Page 1 of 253
CCRN PEDIATRIC AACN A
1. An acutely ill infant is born to a Vietnamese family. The father asks few questions and the
mother asks none, though both speak English. Which is the MOST useful resource for the
nurse?
A. Classes conducted by the primary nurse as the need arises
B. An interpreter proficient in the parents' language
C. Information about cultural backgrounds in the community
D. Ongoing cultural education classes for the community
Answer: B. An interpreter proficient in the parents' language
Rationale: Even if they speak English, a trained interpreter improves clarity, comfort, and
accurate communication in stressful situations.
2. A toddler with unrepaired tetralogy of Fallot becomes cyanotic, diaphoretic, and tachypneic
while crying during IV insertion. What is the priority intervention?
A. Administer pre-medication
B. Apply oxygen via face mask
C. Transfuse red blood cells
D. Place the child in knee-chest position
Answer: D. Place the child in knee-chest position
Rationale: This position increases systemic vascular resistance, improving blood flow to the
lungs and reducing cyanotic spells.
1
,Page 2 of 253
3. A 1-month-old infant presents with failure to thrive, vomiting, and irritability. A sibling died
with similar symptoms. Which finding suggests an inborn error of metabolism?
A. Micrognathia
B. Musty urine odor
C. Microglossia
D. Petite facial features
Answer: B. Musty urine odor
Rationale: A musty odor is classic for metabolic disorders like phenylketonuria (PKU).
4. A school-aged child with autism is hospitalized with a fractured femur and possible head
injury. What promotes best adjustment?
A. Assign a child life therapist every shift
B. Encourage many visitors
C. Initiate new activities
D. Adhere to a home schedule
Answer: D. Adhere to a home schedule
Rationale: Children with autism respond best to routine and minimal change, which reduces
stress.
5. A patient who does not understand English is admitted. Which is an appropriate guideline
when using a translator?
A. Have the translator ask sensitive questions
B. Provide all information first, then translate
C. Stand next to the translator and close to the patient
D. Use medical jargon and allow translator to interpret
2
,Page 3 of 253
Answer: C. Stand next to the translator and close to the patient
Rationale: This maintains patient engagement and ensures clear, direct communication through
the translator.
1. Family members of a patient who has just died are crying loudly on the unit. Staff are
becoming frustrated. The nurse’s best response is to acknowledge the noise and:
A. Ask security to remove the family
B. Guide the family to a nearby room where they can express emotions
C. Tell the family to quiet down or leave
D. Tell staff they are being insensitive
Answer: B. Guide the family to a nearby room where they can express emotions
Rationale: This respects cultural expressions of grief while maintaining a calm environment for
others.
2. To promote effective grieving in a 6-year-old sibling after the death of an infant, the nurse
should:
A. Recommend the sibling not attend the memorial
B. Encourage parents to hide their grief
C. Explain the infant went to heaven
D. Explain that thoughts and wishes did not cause the death
Answer: D. Explain that thoughts and wishes did not cause the death
Rationale: Children at this age may believe they caused the death; reassurance prevents guilt
and supports healthy grieving.
3
, Page 4 of 253
3. A 5-year-old with a VP shunt presents with somnolence, vomiting, headache, and decreased
appetite. What should the nurse anticipate?
A. Lumbar puncture and cultures
B. CT scan followed by possible shunt revision
C. Administration of mannitol
D. Administration of anticonvulsants
Answer: B. CT scan followed by possible shunt revision
Rationale: Symptoms suggest increased intracranial pressure due to shunt malfunction,
requiring imaging and possible surgical correction.
QUESTION: 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.
4
CCRN PEDIATRIC AACN A
1. An acutely ill infant is born to a Vietnamese family. The father asks few questions and the
mother asks none, though both speak English. Which is the MOST useful resource for the
nurse?
A. Classes conducted by the primary nurse as the need arises
B. An interpreter proficient in the parents' language
C. Information about cultural backgrounds in the community
D. Ongoing cultural education classes for the community
Answer: B. An interpreter proficient in the parents' language
Rationale: Even if they speak English, a trained interpreter improves clarity, comfort, and
accurate communication in stressful situations.
2. A toddler with unrepaired tetralogy of Fallot becomes cyanotic, diaphoretic, and tachypneic
while crying during IV insertion. What is the priority intervention?
A. Administer pre-medication
B. Apply oxygen via face mask
C. Transfuse red blood cells
D. Place the child in knee-chest position
Answer: D. Place the child in knee-chest position
Rationale: This position increases systemic vascular resistance, improving blood flow to the
lungs and reducing cyanotic spells.
1
,Page 2 of 253
3. A 1-month-old infant presents with failure to thrive, vomiting, and irritability. A sibling died
with similar symptoms. Which finding suggests an inborn error of metabolism?
A. Micrognathia
B. Musty urine odor
C. Microglossia
D. Petite facial features
Answer: B. Musty urine odor
Rationale: A musty odor is classic for metabolic disorders like phenylketonuria (PKU).
4. A school-aged child with autism is hospitalized with a fractured femur and possible head
injury. What promotes best adjustment?
A. Assign a child life therapist every shift
B. Encourage many visitors
C. Initiate new activities
D. Adhere to a home schedule
Answer: D. Adhere to a home schedule
Rationale: Children with autism respond best to routine and minimal change, which reduces
stress.
5. A patient who does not understand English is admitted. Which is an appropriate guideline
when using a translator?
A. Have the translator ask sensitive questions
B. Provide all information first, then translate
C. Stand next to the translator and close to the patient
D. Use medical jargon and allow translator to interpret
2
,Page 3 of 253
Answer: C. Stand next to the translator and close to the patient
Rationale: This maintains patient engagement and ensures clear, direct communication through
the translator.
1. Family members of a patient who has just died are crying loudly on the unit. Staff are
becoming frustrated. The nurse’s best response is to acknowledge the noise and:
A. Ask security to remove the family
B. Guide the family to a nearby room where they can express emotions
C. Tell the family to quiet down or leave
D. Tell staff they are being insensitive
Answer: B. Guide the family to a nearby room where they can express emotions
Rationale: This respects cultural expressions of grief while maintaining a calm environment for
others.
2. To promote effective grieving in a 6-year-old sibling after the death of an infant, the nurse
should:
A. Recommend the sibling not attend the memorial
B. Encourage parents to hide their grief
C. Explain the infant went to heaven
D. Explain that thoughts and wishes did not cause the death
Answer: D. Explain that thoughts and wishes did not cause the death
Rationale: Children at this age may believe they caused the death; reassurance prevents guilt
and supports healthy grieving.
3
, Page 4 of 253
3. A 5-year-old with a VP shunt presents with somnolence, vomiting, headache, and decreased
appetite. What should the nurse anticipate?
A. Lumbar puncture and cultures
B. CT scan followed by possible shunt revision
C. Administration of mannitol
D. Administration of anticonvulsants
Answer: B. CT scan followed by possible shunt revision
Rationale: Symptoms suggest increased intracranial pressure due to shunt malfunction,
requiring imaging and possible surgical correction.
QUESTION: 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.
4
