AACN CCRN EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
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.
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
Question 2
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
1
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,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.
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
Question 3
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
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,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
Question 4
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.
3
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, 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.
Question 5
The pediatric patient with suspected asphyxia from smoke inhalation will typically present
with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension
CORRECT ANSWER
Answer: C) Confusion: The patient with asphyxia from smoke inhalation will experience
cerebral hypoxemia and demonstrate symptoms of neurologic dysfunction, including
confusion
A) Tachypnea: While the patient with smoke inhalation may experience tachypnea as a result
of damage to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience cyanosis as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn injury may demonstrate
hypotension from fluid shifts, this symptoms is not specific to asphyxia
Question 6
An acutely ill infant is born to a Vietnamese family. The father asks few questions about
the infant's condition, and the mother asks none. Both parents appear to be proficient in
English. Which of the following is the most useful resource for a nurse caring for this
infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
4
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VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
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.
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
Question 2
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
1
@https://www.stuvia.com/user/thestudyvault
,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.
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
Question 3
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
2
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,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
Question 4
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.
3
@https://www.stuvia.com/user/thestudyvault
, 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.
Question 5
The pediatric patient with suspected asphyxia from smoke inhalation will typically present
with:
A) Tachypnea
B) Cyanosis
C) Confusion
D) Hypotension
CORRECT ANSWER
Answer: C) Confusion: The patient with asphyxia from smoke inhalation will experience
cerebral hypoxemia and demonstrate symptoms of neurologic dysfunction, including
confusion
A) Tachypnea: While the patient with smoke inhalation may experience tachypnea as a result
of damage to the lung parenchyma, this symptoms is not specific to asphyxia
B) Cyanosis: While the patient with smoke inhalation may experience cyanosis as a result of
damage to the lung parenchyma, this symptoms is not specific to asphyxia
D) Hypotension: While the patient with smoke inhalation and a burn injury may demonstrate
hypotension from fluid shifts, this symptoms is not specific to asphyxia
Question 6
An acutely ill infant is born to a Vietnamese family. The father asks few questions about
the infant's condition, and the mother asks none. Both parents appear to be proficient in
English. Which of the following is the most useful resource for a nurse caring for this
infant?
A) Classes conducted by the primary nurse as the need arises
B) An interpreter who is proficient in the parents' language
4
@https://www.stuvia.com/user/thestudyvault
