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CCRN Pediatric Practice Exam Questions from
AACN Questions with Detailed Verified 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
Ans: 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.
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
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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)
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Ans: 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.
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
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C) Splenic Laceration
D) Pulmonary Embolism
Ans: 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
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
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CCRN Pediatric Practice Exam Questions from
AACN Questions with Detailed Verified 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
Ans: 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.
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
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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)
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Ans: 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.
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
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C) Splenic Laceration
D) Pulmonary Embolism
Ans: 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
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
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