PEDIATRIC CCRN EXAM STUDY GUIDE 2026
PRACTICE QUESTIONS AND SOLUTIONS
◉Resiliency . Answer: capacity to cope with illness and return to
previous level of function; discharge
◉Complexity . Answer: complicated relationship of 2 or more systems
(body, family, therapy)
◉Novice . Answer: maintains enviornment
◉Competent . Answer: individualizes environment; makes choices
◉Expert . Answer: anticipates
◉Middle east culture . Answer: right hand is clean, left is dirty
(diapers, feeding)
◉Undocumented medical preferences . Answer: can be used to guide
decisions; if expressed to family, that is enough
,◉Autonomy . Answer: get all the information they need to make a
decision
◉Veracity . Answer: truthfulness (documentation)
◉Fidelity . Answer: faithfulness and honoring commitments
◉Futility . Answer: if care will not improve the patient situation or
comfort it should not be done
◉State Practice Act . Answer: guides what you can do
◉Negligence . Answer: doesn't do what a reasonable nurse would do
◉Proximate cause . Answer: theres proof it could have been prevented
◉Direct cause . Answer: I am the cause of the injury
◉malpractice . Answer: failure to use standard or anticipates
consequences
◉Professional misconduct . Answer: failure to meet standard of care
,◉Diaphragm . Answer: used for inspiration; innervated by phrenic
nerve C3, 4, 5
◉Alveoli cells . Answer: epithelial cells
Type I - gas exchange
Type II - surfactant
◉Lung compliance . Answer: ability to stretch and recoil
◉High lung resistance . Answer: can cause barotrauma
◉Pediatric airways . Answer: narrow, small nostrils, large tongue, flex
of large head, decreased muscle tone, short trachea
◉V/Q Ratio . Answer: ration between the amount of air getting to the
alveoli and amount of blood sent to the lungs; usually more perfusion
(0.8)
◉Low V/Q . Answer: most common; decreased ventilation (pulm
edema, occlusion); increased CO2
◉High V/Q . Answer: wasted ventilation (trauma, shock)
, ◉Pulmonary vascular resistance . Answer: RV afterload main
determinant; lung volume, vasoconstriction, viscous blood
◉Tidal volume . Answer: amount of air inhaled AND exhaled; usually
5-8ml/kg
◉Functional residual volume . Answer: volume of air remaining after
normal expiration
◉Residual volume . Answer: volume remaining after forced expiration
◉Mixed venous oxygen saturation (SvO2) . Answer: end result of O2
consumption (65-75%);
◉Low SvO2 . Answer: low Hg, low CO, O2 consumption increased
◉High SvO2 . Answer: increased O2 delivery, reduced O2
consumption, left to right shunt
◉Acid-base buffers . Answer: respiratory is faster, but renal is better
◉Alkalosis . Answer: K is Lo(w); comes out of your mouth (CO2 and
vomit)
PRACTICE QUESTIONS AND SOLUTIONS
◉Resiliency . Answer: capacity to cope with illness and return to
previous level of function; discharge
◉Complexity . Answer: complicated relationship of 2 or more systems
(body, family, therapy)
◉Novice . Answer: maintains enviornment
◉Competent . Answer: individualizes environment; makes choices
◉Expert . Answer: anticipates
◉Middle east culture . Answer: right hand is clean, left is dirty
(diapers, feeding)
◉Undocumented medical preferences . Answer: can be used to guide
decisions; if expressed to family, that is enough
,◉Autonomy . Answer: get all the information they need to make a
decision
◉Veracity . Answer: truthfulness (documentation)
◉Fidelity . Answer: faithfulness and honoring commitments
◉Futility . Answer: if care will not improve the patient situation or
comfort it should not be done
◉State Practice Act . Answer: guides what you can do
◉Negligence . Answer: doesn't do what a reasonable nurse would do
◉Proximate cause . Answer: theres proof it could have been prevented
◉Direct cause . Answer: I am the cause of the injury
◉malpractice . Answer: failure to use standard or anticipates
consequences
◉Professional misconduct . Answer: failure to meet standard of care
,◉Diaphragm . Answer: used for inspiration; innervated by phrenic
nerve C3, 4, 5
◉Alveoli cells . Answer: epithelial cells
Type I - gas exchange
Type II - surfactant
◉Lung compliance . Answer: ability to stretch and recoil
◉High lung resistance . Answer: can cause barotrauma
◉Pediatric airways . Answer: narrow, small nostrils, large tongue, flex
of large head, decreased muscle tone, short trachea
◉V/Q Ratio . Answer: ration between the amount of air getting to the
alveoli and amount of blood sent to the lungs; usually more perfusion
(0.8)
◉Low V/Q . Answer: most common; decreased ventilation (pulm
edema, occlusion); increased CO2
◉High V/Q . Answer: wasted ventilation (trauma, shock)
, ◉Pulmonary vascular resistance . Answer: RV afterload main
determinant; lung volume, vasoconstriction, viscous blood
◉Tidal volume . Answer: amount of air inhaled AND exhaled; usually
5-8ml/kg
◉Functional residual volume . Answer: volume of air remaining after
normal expiration
◉Residual volume . Answer: volume remaining after forced expiration
◉Mixed venous oxygen saturation (SvO2) . Answer: end result of O2
consumption (65-75%);
◉Low SvO2 . Answer: low Hg, low CO, O2 consumption increased
◉High SvO2 . Answer: increased O2 delivery, reduced O2
consumption, left to right shunt
◉Acid-base buffers . Answer: respiratory is faster, but renal is better
◉Alkalosis . Answer: K is Lo(w); comes out of your mouth (CO2 and
vomit)
