
, ✔✔An 8-month-old with bronchopulmonary dysplasia (BPD) is admitted with
heart failure. Nursing interventions should be done to
A. decrease preload.
B. increase afterload.
C. decrease heart rate.
D. increase contractility. - ✔✔decrease preload
✔✔11. A 2-month-old with a history of unrepaired Tetralogy of Fallot begins to cry
while intravenous access is attempted. Cyanosis, diaphoresis and
tachypnea are noted. Nursing interventions are aimed at
A. Increasing pulmonary flow and relaxing the infundibulum.
B. Decreasing systemic flow and increasing pulmonary vascular
resistance.
C. Decreasing pulmonary flow and increasing systemic vascular resistance
(SVR).
D. Increasing systemic flow and relaxing the left ventricular outflow tract. -
✔✔Increasing pulmonary flow and relaxing the infundibulum.
✔✔During surgery on a 2-month-old with Tetralogy of Fallot, a trans-thoracic
PA catheter was placed. Upon removal of this line, the PA pressure is 29
mm Hg systolic. As the line is 'pulled back' into the right ventricle, the
pressure measures 72 mm Hg systolic. RA Sat=72, PA Sat=72. This
change in measurement may indicate a/an
A. right bundle branch block.
B. residual VSD.
C. incompetent pulmonic valve.
D. residual right ventricular outflow obstruction - ✔✔residual right ventricular outflow
obstruction
✔✔A 4-year-old has been admitted twice in the past six months for status
asthmaticus. The parents smell of smoke when they come to the hospital,
but state they don't smoke in the house. The most appropriate discharge
planning intervention would be to
A. discuss with the parents how to avoid asthma triggers at home.
B. give the parents literature about smoking cessation treatment and
support groups.
C. call Child Protective Services to report a medically unsafe home
environment.
D. remind parents they shouldn't smoke around the child. - ✔✔give the parents
literature about smoking cessation treatment and support groups.
QUESTIONS AND SOLUTIONS RATED A+
✔✔1. A 1-month-old infant presents with poor feeding, vomiting and diarrhea since
birth. The infant is lethargic and in mild respiratory distress. The mother reports having
another infant with the same symptoms who died at 2 months of age. Which finding
would cause the nurse to suspect an inborn error of metabolism?
A. micrognathia
B. microglossia
C. petite facial features
D. abnormal urine odor - ✔✔abnormal urine odor
✔✔2. Cardiac defects associated with increased pulmonary blood flow place the patient
at greatest risk for
A. heart failure.
B. systemic air emboli.
C. hypoxemia.
D. syncope. - ✔✔heart failure
✔✔3. Which ventilator parameters would be weaned first in a patient with
bronchopulmonary dysplasia (BPD)?
A. VT and FiO2
B. peak inspiratory pressure and IMV
C. FiO2 and IMV
D. FiO2 and peak inspiratory pressure - ✔✔FiO2 and peak inspiratory pressure
✔✔4. Amrinone lactate (Inocor) produces which of the following effects?
A. vasodilation
B. phospholipid inhibition
C. decreased myocardial contractility
D. antagonism to other catecholamines - ✔✔vasodilation
✔✔5. Which of the following procedures would be most valuable in aiding management
of a child requiring PEEP of 14 cm of water?
A. ECMO therapy
B. placement of a thoracostomy tube
C. placement of a pulmonary artery catheter
D. high-frequency ventilation - ✔✔high-frequency ventilation
,✔✔6. A 15-year-old patient underwent a classic Fontan repair of tricuspid atresia 12
hours ago. The patient is cool, diaphoretic, restless, mottled peripherally, with no pedal
pulses and faint femoral pulses.
Vital signs are:
HR 140
MAP 60 mm Hg
CVP 20 mm Hg
Cardiac Index 2.1 L/min/m2
SVR 2000 dynes/sec/cm-5
The nurse should suspect
A. a pulmonary embolus.
B. cardiac tamponade.
C. cardiogenic shock.
D. hypovolemic shock. - ✔✔cardiogenic shock.
✔✔7. The nurse is providing patient education for a family whose child has cerebral
palsy and will be receiving a Baclofen (Lioresal) pump to control spasticity. Which of the
following is most important for the nurse to include in the discussion?
A. The drug acts to inhibit the neurotransmitter gamma-amniobutyric acid (GABA).
B. Parents can be taught to regulate the dosage based on symptoms.
C. The child will have a normal gait after insertion of the pump.
D. Parents must bring the child back to the clinic to have the medicine
added to the pump. - ✔✔Parents must bring the child back to the clinic to have the
medicine
added to the pump.
✔✔8. A nurse is interested in including other disciplines in the educational process of
developmental care in the NICU. The best way to convince administration that this
venture is financially worthwhile is to
A. present a report summarizing research relating developmental care to
decreased length of stay.
B. request that the neonatologist present the plan.
C. present case studies demonstrating favorable outcomes to
developmental care.
D. invite members of administration to attend the classes. - ✔✔present a report
summarizing research relating developmental care to decreased length of stay.
✔✔9. PEEP is intended to do which of the following?
A. increase functional residual capacity
B. decrease functional residual capacity
C. increase venous return to the heart
D. increase cardiac output - ✔✔increase functional residual capacity
, ✔✔An 8-month-old with bronchopulmonary dysplasia (BPD) is admitted with
heart failure. Nursing interventions should be done to
A. decrease preload.
B. increase afterload.
C. decrease heart rate.
D. increase contractility. - ✔✔decrease preload
✔✔11. A 2-month-old with a history of unrepaired Tetralogy of Fallot begins to cry
while intravenous access is attempted. Cyanosis, diaphoresis and
tachypnea are noted. Nursing interventions are aimed at
A. Increasing pulmonary flow and relaxing the infundibulum.
B. Decreasing systemic flow and increasing pulmonary vascular
resistance.
C. Decreasing pulmonary flow and increasing systemic vascular resistance
(SVR).
D. Increasing systemic flow and relaxing the left ventricular outflow tract. -
✔✔Increasing pulmonary flow and relaxing the infundibulum.
✔✔During surgery on a 2-month-old with Tetralogy of Fallot, a trans-thoracic
PA catheter was placed. Upon removal of this line, the PA pressure is 29
mm Hg systolic. As the line is 'pulled back' into the right ventricle, the
pressure measures 72 mm Hg systolic. RA Sat=72, PA Sat=72. This
change in measurement may indicate a/an
A. right bundle branch block.
B. residual VSD.
C. incompetent pulmonic valve.
D. residual right ventricular outflow obstruction - ✔✔residual right ventricular outflow
obstruction
✔✔A 4-year-old has been admitted twice in the past six months for status
asthmaticus. The parents smell of smoke when they come to the hospital,
but state they don't smoke in the house. The most appropriate discharge
planning intervention would be to
A. discuss with the parents how to avoid asthma triggers at home.
B. give the parents literature about smoking cessation treatment and
support groups.
C. call Child Protective Services to report a medically unsafe home
environment.
D. remind parents they shouldn't smoke around the child. - ✔✔give the parents
literature about smoking cessation treatment and support groups.
