AACN Pediatric Practice Exam Questions For 2026/2027 Update | Graded
A+
1. In caring for a patient with salicylate intoxication, the critical care nurse would anticipate which of
the following as a primary treatment measure?
A. Administration of protamine sulfate
B. Administration of glucose
C. Transfusion of packed RBCs
D. Replacement of fluid and electrolytes - ANSWER D. Replacement of fluid and electrolytes
2. An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. The
best way to prepare the patient for this procedure is to
A. Use short simple sentences and limit descriptions to concrete explanations.
B. Show the patient a chest tube and explain how it will feel.
C. Explain in detail why a chest tube is needed and how it works.
D. Tell the parents what will be done so they can explain it to their child. - ANSWER Use short simple
sentences and limit descriptions to concrete explanations.
3. A child admitted with a gunshot wound to the head, accidentally inflicted by an older sibling. The
parents are overcome with grief and appear to be ignoring the following statements made by the
older sibling: "It was an accident; I didn't mean to do it; I'm sorry!" Which of the following actions by
the nurse would be most appropriate?
A. Discuss the importance of gun safety with the older sibling while the parents are at the bedside.
B. Seek additional support for the parents for ways they can assist the older sibling
C. Tell the parents that they need to provide support for the older sibling
D. Tell the older sibling, "Accidents happen; I know you didn't mean to do it." - ANSWER Seek
additional support for the parents for ways they can assist the older sibling
4. Which of the following laboratory findings is indicative of the syndrome of inappropriate ADH
secretion (SIADH)?
,A. Serum sodium = 148 mEq/L
B. Decreased serum osmolality
C. Blood urea nitrogen (BUN) = 28 mg/dl
D. Serum potassium = 5.1 mEq/L - ANSWER Decreased serum osmolality
5. A 3-year-old is admitted to the ICU with a 10-hour history of an acute-onset asthma attack. Initial
assessment reveals the following
HR 160
pH 7.25
RR 48
pCO2 35
BP 112/76
pO2 40
T 32*C
HCO3 22
A. Administration of NaHCO3
B. Fluid resuscitation
C. Racemic epinephrine
D. Intubation - ANSWER Intubation
6. A 2-year-old is experiencing manifestations of digoxin (Lanoxin) toxicity. BP is 94/60, capillary refill
time is 2 seconds and the electrocardiogram reveals AV block with a heart rate of 60. The critical care
nurse would anticipate which of the following interventions?
A. Performance of cardioversion
B. Administration of Atropine
C. Performance of vasovagal maneuvers
D. Monitoring of HR and rhythm and perfusion status - ANSWER Monitoring of HR and rhythm and
perfusion status
7. An adolescent with asthma is readmitted just a week after discharge from the hospital. On
questioning, the nurse learns that the patient refuses to use the inhalers at school. The nurse should
A. Talk to the teen about long-term consequences of the disease if the treatment plan is not followed
,B. Talk to the school nurse to find out why they are not monitoring the medications at school
C. Help the parents set up a disciplinary contract with the teen
D. Arrange for the teen to attend an asthma support group - ANSWER Arrange for the teen to attend
an asthma support group
8. An unconscious 5-month-old is admitted. The parent reports the baby fell off the table during a
diaper change by an older sibling. What findings would indicate further inquiry of the history?
A. A reddened or bruised are on the skull
B. Poorly reactive pupils
C. Retinal hemorrhage
D. A linear skull fracture - ANSWER Retinal hemorrhage
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 - ANSWER 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. - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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.
A+
1. In caring for a patient with salicylate intoxication, the critical care nurse would anticipate which of
the following as a primary treatment measure?
A. Administration of protamine sulfate
B. Administration of glucose
C. Transfusion of packed RBCs
D. Replacement of fluid and electrolytes - ANSWER D. Replacement of fluid and electrolytes
2. An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. The
best way to prepare the patient for this procedure is to
A. Use short simple sentences and limit descriptions to concrete explanations.
B. Show the patient a chest tube and explain how it will feel.
C. Explain in detail why a chest tube is needed and how it works.
D. Tell the parents what will be done so they can explain it to their child. - ANSWER Use short simple
sentences and limit descriptions to concrete explanations.
3. A child admitted with a gunshot wound to the head, accidentally inflicted by an older sibling. The
parents are overcome with grief and appear to be ignoring the following statements made by the
older sibling: "It was an accident; I didn't mean to do it; I'm sorry!" Which of the following actions by
the nurse would be most appropriate?
A. Discuss the importance of gun safety with the older sibling while the parents are at the bedside.
B. Seek additional support for the parents for ways they can assist the older sibling
C. Tell the parents that they need to provide support for the older sibling
D. Tell the older sibling, "Accidents happen; I know you didn't mean to do it." - ANSWER Seek
additional support for the parents for ways they can assist the older sibling
4. Which of the following laboratory findings is indicative of the syndrome of inappropriate ADH
secretion (SIADH)?
,A. Serum sodium = 148 mEq/L
B. Decreased serum osmolality
C. Blood urea nitrogen (BUN) = 28 mg/dl
D. Serum potassium = 5.1 mEq/L - ANSWER Decreased serum osmolality
5. A 3-year-old is admitted to the ICU with a 10-hour history of an acute-onset asthma attack. Initial
assessment reveals the following
HR 160
pH 7.25
RR 48
pCO2 35
BP 112/76
pO2 40
T 32*C
HCO3 22
A. Administration of NaHCO3
B. Fluid resuscitation
C. Racemic epinephrine
D. Intubation - ANSWER Intubation
6. A 2-year-old is experiencing manifestations of digoxin (Lanoxin) toxicity. BP is 94/60, capillary refill
time is 2 seconds and the electrocardiogram reveals AV block with a heart rate of 60. The critical care
nurse would anticipate which of the following interventions?
A. Performance of cardioversion
B. Administration of Atropine
C. Performance of vasovagal maneuvers
D. Monitoring of HR and rhythm and perfusion status - ANSWER Monitoring of HR and rhythm and
perfusion status
7. An adolescent with asthma is readmitted just a week after discharge from the hospital. On
questioning, the nurse learns that the patient refuses to use the inhalers at school. The nurse should
A. Talk to the teen about long-term consequences of the disease if the treatment plan is not followed
,B. Talk to the school nurse to find out why they are not monitoring the medications at school
C. Help the parents set up a disciplinary contract with the teen
D. Arrange for the teen to attend an asthma support group - ANSWER Arrange for the teen to attend
an asthma support group
8. An unconscious 5-month-old is admitted. The parent reports the baby fell off the table during a
diaper change by an older sibling. What findings would indicate further inquiry of the history?
A. A reddened or bruised are on the skull
B. Poorly reactive pupils
C. Retinal hemorrhage
D. A linear skull fracture - ANSWER Retinal hemorrhage
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 - ANSWER 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. - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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.
