PEDIATRIC CCRN AACN 2026/2027 QUESTIONS AND
SOLUTIONS RATED A+
✔✔A 1-month old infant presents with failure to thrive, frequent vomiting and irritability
since birth. The mother reports having another infant with the same symptoms who died
at 2 months of age. Which additional assessment finding would cause the nurse to
suspect an inborn error of metabolism?
A) Micrognathia
B) Microglossia
C) Petite Facial Features
D) Musty Urine Odor - ✔✔Answer: D) Musty urine odor: This is a common indicator of a
metabolic disorder, especially with a family history of siblings dying early
A) Micrognathia: This is not associated with an inborn error of metabolism
B) Microglossia: This is not associated with an inborn error of metabolism
C) Petite Facial Features: This is not associated with an inborn error of metabolism
✔✔A school-aged child with autism is admitted with a fractured femur and possible
head injury. Which of the following is important to promote adjustment to the hospital
setting?
A) Assign a child life therapist per shift
B) Encourage lots of visitors
C) Adhere to a home schedule
D) Initiate new activities to keep the patient occupied - ✔✔Answer: C) Adhere to a home
schedule: Autism spectrum disorders are a complex neurodevelopmental disorder of
brain function accompanied by a broad range and severity of intellectual and behavioral
deficits, which is best managed when adhering to a schedule and minimizing change,
so adhering to a home schedule is optimal. The schedule allows the child and family to
optimally cope.
A) Assign a child life therapist per shift: The assignment of a child life therapist can be
very beneficial to help facilitate patient and family understanding of the hospital
environment and provide therapeutic coping interventions, but it is not realistic that a
child life therapist would be assigned to an individual patient for every shift.
B) Encourage lots of visitors: The management of a possible head injury includes a
quiet restful environment, which is consistent with Caring Practices that will optimally
provide patient and family coping and safety. maintenance of a schedule and minimizing
visitors will provide a healing environment appropriate for an autistic patient who has a
possible head injury.
D) Initiate new activities to keep the patient occupied: Management of a possible head
injury includes a quiet restful environment, which is consistent with Caring Practices that
will optimally provide patient and family coping and safety. The introduction of new
activities may be stressful and potentially harmful with a head injury, so maintenance of
a schedule and known activities will provide a healing environment appropriate for an
autistic patient with a possible head injury.
✔✔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 translation and asking of questions
D) Allowing time for the translator to decode the medical jargon used in the teaching. -
✔✔Answer: B) Standing next to the translator and as close to the patient as possible:
This response is consistent with high competency levels in Facilitation of Learning. It
supports the patient through the process of obtaining the information required from a
professional individual and the translator
A) Having the translator ask questions that you don't feel comfortable asking: This
response is not consistent with high competency levels in Facilitation of Learning. A
translator should be used to obtain all pertinent patient information
C) Providing all of the information, then allowing translation and asking of questions:
This response is not consistent with high competency levels in Facilitation of Learning.
Content may be accidentally omitted with the process described in this option.
D) Allowing time for the translator to decode the medical jargon used in the teaching:
This response is not consistent with high competency levels in Facilitation of Learning.
Jargon should not have to be decoded by the translator. This can lead to errors by the
translator, who might provide inaccurate information.
✔✔Family members of a patient who has just died are crying and wailing loudly both
inside and outside the patient's room. Staff are expressing frustration with the outbursts.
The nurse's best response is to acknowledge the noise and
A) Ask a security officer to remove the family from the unit
B) Guide the family to a nearby room where they can express their emotions
C) Tell the family they must quiet down, or they will have to leave the unit
D) Tell the other staff they are being insensitive to the family's expression of grief -
✔✔Answer: B) Guide the family to a nearby room where they can express their
emotions: People from various cultures express grief and mourning in different ways.
This expression may include loud, emotional responses. Providing the family a place
close to the patient's room allows them privacy while minimizing disruption to other
patients and staff in the area.
A) Ask a security officer to remove the family from the unit: Removing the family is not a
culturally sensitive way to allow the family to experience their grief and mourning
C) Tell the family they must quiet down or they will have to leave the unit: Asking the
family to be quiet or removing them from the unit are not culturally sensitive ways to
allow the family toe experience their grief and mourning
D) Tell the other staff they are being insensitive to the family's expression of grief:
Telling other staff members that they are being insensitive does not promote cultural
awareness and does not address the family's need to express their grief and mourning.
✔✔Cardiac defects associated with increased pulmonary blood flow place the patient at
greatest risk for:
A) Heart Failure
B) Air Emboli
C) Hypoxemia
, D) Syncope - ✔✔Answer: A) Heart Failure: Heart Failure is a common manifestation
associated with increased pulmonary blood flow
B) Air Emboli: Although air emboli are possible with a septal defect, it would be a rare
occurrence. This may be seen later in life due to chronic increased pulmonary blood
flow
C) Hypoxemia: Hypoxemia is not usually associated with cardiac defects that result in
increased pulmonary blood flow
D) Syncope: Syncope is not associated with cardiac defects that result in increased
pulmonary blood flow
✔✔A nurse believes the number of hemolyzed blood samples that have been reported
by the laboratory is excessive. The best action for the nurse would be to
A) Track the number of blood samples drawn, by what method and the number reported
as hemolyzed
B) Request a staff meeting to discuss the problem and ask for feedback
C) Develop an educational in-service on the proper blood-sampling technique for the
staff
D) Create a poster and post-test demonstrating the proper method of drawing blood
samples - ✔✔Answer: A) Track the number of blood samples drawn, by what method
and the number reported as hemolyzed: Evidence-based practice is the use of available
data to support care and address care concerns. The nurse currently has only an
impression and no data to support the concern
B) Request a staff meeting to discuss the problem and ask for feedback: this
intervention will not address the need for data to validate the concern
C) Develop an educational in-service on the proper blood-sampling technique for the
staff: This intervention will not address the need for data to validate the concern
D) Create a poster and post-test demonstrating the proper method of drawing blood
samples: This intervention will not address the need for data to validate the concern
✔✔Which ventilatory parameters should be weaned first in a patient with
bronchopulmonary dysplasia (BPD)?
A) Tidal Volume (VT) and oxygen (FiO2)
B) Peak inspiratory pressure (PIP) and intermittent mandatory ventilation (IMV)
C) Oxygen (FiO2) and intermittent mandatory ventilation (IMV)
D) Oxygent (FiO2) and peak inspiratory pressure (PIP) - ✔✔Answer: D) Oxygen (FiO2)
and peak inspiratory pressure (PIP): FiO2 should be weaned as soon as oxygenation
improves. PIP is weaned as lung compliance improves
A) Tidal Volume (VT) and oxygen (FiO2): Patients with BPD are usually ventilated using
a pressure cycled ventilator mode, as breaths delivered at a set volume to non
compliant lungs may generate a pressure higher than the desired peak pressure.
B) Peak inspiratory pressure (PIP) and intermittent mandatory ventilation (IMV): PIP is
weaned as the lung compliance improves but IMV is a mode of ventilation, not a
weanable parameter
C) Oxygent (FiO2) and intermittent mandatory ventilation (IMV): FiO2 is weaned as
oxygenation improves but IMV is a mode of ventilation, not a weanable parameter
SOLUTIONS RATED A+
✔✔A 1-month old infant presents with failure to thrive, frequent vomiting and irritability
since birth. The mother reports having another infant with the same symptoms who died
at 2 months of age. Which additional assessment finding would cause the nurse to
suspect an inborn error of metabolism?
A) Micrognathia
B) Microglossia
C) Petite Facial Features
D) Musty Urine Odor - ✔✔Answer: D) Musty urine odor: This is a common indicator of a
metabolic disorder, especially with a family history of siblings dying early
A) Micrognathia: This is not associated with an inborn error of metabolism
B) Microglossia: This is not associated with an inborn error of metabolism
C) Petite Facial Features: This is not associated with an inborn error of metabolism
✔✔A school-aged child with autism is admitted with a fractured femur and possible
head injury. Which of the following is important to promote adjustment to the hospital
setting?
A) Assign a child life therapist per shift
B) Encourage lots of visitors
C) Adhere to a home schedule
D) Initiate new activities to keep the patient occupied - ✔✔Answer: C) Adhere to a home
schedule: Autism spectrum disorders are a complex neurodevelopmental disorder of
brain function accompanied by a broad range and severity of intellectual and behavioral
deficits, which is best managed when adhering to a schedule and minimizing change,
so adhering to a home schedule is optimal. The schedule allows the child and family to
optimally cope.
A) Assign a child life therapist per shift: The assignment of a child life therapist can be
very beneficial to help facilitate patient and family understanding of the hospital
environment and provide therapeutic coping interventions, but it is not realistic that a
child life therapist would be assigned to an individual patient for every shift.
B) Encourage lots of visitors: The management of a possible head injury includes a
quiet restful environment, which is consistent with Caring Practices that will optimally
provide patient and family coping and safety. maintenance of a schedule and minimizing
visitors will provide a healing environment appropriate for an autistic patient who has a
possible head injury.
D) Initiate new activities to keep the patient occupied: Management of a possible head
injury includes a quiet restful environment, which is consistent with Caring Practices that
will optimally provide patient and family coping and safety. The introduction of new
activities may be stressful and potentially harmful with a head injury, so maintenance of
a schedule and known activities will provide a healing environment appropriate for an
autistic patient with a possible head injury.
✔✔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 translation and asking of questions
D) Allowing time for the translator to decode the medical jargon used in the teaching. -
✔✔Answer: B) Standing next to the translator and as close to the patient as possible:
This response is consistent with high competency levels in Facilitation of Learning. It
supports the patient through the process of obtaining the information required from a
professional individual and the translator
A) Having the translator ask questions that you don't feel comfortable asking: This
response is not consistent with high competency levels in Facilitation of Learning. A
translator should be used to obtain all pertinent patient information
C) Providing all of the information, then allowing translation and asking of questions:
This response is not consistent with high competency levels in Facilitation of Learning.
Content may be accidentally omitted with the process described in this option.
D) Allowing time for the translator to decode the medical jargon used in the teaching:
This response is not consistent with high competency levels in Facilitation of Learning.
Jargon should not have to be decoded by the translator. This can lead to errors by the
translator, who might provide inaccurate information.
✔✔Family members of a patient who has just died are crying and wailing loudly both
inside and outside the patient's room. Staff are expressing frustration with the outbursts.
The nurse's best response is to acknowledge the noise and
A) Ask a security officer to remove the family from the unit
B) Guide the family to a nearby room where they can express their emotions
C) Tell the family they must quiet down, or they will have to leave the unit
D) Tell the other staff they are being insensitive to the family's expression of grief -
✔✔Answer: B) Guide the family to a nearby room where they can express their
emotions: People from various cultures express grief and mourning in different ways.
This expression may include loud, emotional responses. Providing the family a place
close to the patient's room allows them privacy while minimizing disruption to other
patients and staff in the area.
A) Ask a security officer to remove the family from the unit: Removing the family is not a
culturally sensitive way to allow the family to experience their grief and mourning
C) Tell the family they must quiet down or they will have to leave the unit: Asking the
family to be quiet or removing them from the unit are not culturally sensitive ways to
allow the family toe experience their grief and mourning
D) Tell the other staff they are being insensitive to the family's expression of grief:
Telling other staff members that they are being insensitive does not promote cultural
awareness and does not address the family's need to express their grief and mourning.
✔✔Cardiac defects associated with increased pulmonary blood flow place the patient at
greatest risk for:
A) Heart Failure
B) Air Emboli
C) Hypoxemia
, D) Syncope - ✔✔Answer: A) Heart Failure: Heart Failure is a common manifestation
associated with increased pulmonary blood flow
B) Air Emboli: Although air emboli are possible with a septal defect, it would be a rare
occurrence. This may be seen later in life due to chronic increased pulmonary blood
flow
C) Hypoxemia: Hypoxemia is not usually associated with cardiac defects that result in
increased pulmonary blood flow
D) Syncope: Syncope is not associated with cardiac defects that result in increased
pulmonary blood flow
✔✔A nurse believes the number of hemolyzed blood samples that have been reported
by the laboratory is excessive. The best action for the nurse would be to
A) Track the number of blood samples drawn, by what method and the number reported
as hemolyzed
B) Request a staff meeting to discuss the problem and ask for feedback
C) Develop an educational in-service on the proper blood-sampling technique for the
staff
D) Create a poster and post-test demonstrating the proper method of drawing blood
samples - ✔✔Answer: A) Track the number of blood samples drawn, by what method
and the number reported as hemolyzed: Evidence-based practice is the use of available
data to support care and address care concerns. The nurse currently has only an
impression and no data to support the concern
B) Request a staff meeting to discuss the problem and ask for feedback: this
intervention will not address the need for data to validate the concern
C) Develop an educational in-service on the proper blood-sampling technique for the
staff: This intervention will not address the need for data to validate the concern
D) Create a poster and post-test demonstrating the proper method of drawing blood
samples: This intervention will not address the need for data to validate the concern
✔✔Which ventilatory parameters should be weaned first in a patient with
bronchopulmonary dysplasia (BPD)?
A) Tidal Volume (VT) and oxygen (FiO2)
B) Peak inspiratory pressure (PIP) and intermittent mandatory ventilation (IMV)
C) Oxygen (FiO2) and intermittent mandatory ventilation (IMV)
D) Oxygent (FiO2) and peak inspiratory pressure (PIP) - ✔✔Answer: D) Oxygen (FiO2)
and peak inspiratory pressure (PIP): FiO2 should be weaned as soon as oxygenation
improves. PIP is weaned as lung compliance improves
A) Tidal Volume (VT) and oxygen (FiO2): Patients with BPD are usually ventilated using
a pressure cycled ventilator mode, as breaths delivered at a set volume to non
compliant lungs may generate a pressure higher than the desired peak pressure.
B) Peak inspiratory pressure (PIP) and intermittent mandatory ventilation (IMV): PIP is
weaned as the lung compliance improves but IMV is a mode of ventilation, not a
weanable parameter
C) Oxygent (FiO2) and intermittent mandatory ventilation (IMV): FiO2 is weaned as
oxygenation improves but IMV is a mode of ventilation, not a weanable parameter
