CCRN Pediatric Practice Exam Questions
from AACN questions and answers 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 -
ANSWER 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) - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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
D) Ongoing classes addressing the cultural needs of the community - ANSWER
Answer: B) An interpreter who is proficient in the parents' language: This intervention is
consistent with Response to Diversity. Providing an interpreter may facilitate
communication by the parents. Trained interpreters can improve outcomes by helping to
ensure effective communication between the healthcare team and the patient/family
A) Classes conducted by the primary nurse as the need arises: This intervention is not
consistent with Response to Diversity. It will not help in this situation. While addressing
needs as they arise is important, the parents are not communicating these needs at
present.
C) Information about the cultural backgrounds represented in the community: This
intervention will not help in this situation. Cultural backgrounds in the community will not
address the parents' needs during this stressful time.
D) Ongoing classes addressing the cultural needs of the community: This intervention
will not help in this situation. Cultural backgrounds in the community will not address the
parents; needs during this stressful time.
A toddler with a history of unrepaired tetralogy of Fallot begins to cry while intravenous
access is attempted. Cyanosis, diaphoresis and tachypnea are noted. The most
appropriate nursing intervention would be to:
A) Administer A pre-medication before attempting the IV
B) Apply a face mask with oxygen
C) Transfuse red blood cells
from AACN questions and answers 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 -
ANSWER 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) - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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
D) Ongoing classes addressing the cultural needs of the community - ANSWER
Answer: B) An interpreter who is proficient in the parents' language: This intervention is
consistent with Response to Diversity. Providing an interpreter may facilitate
communication by the parents. Trained interpreters can improve outcomes by helping to
ensure effective communication between the healthcare team and the patient/family
A) Classes conducted by the primary nurse as the need arises: This intervention is not
consistent with Response to Diversity. It will not help in this situation. While addressing
needs as they arise is important, the parents are not communicating these needs at
present.
C) Information about the cultural backgrounds represented in the community: This
intervention will not help in this situation. Cultural backgrounds in the community will not
address the parents' needs during this stressful time.
D) Ongoing classes addressing the cultural needs of the community: This intervention
will not help in this situation. Cultural backgrounds in the community will not address the
parents; needs during this stressful time.
A toddler with a history of unrepaired tetralogy of Fallot begins to cry while intravenous
access is attempted. Cyanosis, diaphoresis and tachypnea are noted. The most
appropriate nursing intervention would be to:
A) Administer A pre-medication before attempting the IV
B) Apply a face mask with oxygen
C) Transfuse red blood cells
