PEDIATRIC CCRN EXAM STUDY GUIDE
QUESTIONS WITH COMPLETE SOLUTIONS
2026
◉ When does the Ductus Arteriosus close? Answer: within 10-24
hours of birth
◉ When does the Foramen Ovale Close? Answer: When LA pressure
exceeds RA pressure (can stay open for 6mo to a year)
◉ What does Cardiac Output measure? Answer: Efficiency of the
heart
◉ Cardiac Output is the measure of what? Answer: Volume of blood
pumped by the heart in one minute
◉ How is cardiac output calculated? Answer: Stroke volume x heart
rate
◉ Define Preload Answer: Elasticity of the heart when the ventricles
are at max fill
,◉ Two factors contributing to DECREASE in preload Answer: 1.
dehydration
2. vasodilation
◉ Define Afterload Answer: Resistant force that the ventricles must
pump against. Work that the ventricles must do to push blood
through the aorta into the periphery of the body
◉ Define Contractility Answer: The amount of force exerted by the
heart with each contraction
◉ Name one factor that decreases contractility in the heart Answer:
hypoxemia
◉ How does dopamine affect heart function Answer: increases
contractility and stroke volume
◉ Describe the conduction pathway of the heart Answer: SA node -
Atrium - AV node - Bundle of His - Ventricle - Purkinje Fibers
◉ Define Chronic Heart Failure Answer: The hearts inability to
pump oxygenated blood to the body due to abnormalities in the
heart and other areas of the body. Contributing to edema, resp.
distress, activity intolerance, and growth failure
,◉ Name 2 compensatory mechanisms of Chronic Heart Failure
Answer: 1. Activation of the Sympathetic Nervous System
2. Cardiac reserve; i.e. hypertrophy and dilation of cardiac muscle
◉ Describe Right Sided Heart Failure Answer: RV is unable to pump
blood efficiently into the Pulmonary artery, so blood backs up into
veins and periphery of body
◉ Describe Left Sided Heart Failure Answer: LV is unable to
effectively pump blood into aorta and out into body, so blood backs
up into pulmonary outlets and increases pressure in LA
◉ Name 3 causes of Chronic Heart Failure in Children Answer: 1.
Structural Abnormalities
2. Failure of the heart muscle
3. excessive demands on normal heart muscle
◉ List Manifestations of Impaired Myocardial function Answer: 1.
tachycardia
2. Sweating
2. Decreased UOP
3. fatigue
4. anorexia
, 5. decrease interest in activities
6. cardiomegaly
7. pale/cool extremities
8. decreased BP
◉ List manifestations of Right Sided Heart Failure Answer: 1. weight
gain
2. edema
3. hepatomegaly
4. ascites
5. distended neck veins
◉ List manifestations of Left Sided Heart Failure Answer: 1.
Tachycardia
2. dyspnia
3. Activity intolerance
4. persistent cough
5. cyanosis
6. wheezing/grunting
7. orthopnea
QUESTIONS WITH COMPLETE SOLUTIONS
2026
◉ When does the Ductus Arteriosus close? Answer: within 10-24
hours of birth
◉ When does the Foramen Ovale Close? Answer: When LA pressure
exceeds RA pressure (can stay open for 6mo to a year)
◉ What does Cardiac Output measure? Answer: Efficiency of the
heart
◉ Cardiac Output is the measure of what? Answer: Volume of blood
pumped by the heart in one minute
◉ How is cardiac output calculated? Answer: Stroke volume x heart
rate
◉ Define Preload Answer: Elasticity of the heart when the ventricles
are at max fill
,◉ Two factors contributing to DECREASE in preload Answer: 1.
dehydration
2. vasodilation
◉ Define Afterload Answer: Resistant force that the ventricles must
pump against. Work that the ventricles must do to push blood
through the aorta into the periphery of the body
◉ Define Contractility Answer: The amount of force exerted by the
heart with each contraction
◉ Name one factor that decreases contractility in the heart Answer:
hypoxemia
◉ How does dopamine affect heart function Answer: increases
contractility and stroke volume
◉ Describe the conduction pathway of the heart Answer: SA node -
Atrium - AV node - Bundle of His - Ventricle - Purkinje Fibers
◉ Define Chronic Heart Failure Answer: The hearts inability to
pump oxygenated blood to the body due to abnormalities in the
heart and other areas of the body. Contributing to edema, resp.
distress, activity intolerance, and growth failure
,◉ Name 2 compensatory mechanisms of Chronic Heart Failure
Answer: 1. Activation of the Sympathetic Nervous System
2. Cardiac reserve; i.e. hypertrophy and dilation of cardiac muscle
◉ Describe Right Sided Heart Failure Answer: RV is unable to pump
blood efficiently into the Pulmonary artery, so blood backs up into
veins and periphery of body
◉ Describe Left Sided Heart Failure Answer: LV is unable to
effectively pump blood into aorta and out into body, so blood backs
up into pulmonary outlets and increases pressure in LA
◉ Name 3 causes of Chronic Heart Failure in Children Answer: 1.
Structural Abnormalities
2. Failure of the heart muscle
3. excessive demands on normal heart muscle
◉ List Manifestations of Impaired Myocardial function Answer: 1.
tachycardia
2. Sweating
2. Decreased UOP
3. fatigue
4. anorexia
, 5. decrease interest in activities
6. cardiomegaly
7. pale/cool extremities
8. decreased BP
◉ List manifestations of Right Sided Heart Failure Answer: 1. weight
gain
2. edema
3. hepatomegaly
4. ascites
5. distended neck veins
◉ List manifestations of Left Sided Heart Failure Answer: 1.
Tachycardia
2. dyspnia
3. Activity intolerance
4. persistent cough
5. cyanosis
6. wheezing/grunting
7. orthopnea
