CCRN PEDS AACN UPDATED ACTUAL
Questions and CORRECT Answers
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 - CORRECT 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. - CORRECT
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." - CORRECT
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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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. - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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:
Questions and CORRECT Answers
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 - CORRECT 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. - CORRECT
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." - CORRECT
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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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. - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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:
