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CCRN Critical Care Registered Nurse Pediatrics AACN 2026/2027 Exam Review Questions and Answers 100% Pass

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1. Pediatric Critical Care Principles Critical Care Pediatric Nurse: Provides specialized care for critically ill children, including infants, toddlers, and adolescents. Assessment: Always consider age-specific developmental needs when preparing procedures. 2. Key Pediatric Interventions Salicylate Intoxication Primary treatment: Replacement of fluids and electrolytes Avoid protamine sulfate, glucose, or packed RBCs unless indicated for another condition. Procedural Preparation for Young Children Use short, simple sentences Limit explanations to concrete, age-appropriate terms Avoid overwhelming the child with too much detail Family Support During Pediatric Trauma Example: Child injured by sibling Action: Seek additional support for parents so they can assist the older sibling Avoid placing blame, giving empty reassurance, or instructing parents in a directive manner 3. Pediatric Lab Values and Conditions Syndrome of Inappropriate ADH (SIADH) Characteristic lab finding: Decreased serum osmolality Serum sodium may be low (not elevated), BUN may be low, potassium usually normal Digoxin Toxicity in Children Signs: AV block, bradycardia, normal BP and perfusion Action: Monitor heart rate, rhythm, and perfusion status Do NOT: perform cardioversion, vasovagal maneuvers, or automatically give atropine unless symptomatic instability occurs 4. Pediatric Respiratory Emergencies Acute Severe Asthma in a 3-Year-Old ABG Example: pH 7.25, pCO2 35, pO2 40 → severe respiratory compromise Primary intervention: Intubation Sodium bicarbonate, fluids, or racemic epinephrine are not first-line in severe decompensation Adolescent Asthma Noncompliance Encourage participation in support groups Focus on empowerment rather than punishment or fear-based education 5. Pediatric Trauma Red Flags Unconscious infant after fall Findings warranting further investigation: Retinal hemorrhage → could indicate non-accidental trauma (abuse) Other injuries like linear skull fractures may be consistent with accidental trauma

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CCRN Critical Care Registered
Nurse Pediatrics AACN 2024
Exam Review Questions and
Answers 100% Pass

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

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