Pediatric CCRN AACN Practice Questions with
Correct Solutions
hypertensive crisis as evidenced by acidosis, hypothermia, and alveolar hypoxia may be
demonstrated in which types of patients?
A. increased ventricular after load
B. reactive pulmonary vascular bed
C. sustained increased in after load
D. systemic vascular disease
B
A mother who is developmentally disabled delivers an infant with Pierre Robin syndrome.
Throughout hospitalization, the mother actively participates in caring for her neonate and
attends parent education classes in anticipation of discharge. The maternal grandmother
expresses to the nurse concern that the mother will be unable to care for the infant at home
and that the neonate should be placed in medical foster care. The nurse should:
A. explore the grandmother's concerns in more detail
B. refer the concern to the neonatologist for determination
C. schedule a multidisciplinary care conference
D. ask the social worker to make a referral to the medical foster care system
C
A 5 month old with no past medical history is admitted with vomiting and diarrhea due to
gastroenteritis. The infant becomes unresponsive with generalized seizures. Labs reveal
normal serum electrolytes and a glucose of 30 mg/dL. Urinalysis is negative for ketones.
,The MOST likely diagnosis is:
A. fatty acid metabolism defect
B. galactosemia
C. phenylketonuria
D. maple syrup urine disease
A
A patient is 4 days post-op from a cardiac surgery. The nurse notes on the cardiac monitor
tall peaked T waves with a narrow base. Lab results are as follows:
Na 145, K 6.8, Cl 104, HcO3 23, BUN elevated, Creatinine normal, Glucose 224, Ca low,
Mag normal
What immediate treatment should the nurse anticipate to be ordered by the provider?
A. hemodialysis
B. insulin infusion
C. calcium gluconate
D. ECMO
C
Which intervention would be the MOST valuable in aiding the management of a child
requiring PEEP of 14 cm water?
A. high frequency oscillatory ventilation (HFOV)
B. placement of a thoracostomy tube
,C. extracorporeal membrane oxygenation (ECMO)
D. placement of a pulmonary artery catheter
A
A resident is overheard being disrespectful to a patient and blaming the patient for being
critically ill. The nurse should INITIALLY:
A. notify the chief resident
B. remind the resident of the hospital's code of conduct
C. interrupt and pull the resident out of the room
D. ask the nurse manager to address this leadership issue with the resident
B
A patient post-cardiac arrest has a new diagnosis of hypertrophic cardiomyopathy. The
parents are concerned about what to do if their child collapses again. The nurse's BEST
response would be:
A. "Would teaching you CPR help ease your anxieties?"
B. "I will have your child's cardiologist speak with you"
C. "Do you know how to access the EMS system?"
D. "Now that your child has been diagnoses and treated, you need not worry"
A
A patient is admitted with multiple organ dysfunction syndrome (MODS), is sedated, on
mechanical ventilation, and multiple vasopressor agents. After a discussion with the
patient's spouse, a "Do Not Resuscitate" order is written. When the daughter arrives and
learns of the status, she tells the nurse "my father would never agree to a DNR order. He
, always has a strong will to live. My mother wants to get rid of him>". The nurse should
INITIALLY:
A. explain to the daughter that the wife has the final say
B. notify the provider
C. collaborate with the social worker
D. call for an ethics consult
B
A 16 year old intubated patient has a RASS score of +4. The nurse should expect the
provider to order what medication?
A. fentanyl (Sublimaze)
B. lorazepam (Ativan)
C. midazolam (Versed)
D. dexmedetomidine (Precedex)
D
Following a bladder surgery, bladder pressures are being monitored each shift. The most
recent pressure is significantly higher than the previous value. The nurse should:
A. recalibrate the bladder monitoring system before rechecking the bladder pressure
B. immediately alert the provider of the increased pressure
C. confirm that the urinary catheter is draining properly
D. open and set up a new bladder pressure monitoring system before rechecking the
bladder pressure
A
Correct Solutions
hypertensive crisis as evidenced by acidosis, hypothermia, and alveolar hypoxia may be
demonstrated in which types of patients?
A. increased ventricular after load
B. reactive pulmonary vascular bed
C. sustained increased in after load
D. systemic vascular disease
B
A mother who is developmentally disabled delivers an infant with Pierre Robin syndrome.
Throughout hospitalization, the mother actively participates in caring for her neonate and
attends parent education classes in anticipation of discharge. The maternal grandmother
expresses to the nurse concern that the mother will be unable to care for the infant at home
and that the neonate should be placed in medical foster care. The nurse should:
A. explore the grandmother's concerns in more detail
B. refer the concern to the neonatologist for determination
C. schedule a multidisciplinary care conference
D. ask the social worker to make a referral to the medical foster care system
C
A 5 month old with no past medical history is admitted with vomiting and diarrhea due to
gastroenteritis. The infant becomes unresponsive with generalized seizures. Labs reveal
normal serum electrolytes and a glucose of 30 mg/dL. Urinalysis is negative for ketones.
,The MOST likely diagnosis is:
A. fatty acid metabolism defect
B. galactosemia
C. phenylketonuria
D. maple syrup urine disease
A
A patient is 4 days post-op from a cardiac surgery. The nurse notes on the cardiac monitor
tall peaked T waves with a narrow base. Lab results are as follows:
Na 145, K 6.8, Cl 104, HcO3 23, BUN elevated, Creatinine normal, Glucose 224, Ca low,
Mag normal
What immediate treatment should the nurse anticipate to be ordered by the provider?
A. hemodialysis
B. insulin infusion
C. calcium gluconate
D. ECMO
C
Which intervention would be the MOST valuable in aiding the management of a child
requiring PEEP of 14 cm water?
A. high frequency oscillatory ventilation (HFOV)
B. placement of a thoracostomy tube
,C. extracorporeal membrane oxygenation (ECMO)
D. placement of a pulmonary artery catheter
A
A resident is overheard being disrespectful to a patient and blaming the patient for being
critically ill. The nurse should INITIALLY:
A. notify the chief resident
B. remind the resident of the hospital's code of conduct
C. interrupt and pull the resident out of the room
D. ask the nurse manager to address this leadership issue with the resident
B
A patient post-cardiac arrest has a new diagnosis of hypertrophic cardiomyopathy. The
parents are concerned about what to do if their child collapses again. The nurse's BEST
response would be:
A. "Would teaching you CPR help ease your anxieties?"
B. "I will have your child's cardiologist speak with you"
C. "Do you know how to access the EMS system?"
D. "Now that your child has been diagnoses and treated, you need not worry"
A
A patient is admitted with multiple organ dysfunction syndrome (MODS), is sedated, on
mechanical ventilation, and multiple vasopressor agents. After a discussion with the
patient's spouse, a "Do Not Resuscitate" order is written. When the daughter arrives and
learns of the status, she tells the nurse "my father would never agree to a DNR order. He
, always has a strong will to live. My mother wants to get rid of him>". The nurse should
INITIALLY:
A. explain to the daughter that the wife has the final say
B. notify the provider
C. collaborate with the social worker
D. call for an ethics consult
B
A 16 year old intubated patient has a RASS score of +4. The nurse should expect the
provider to order what medication?
A. fentanyl (Sublimaze)
B. lorazepam (Ativan)
C. midazolam (Versed)
D. dexmedetomidine (Precedex)
D
Following a bladder surgery, bladder pressures are being monitored each shift. The most
recent pressure is significantly higher than the previous value. The nurse should:
A. recalibrate the bladder monitoring system before rechecking the bladder pressure
B. immediately alert the provider of the increased pressure
C. confirm that the urinary catheter is draining properly
D. open and set up a new bladder pressure monitoring system before rechecking the
bladder pressure
A
