CCRN PEDIATRIC PRACTICE EXAM
FROM AACN WITH UPGRADED
QUESTIONS AND ANSWERS
2025/2026
To promote effective grieving in a 6-year-old sibling following the death of an infant, the nurse should:
A) Recommend that the sibling not attend the infant's memorial service
B) Encourage the parents to minimize their expression of grief with the sibling
C) Explain to the sibling that the infant went to heaven
D) Explain to the sibling that thoughts and wishes did not cause the infant's death - correct answers-
Answer: D) Explain to the sibling that thoughts and wishes did not cause the infant's death: At age 6,
children may take words literally and because of their egocentrism, they believe that thoughts are all-
powerful. They may truly believe they caused the death of their sibling. A simple, honest explanation of
why the sibling died is indicated. This intervention is consistent with Caring Processes.
A) Recommend that the sibling not attend the infant's memorial service: This intervention is not a
solution to the problem and will not promote effective grieving for the sibling. It is not consistent with
Caring Processes.
B) Encourage the parents to minimize their expression of grief with the sibling: This intervention will
lead to ineffective grieving for the sibling and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This intervention will not address the sibling's
problem
A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at four weeks of age is
admitted with increased somnolence, decreased appetite, and increased complaints of headache. This
morning the child vomited twice. The nurse should anticipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) the patient having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilantin) or fosphenytoin (Cerebyx) - correct answers-Answer: B) The
patient having a CT scan followed by possible shunt revision: This patient is demonstrating signs of
increased intracranial pressure. The most likely etiology is malfunction of the VP shunt as a result of
blockage or disconnection, which is particularly likely over time as the child grows. The definitive
,diagnosis is made by a CT scan and a shunt series. Surgical intervention for a shunt revision would be
indicated.
A) The physician ordering lumbar puncture and blood and urine cultures: These interventions will not
address the most likely primary problem, which is suspected VP shunt malfunction. Additionally, lumbar
puncture is contraindicated in the presence of increased intracranial pressure, because downward
herniation of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medication are indicated for the medical
management of increased intracranial pressure, of which this patient has symptoms. However, they will
not address the most likely primary problem, which is suspected VP shunt malfunction.
D) Administering phenytoin (Dilantin) or fosphenytoin (Cerebyx): These medications are indicated for
seizure management and would not address the patient's most likely primary problem, which is
suspected increased intracranial pressure as a result of VP shunt malfunction
An adolescent trauma patient is complaining of left upper quadrant abdominal pain radiating to the left
shoulder. Blood pressure has dropped to 80/50. Which condition is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Laceration
D) Pulmonary Embolism - correct answers-Answer: C) Splenic laceration: Kehr's sign, which is referred
pain to the left shoulder during compression of the left upper abdominal quadrant, is an indication of
splenic injury. Additional symptoms include tachycardia, hypotension, and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include progressive abdominal distension, not
referred left shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain, arrhythmias, and other indicators of
myocardial dysfunction, such as elevated cardiac isoenzymes. Upper quadrant abdominal pain with
radiation to the left shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include chest pain and dyspnea on
exertion, not left shoulder pain
An infant has been admitted with encephalitis. The nurse should first assess the patient's:
A) Pupillary response
B) Blood glucose level
C) Level of consciousness
, D) Airway Patency - correct answers-Answer: D) Airway Patency: The first priority after admitting an
infant with encephalitis is to assess the patient's ability to maintain airway patency. Such patients can
develop rapid neurologic deterioration, and the nurse must be prepared to support the airway,
oxygenation, and ventilation as needed.
A) Pupillary Response: The infant with encephalitis should be monitored for changes in neurologic
status, including pupillary response. However, assessing the patient;s ability to maintain airway patency
is the first priority.
B) Blood Glucose Level: The infant with encephalitis will need blood glucose levels monitored, especially
if unable to maintain adequate oral intake. However, assessing the patient's ability to maintain airway
patency is the first priority.
C) Level of consciousness: The infant with encephalitis should be monitored for changes in neurologic
status, including assessment of the level of consciousness. However, assessing the patient's ability to
maintain airway patency is the first priority.
The pediatric patient with suspected asphyxia from smoke inhalation will typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - correct answers-Answer: C) Confusion: The patient with asphyxia from smoke
inhalation will experience cerebral hypoxemia and demonstrate symptoms of neurologic dysfunction,
including confusion
A) Tachypnea: While the patient with smoke inhalation may experience tachypnea as a result of damage
to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience cyanosis as a result of damage to
the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn injury may demonstrate
hypotension from fluid shifts, this symptoms is not specific to asphyxia
An acutely ill infant is born to a Vietnamese family. The father asks few questions about the infant's
condition, and the mother asks none. Both parents appear to be proficient in English. Which of the
following is the most useful resource for a nurse caring for this infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
C) Information about the cultural backgrounds represented in the community
FROM AACN WITH UPGRADED
QUESTIONS AND ANSWERS
2025/2026
To promote effective grieving in a 6-year-old sibling following the death of an infant, the nurse should:
A) Recommend that the sibling not attend the infant's memorial service
B) Encourage the parents to minimize their expression of grief with the sibling
C) Explain to the sibling that the infant went to heaven
D) Explain to the sibling that thoughts and wishes did not cause the infant's death - correct answers-
Answer: D) Explain to the sibling that thoughts and wishes did not cause the infant's death: At age 6,
children may take words literally and because of their egocentrism, they believe that thoughts are all-
powerful. They may truly believe they caused the death of their sibling. A simple, honest explanation of
why the sibling died is indicated. This intervention is consistent with Caring Processes.
A) Recommend that the sibling not attend the infant's memorial service: This intervention is not a
solution to the problem and will not promote effective grieving for the sibling. It is not consistent with
Caring Processes.
B) Encourage the parents to minimize their expression of grief with the sibling: This intervention will
lead to ineffective grieving for the sibling and is not consistent with Caring Processes
C) Explain to the sibling that the infant went to heaven: This intervention will not address the sibling's
problem
A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at four weeks of age is
admitted with increased somnolence, decreased appetite, and increased complaints of headache. This
morning the child vomited twice. The nurse should anticipate:
A) The physician ordering lumbar puncture and blood and urine cultures
B) the patient having a CT scan followed by possible shunt revision
C) Administering mannitol or hypertonic saline
D) Administering phenytoin (Dilantin) or fosphenytoin (Cerebyx) - correct answers-Answer: B) The
patient having a CT scan followed by possible shunt revision: This patient is demonstrating signs of
increased intracranial pressure. The most likely etiology is malfunction of the VP shunt as a result of
blockage or disconnection, which is particularly likely over time as the child grows. The definitive
,diagnosis is made by a CT scan and a shunt series. Surgical intervention for a shunt revision would be
indicated.
A) The physician ordering lumbar puncture and blood and urine cultures: These interventions will not
address the most likely primary problem, which is suspected VP shunt malfunction. Additionally, lumbar
puncture is contraindicated in the presence of increased intracranial pressure, because downward
herniation of the brainstem can occur.
C) Administering mannitol or hypertonic saline: These medication are indicated for the medical
management of increased intracranial pressure, of which this patient has symptoms. However, they will
not address the most likely primary problem, which is suspected VP shunt malfunction.
D) Administering phenytoin (Dilantin) or fosphenytoin (Cerebyx): These medications are indicated for
seizure management and would not address the patient's most likely primary problem, which is
suspected increased intracranial pressure as a result of VP shunt malfunction
An adolescent trauma patient is complaining of left upper quadrant abdominal pain radiating to the left
shoulder. Blood pressure has dropped to 80/50. Which condition is most likely?
A) Small Bowel Injury
B) Cardiac Contusion
C) Splenic Laceration
D) Pulmonary Embolism - correct answers-Answer: C) Splenic laceration: Kehr's sign, which is referred
pain to the left shoulder during compression of the left upper abdominal quadrant, is an indication of
splenic injury. Additional symptoms include tachycardia, hypotension, and leukocytosis
A) Small bowel injury: Signs of small bowel injury may include progressive abdominal distension, not
referred left shoulder pain.
B) Cardiac Contusion: Signs of cardiac contusion include chest pain, arrhythmias, and other indicators of
myocardial dysfunction, such as elevated cardiac isoenzymes. Upper quadrant abdominal pain with
radiation to the left shoulder is not consistent with a cardiac contusion
D) Pulmonary Embolism: Symptoms of pulmonary embolism include chest pain and dyspnea on
exertion, not left shoulder pain
An infant has been admitted with encephalitis. The nurse should first assess the patient's:
A) Pupillary response
B) Blood glucose level
C) Level of consciousness
, D) Airway Patency - correct answers-Answer: D) Airway Patency: The first priority after admitting an
infant with encephalitis is to assess the patient's ability to maintain airway patency. Such patients can
develop rapid neurologic deterioration, and the nurse must be prepared to support the airway,
oxygenation, and ventilation as needed.
A) Pupillary Response: The infant with encephalitis should be monitored for changes in neurologic
status, including pupillary response. However, assessing the patient;s ability to maintain airway patency
is the first priority.
B) Blood Glucose Level: The infant with encephalitis will need blood glucose levels monitored, especially
if unable to maintain adequate oral intake. However, assessing the patient's ability to maintain airway
patency is the first priority.
C) Level of consciousness: The infant with encephalitis should be monitored for changes in neurologic
status, including assessment of the level of consciousness. However, assessing the patient's ability to
maintain airway patency is the first priority.
The pediatric patient with suspected asphyxia from smoke inhalation will typically present with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension - correct answers-Answer: C) Confusion: The patient with asphyxia from smoke
inhalation will experience cerebral hypoxemia and demonstrate symptoms of neurologic dysfunction,
including confusion
A) Tachypnea: While the patient with smoke inhalation may experience tachypnea as a result of damage
to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience cyanosis as a result of damage to
the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn injury may demonstrate
hypotension from fluid shifts, this symptoms is not specific to asphyxia
An acutely ill infant is born to a Vietnamese family. The father asks few questions about the infant's
condition, and the mother asks none. Both parents appear to be proficient in English. Which of the
following is the most useful resource for a nurse caring for this infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
C) Information about the cultural backgrounds represented in the community
