CCRN Pediatric Practice Exam
Questions from AACN 2025 Questions
and Answers
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 - Correct
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.
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,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) - Correct 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.
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,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 - Correct 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
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, 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 - Correct 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
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
Questions from AACN 2025 Questions
and Answers
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 - Correct
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.
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 1
,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) - Correct 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.
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 2
,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 - Correct 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
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 3
, 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 - Correct 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
FOR STUDY PURPOSES ONLY COPYRIGHT © 2025 ALL RIGHTS RESERVED 4
