PEDIATRIC CCRN AACN COMPREHENSIVE EXAM
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔While performing an exchange transfusion for a patient with sickle cell disease,
which of the following electrolyte abnormalities should the nurse anticipate?
A) Hypocalcemia
B) Hypercalcemia
C) Hypokalemia
D) Hypomagnesemia - ✔✔Answer: A) Hypocalcemia: metabolic complications of blood
transfusion include hypocalcemia
B) Hypercalcemia: Hypocalcemia is a complication of blood transfusion.
C) Hypokalemia: Hyperkalemia is a complication of blood transfusion.
D) Hypomagnesemia: This is not a complication of blood transfusion
✔✔An adolescent with a history of admission for chronic status asthmaticus is being
prepared for discharge. The nurse determines that the patient has not been compliant
with medications, because doing so "makes him feel too different" from his peers. The
nurse should:
A) Arrange for the patient's school nurse to monitor compliance
B) Provide the patient with articles on the relationship of hospitalization and medication
compliance.
C) refer the patient to a support group for adolescents with asthma
D) Advise the parents to withhold privileges if the patient remains non-compliant. -
✔✔Answer: C) Refer the patient to a support group for adolescents with asthma: this
intervention will help normalize the experience and increase compliance
A) Arrange for the patient's school nurse to monitor compliance: This will not help with
the issue causing noncompliance and may worsen the problem.
B) Provide the patient with articles on the relationship of hospitalization and medication
compliance: Parents and older children often need education about eh maintenance
aspect of asthma management to be reinforced.
D) Advise the parents to withhold privileges if the patient remains non-compliant: For
most children, withholding privileges is not a motivator to promote compliance.
✔✔Amrinone lactate (Inocor) is given for which desired effect?
A) Vasodilation
B) Phospholipid inhibition
C) Decreased myocardial contractility
D) Catecholamine antagonism - ✔✔Answer: A) Vasodilation: Amrinone is a
phosphodiesterase inhibitor that increases intercellular cAMP and delays uptake of
intercellular calcium, resulting in improved cardiac contractility and vasodilation.
B) Phospholipid Inhibition: This is not an effect of amrinone administration
C) Decreased myocardial contractility: This is not an effect of amrinone administration.
D) Catecholamine antagonism: This is not an effect of amrinone administration
,✔✔A family meeting is planned to discuss the family's ethical concerns regarding
continuing life support measures for a child with end-stage cancer. The nurse's role
should be to:
A) Provide the legal standpoint regarding end-of-life decisions for children.
B) Articulate the reason for the child's poor prognosis and anticipated life expectancy
C) Coordinate the meeting to ensure that everyone has the opportunity to speak
D) Assist the parents in articulating their questions and concerns. - ✔✔Answer: D)
Assist the parents in articulating their questions and concerns: The parents' thoughts
and understanding are critical for making decisions about their child's care. Nurses act
as advocates by assisting the parents in articulating their questions and concerns and
empowering the family to speak for their child and themselves.
A) Provide the legal standpoint regarding end-of-life decisions for children: This does
not address the parents' concenrs.
B) Articulate the reason for the child's poor prognosis and anticipated life expectancy:
This does not specifically address the parents' concerns regarding continued life
support measures and is not consistent with Caring Practices.
C) Coordinate the meeting to ensure that everyone has the opportunity to speak: This
intervention is not consistent with Caring Practices or Advocacy and Moral Agency, as
the nurse's opinions and decisions may be in conflict with those of the parents.
✔✔A hypertensive crisis as evidenced by acidosis, hypothermia, and alveolar hypoxia
may be demostrated in which of the following children?
A) Those with reactive pulmonary vascular bed
B) Those with systemic vascular disease.
C) Those with increases in ventricular afterload.
D)Those with sustained increases in afterload - ✔✔Answer: A) Those with reactive
pulmonary vascular bed: Children with pulmonary vascular disease are at risk for
developing a pulmonary hypertensive crisis.
B) Those with systemic vascular disease: Systemic vascular disease does not affect
pulmonary pressure
C) Those with increases in ventricular afterload: The pediatric ventricle adapts to
increases in ventricular afterload, provided the increases are not severe or acute.
D) Those with sustained increases in afterload: Acute increases in afterload are poorly
tolerated.
✔✔The nurse is providing patient education for a family whose child has cerebral palsy
and will be receiving a baclofen (Lioresal) pump to control spasticity. Which of the
following is most important for the nurse to include in the discussion?
A) The durg acts to inhibit the neurotransmitter gamma-aminobutyric acid (GABA)
B) Parents can be taught to regulate the dosage based on symptoms.
C) The child will have a normal gait after insertion of the pump.
D) Parents must bring the child back to the clinic to have medicine added to the pump. -
✔✔Answer: D) Parents must bring the child back to the clinic to have medicine added to
the pump: The intrathecal dose of baclofen delivered via implanted pump is adjusted in
the outpatient clinic using a telemetry wand every three to six months.
, A) The drug acts to inhibit the neurotransmitter gamma-aminobutyric acid (GABA):
Baclofen has the opposite effect described in this answer, as it is a GABA agonist.
B) Parents can be taught to regulate the dosage based on symptoms: The intrathecal
dose of baclofen is adjusted in the outpatient clinic using a telemetry wand.
C) The child will have a normal gait after insertion of the pump: The child's gait may be
improved due to relief of severe spasticity, but there is no guarantee of a normal gait
with this therapy.
✔✔Positive end-expiratory pressure (PEEP) is intended to do which of the following?
A) Increase functional residual capacity
B) Decrease functional residual capacity
C) Increase venous return to the heart
D) Increase cardiac output - ✔✔Answer: A) Increase functional residual capacity: PEEP
increases functional residual capacity (FRC) by keeping the alveoli open after
expiration, increasing alveolar volume
B) Decrease functional residual capacity: This is the opposite of what occurs when
PEEP is used.
C) Increase venous return to the heart: PEEP can impede systemic venous return
D) Increase cardiac output: At high levels, PEEP may decrease cardiac output.
✔✔A nurse is interested in including other disciplines in the educational process of
developmental care in the NICU. The best way to convince administration this venture is
financially worthwhile is to:
A) Present a report summarizing research relating developmental care to decrease
length of stay.
B) Request that the neonatoogist present the plan.
C) Present case studies demonstrating favorable outcomes for developmental care.
D) Invite members of administration to attend the classes. - ✔✔Answer: A) Present a
report summarizing research relating developmental care to decreased length of stay:
Evidence-based practice is the use of available data to support care. A decrease in
length of stay is a motivator to support practice.
B) Request that the neonatologist present the plan: This intervention will not address
the financial concerns of the administrators.
C) Present case studies demonstrating favorable outcomes for developmental care:
This intervention will not address the financial concerns of the administrators.
D) Invite members of the administration to attend the classes: This intervention will not
address the financial concerns of the administrators.
✔✔A 2-year-old with left-sided ventricular heart failure and pulmonary edema is
experiencing extreme dyspnea. Which of the following would the nurse suggest to
improve the work of breathing and decrease the child's anxiety and agitation?
A) Digoxin (Lanoxin)
B) Morphine (Duramorph)
C) Furosemide (Lasix)
2026/2027 QUESTIONS AND SOLUTIONS RATED A+
✔✔While performing an exchange transfusion for a patient with sickle cell disease,
which of the following electrolyte abnormalities should the nurse anticipate?
A) Hypocalcemia
B) Hypercalcemia
C) Hypokalemia
D) Hypomagnesemia - ✔✔Answer: A) Hypocalcemia: metabolic complications of blood
transfusion include hypocalcemia
B) Hypercalcemia: Hypocalcemia is a complication of blood transfusion.
C) Hypokalemia: Hyperkalemia is a complication of blood transfusion.
D) Hypomagnesemia: This is not a complication of blood transfusion
✔✔An adolescent with a history of admission for chronic status asthmaticus is being
prepared for discharge. The nurse determines that the patient has not been compliant
with medications, because doing so "makes him feel too different" from his peers. The
nurse should:
A) Arrange for the patient's school nurse to monitor compliance
B) Provide the patient with articles on the relationship of hospitalization and medication
compliance.
C) refer the patient to a support group for adolescents with asthma
D) Advise the parents to withhold privileges if the patient remains non-compliant. -
✔✔Answer: C) Refer the patient to a support group for adolescents with asthma: this
intervention will help normalize the experience and increase compliance
A) Arrange for the patient's school nurse to monitor compliance: This will not help with
the issue causing noncompliance and may worsen the problem.
B) Provide the patient with articles on the relationship of hospitalization and medication
compliance: Parents and older children often need education about eh maintenance
aspect of asthma management to be reinforced.
D) Advise the parents to withhold privileges if the patient remains non-compliant: For
most children, withholding privileges is not a motivator to promote compliance.
✔✔Amrinone lactate (Inocor) is given for which desired effect?
A) Vasodilation
B) Phospholipid inhibition
C) Decreased myocardial contractility
D) Catecholamine antagonism - ✔✔Answer: A) Vasodilation: Amrinone is a
phosphodiesterase inhibitor that increases intercellular cAMP and delays uptake of
intercellular calcium, resulting in improved cardiac contractility and vasodilation.
B) Phospholipid Inhibition: This is not an effect of amrinone administration
C) Decreased myocardial contractility: This is not an effect of amrinone administration.
D) Catecholamine antagonism: This is not an effect of amrinone administration
,✔✔A family meeting is planned to discuss the family's ethical concerns regarding
continuing life support measures for a child with end-stage cancer. The nurse's role
should be to:
A) Provide the legal standpoint regarding end-of-life decisions for children.
B) Articulate the reason for the child's poor prognosis and anticipated life expectancy
C) Coordinate the meeting to ensure that everyone has the opportunity to speak
D) Assist the parents in articulating their questions and concerns. - ✔✔Answer: D)
Assist the parents in articulating their questions and concerns: The parents' thoughts
and understanding are critical for making decisions about their child's care. Nurses act
as advocates by assisting the parents in articulating their questions and concerns and
empowering the family to speak for their child and themselves.
A) Provide the legal standpoint regarding end-of-life decisions for children: This does
not address the parents' concenrs.
B) Articulate the reason for the child's poor prognosis and anticipated life expectancy:
This does not specifically address the parents' concerns regarding continued life
support measures and is not consistent with Caring Practices.
C) Coordinate the meeting to ensure that everyone has the opportunity to speak: This
intervention is not consistent with Caring Practices or Advocacy and Moral Agency, as
the nurse's opinions and decisions may be in conflict with those of the parents.
✔✔A hypertensive crisis as evidenced by acidosis, hypothermia, and alveolar hypoxia
may be demostrated in which of the following children?
A) Those with reactive pulmonary vascular bed
B) Those with systemic vascular disease.
C) Those with increases in ventricular afterload.
D)Those with sustained increases in afterload - ✔✔Answer: A) Those with reactive
pulmonary vascular bed: Children with pulmonary vascular disease are at risk for
developing a pulmonary hypertensive crisis.
B) Those with systemic vascular disease: Systemic vascular disease does not affect
pulmonary pressure
C) Those with increases in ventricular afterload: The pediatric ventricle adapts to
increases in ventricular afterload, provided the increases are not severe or acute.
D) Those with sustained increases in afterload: Acute increases in afterload are poorly
tolerated.
✔✔The nurse is providing patient education for a family whose child has cerebral palsy
and will be receiving a baclofen (Lioresal) pump to control spasticity. Which of the
following is most important for the nurse to include in the discussion?
A) The durg acts to inhibit the neurotransmitter gamma-aminobutyric acid (GABA)
B) Parents can be taught to regulate the dosage based on symptoms.
C) The child will have a normal gait after insertion of the pump.
D) Parents must bring the child back to the clinic to have medicine added to the pump. -
✔✔Answer: D) Parents must bring the child back to the clinic to have medicine added to
the pump: The intrathecal dose of baclofen delivered via implanted pump is adjusted in
the outpatient clinic using a telemetry wand every three to six months.
, A) The drug acts to inhibit the neurotransmitter gamma-aminobutyric acid (GABA):
Baclofen has the opposite effect described in this answer, as it is a GABA agonist.
B) Parents can be taught to regulate the dosage based on symptoms: The intrathecal
dose of baclofen is adjusted in the outpatient clinic using a telemetry wand.
C) The child will have a normal gait after insertion of the pump: The child's gait may be
improved due to relief of severe spasticity, but there is no guarantee of a normal gait
with this therapy.
✔✔Positive end-expiratory pressure (PEEP) is intended to do which of the following?
A) Increase functional residual capacity
B) Decrease functional residual capacity
C) Increase venous return to the heart
D) Increase cardiac output - ✔✔Answer: A) Increase functional residual capacity: PEEP
increases functional residual capacity (FRC) by keeping the alveoli open after
expiration, increasing alveolar volume
B) Decrease functional residual capacity: This is the opposite of what occurs when
PEEP is used.
C) Increase venous return to the heart: PEEP can impede systemic venous return
D) Increase cardiac output: At high levels, PEEP may decrease cardiac output.
✔✔A nurse is interested in including other disciplines in the educational process of
developmental care in the NICU. The best way to convince administration this venture is
financially worthwhile is to:
A) Present a report summarizing research relating developmental care to decrease
length of stay.
B) Request that the neonatoogist present the plan.
C) Present case studies demonstrating favorable outcomes for developmental care.
D) Invite members of administration to attend the classes. - ✔✔Answer: A) Present a
report summarizing research relating developmental care to decreased length of stay:
Evidence-based practice is the use of available data to support care. A decrease in
length of stay is a motivator to support practice.
B) Request that the neonatologist present the plan: This intervention will not address
the financial concerns of the administrators.
C) Present case studies demonstrating favorable outcomes for developmental care:
This intervention will not address the financial concerns of the administrators.
D) Invite members of the administration to attend the classes: This intervention will not
address the financial concerns of the administrators.
✔✔A 2-year-old with left-sided ventricular heart failure and pulmonary edema is
experiencing extreme dyspnea. Which of the following would the nurse suggest to
improve the work of breathing and decrease the child's anxiety and agitation?
A) Digoxin (Lanoxin)
B) Morphine (Duramorph)
C) Furosemide (Lasix)
