CCRN LEAKED DEFINITIONS RETAKE
ACTUAL ASSESSMENT EXAM 2025
UPDATED QUESTIONS AND CORRECT R,
Exams of Nursing
Which if the following is commonly seen in acute tumor lysis syndrome?
a Symptoms mimicking appendicitis
b Increased UOP
c Numbness and tingling
d Weight loss
c Numbness and tingling
Because of hypocalcemia, numbness and tingling are commomly seen. Decreased UOP and
weight gain are also seen.
The nurse is caring for a child who has been admitted with acute tumor lysis syndrome. The
nurse anicipates that the plan of care will include:
a Fluid restriction
b Allopurionol admin
c Potassium supplement admin
d Phosphorus supplement admin
b Allopurionol admin
Allopurinol is administered to decrease uric acid formation. The child is aggressively rehydrated,
K and phos are restricted.
The nurse is caring for a 12yo with chronic myelogenous leukemia. Her WBC is 275,000. Which
of the following should the nurse anticipate?
a Repeat the labs as WBC count is unusually high and not likely to been seen in a child with an
oncologic disorder
b Discontinue all chemo
c Prepare for an exchange transfusion
d Place the child on fluid restriction
c Prepare for an exchange transfusion
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,Management of hyperleukocytosis: aggressive IVF administration, immediate chemo, exchange
transfusions
A 14yo with a brain tumor complains that he feels very weak and is having neck pain. He is
noted to be ataxic having new onset bladder incontinence. A diagnosis of spinal cord
compression is made. When reviewing the plan of care, the nurse questions which component?
a An immediate MRI of the spine
b High dose steroids
c Surgical decompression
d Cessation of any radiation treatments
d Cessation of any radiation treatments
Management of spinal cord compression: MRI, immediate radiation therapy, high dose steroids,
surgical decompression
After obtaining a differential on a CBC, the eosinophils are noted to be 0.5%. Potential causes
could be:
a Trauma
b Eczema
c Asthma
d Parasitic disease
a Trauma
Situations causing stress lead to increased adrenal steroid production resulting in decreased
eosinophil production.
Eczema, asthma, and parasitic disease are assosiated with increased eosinophil production
Which of the following is consistent with DIC?
a PLT 18,000
b Fibrinogen 45,000
c Prothrombin time 12 sec
d D-dimer 580
c Prothrombin time 12 sec
In DIC, PLT and fibrinogen are decreased. Ptt and Ddimer are increased.
Which of the following represents the differences and similarities between ITP and DIC?
a The PLT are normal in DIC but decreased in ITP
b The PT and PTT are usually normal in both DIC and ITP
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,c The FSP is low in DIC and normal in ITP
d PLTs are decreased in both DIC and ITP
d PLTs are decreased in both DIC and ITP
A 7yo male with hemophilia B is currently experiencing moderate bleeding from an abrasion to
his shin. Which of the following would the nurse anticipate for this child?
a Recombinant factor IX
b DDVAP
c Recombinant factor VIII
d Monitor without medication administration as he is only experiencing mild bleeding
a Recombinant factor IX
Hemophilia B: managed with recombinant factor IX
Hemophilia A: managed with DDAVP + factor VIII
When 2 parents carry the sickle cell trait, the chance that each pregnancy will result in a child
who is a carrier is:
a 25
b 50
c 75
d 100
b 50
Sickle cell is an autosomal recessive disorder.
The nurse is caring for a 4yo with sickle cell disease who is admitted with a Vaso occlusive crisis.
The child's HR is 128 and oxygen sat is 96% on RA. The child rates his pain as an 8 on the FACES
scale. Which intervention is the priority?
a Consult child life to provide distraction
b Admin a 20ml/kg bolus of NS
c Admin oxygen via nasal cannula
d Admin an NSAID for pain
b Admin a 20ml/kg bolus of NS
Hydration is the priority intervention for a child experiencing a vaso-occlusive crisis.
A 9yo has been diagnosed with pheochromocytoma. Which of the following manifestations
would not likely be present?
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, a Pallor
b Hypotension
c Headaches
d Palpitations
b Hypotension
Pheochromocytoma is a catecholamine-secreting tumor that leads to HTN, HA, and palpitations
When orienting a new nurse, the preceptor knows that more education is needed when the
new nurse discusses erythropoietin and states that:
a Side effects include flu-like symptoms
b It can be admin in the absence of iron stores
c It can be admin for children with bone marrow suppression
d It promotes the production of RBCs
b It can be admin in the absence of iron stores
Iron stores are necessary for administration.
Which of the following is true concerning corticosteroids?
a They decrease migration of neutrophils an monocytes to areas of inflammation
b They increase vasculature capillary permeability
c They encourage the movement of cells from vascular space to tissue
d They increase the number of cells available to participate in inflammatory response
a They decrease migration of neutrophils an monocytes to areas of inflammation
By decreasing vasculature permeability, the movement of cells from the vascular space to the
tissue is prevented.
It is essential for blood to be administered within 4hrs to prevent:
a DIC
b Hemolysis of cells
c Transfusion reaction
d Bacterial infection
d Bacterial infection
The nurse is caring for a child who has received multiple transfusions of PRBCs. Which of the
following electrolyte imbalances should the nurse anticipate?
a hyperkalemia and hypocalcemia
4|Page
ACTUAL ASSESSMENT EXAM 2025
UPDATED QUESTIONS AND CORRECT R,
Exams of Nursing
Which if the following is commonly seen in acute tumor lysis syndrome?
a Symptoms mimicking appendicitis
b Increased UOP
c Numbness and tingling
d Weight loss
c Numbness and tingling
Because of hypocalcemia, numbness and tingling are commomly seen. Decreased UOP and
weight gain are also seen.
The nurse is caring for a child who has been admitted with acute tumor lysis syndrome. The
nurse anicipates that the plan of care will include:
a Fluid restriction
b Allopurionol admin
c Potassium supplement admin
d Phosphorus supplement admin
b Allopurionol admin
Allopurinol is administered to decrease uric acid formation. The child is aggressively rehydrated,
K and phos are restricted.
The nurse is caring for a 12yo with chronic myelogenous leukemia. Her WBC is 275,000. Which
of the following should the nurse anticipate?
a Repeat the labs as WBC count is unusually high and not likely to been seen in a child with an
oncologic disorder
b Discontinue all chemo
c Prepare for an exchange transfusion
d Place the child on fluid restriction
c Prepare for an exchange transfusion
1|Page
,Management of hyperleukocytosis: aggressive IVF administration, immediate chemo, exchange
transfusions
A 14yo with a brain tumor complains that he feels very weak and is having neck pain. He is
noted to be ataxic having new onset bladder incontinence. A diagnosis of spinal cord
compression is made. When reviewing the plan of care, the nurse questions which component?
a An immediate MRI of the spine
b High dose steroids
c Surgical decompression
d Cessation of any radiation treatments
d Cessation of any radiation treatments
Management of spinal cord compression: MRI, immediate radiation therapy, high dose steroids,
surgical decompression
After obtaining a differential on a CBC, the eosinophils are noted to be 0.5%. Potential causes
could be:
a Trauma
b Eczema
c Asthma
d Parasitic disease
a Trauma
Situations causing stress lead to increased adrenal steroid production resulting in decreased
eosinophil production.
Eczema, asthma, and parasitic disease are assosiated with increased eosinophil production
Which of the following is consistent with DIC?
a PLT 18,000
b Fibrinogen 45,000
c Prothrombin time 12 sec
d D-dimer 580
c Prothrombin time 12 sec
In DIC, PLT and fibrinogen are decreased. Ptt and Ddimer are increased.
Which of the following represents the differences and similarities between ITP and DIC?
a The PLT are normal in DIC but decreased in ITP
b The PT and PTT are usually normal in both DIC and ITP
2|Page
,c The FSP is low in DIC and normal in ITP
d PLTs are decreased in both DIC and ITP
d PLTs are decreased in both DIC and ITP
A 7yo male with hemophilia B is currently experiencing moderate bleeding from an abrasion to
his shin. Which of the following would the nurse anticipate for this child?
a Recombinant factor IX
b DDVAP
c Recombinant factor VIII
d Monitor without medication administration as he is only experiencing mild bleeding
a Recombinant factor IX
Hemophilia B: managed with recombinant factor IX
Hemophilia A: managed with DDAVP + factor VIII
When 2 parents carry the sickle cell trait, the chance that each pregnancy will result in a child
who is a carrier is:
a 25
b 50
c 75
d 100
b 50
Sickle cell is an autosomal recessive disorder.
The nurse is caring for a 4yo with sickle cell disease who is admitted with a Vaso occlusive crisis.
The child's HR is 128 and oxygen sat is 96% on RA. The child rates his pain as an 8 on the FACES
scale. Which intervention is the priority?
a Consult child life to provide distraction
b Admin a 20ml/kg bolus of NS
c Admin oxygen via nasal cannula
d Admin an NSAID for pain
b Admin a 20ml/kg bolus of NS
Hydration is the priority intervention for a child experiencing a vaso-occlusive crisis.
A 9yo has been diagnosed with pheochromocytoma. Which of the following manifestations
would not likely be present?
3|Page
, a Pallor
b Hypotension
c Headaches
d Palpitations
b Hypotension
Pheochromocytoma is a catecholamine-secreting tumor that leads to HTN, HA, and palpitations
When orienting a new nurse, the preceptor knows that more education is needed when the
new nurse discusses erythropoietin and states that:
a Side effects include flu-like symptoms
b It can be admin in the absence of iron stores
c It can be admin for children with bone marrow suppression
d It promotes the production of RBCs
b It can be admin in the absence of iron stores
Iron stores are necessary for administration.
Which of the following is true concerning corticosteroids?
a They decrease migration of neutrophils an monocytes to areas of inflammation
b They increase vasculature capillary permeability
c They encourage the movement of cells from vascular space to tissue
d They increase the number of cells available to participate in inflammatory response
a They decrease migration of neutrophils an monocytes to areas of inflammation
By decreasing vasculature permeability, the movement of cells from the vascular space to the
tissue is prevented.
It is essential for blood to be administered within 4hrs to prevent:
a DIC
b Hemolysis of cells
c Transfusion reaction
d Bacterial infection
d Bacterial infection
The nurse is caring for a child who has received multiple transfusions of PRBCs. Which of the
following electrolyte imbalances should the nurse anticipate?
a hyperkalemia and hypocalcemia
4|Page
