Prepare CCRN-Pediatric Question Answers - CCRN-Pediatric Exam Dumps
Real AACN CCRN-Pediatric Exam Questions [Updated 2026]
NEW QUESTION # 69
A nurse enters the room of Jamal, a 3 year-old child, who is having a generalized seizure. Which intervention should the nurse do first?
- A. Give the ordered anticonvulsant
- B. Restrain Jamal
- C. Place him on side-lying position
- D. Clear the area of any hazards
Answer: B
Explanation:
Explanation: Protecting the airway is the top priority in a seizure. If a child is actively convulsing, a patent airway and oxygenation must be assured. Children usually have both cardiac and respiratory arrest.
NEW QUESTION # 70
A 9-year-old boy scout was treated with Lyme disease. He expresses fear of going camping again because of deer ticks. The nurse's best response would be:
- A. "I can't belive you're afraid of ticks"
- B. "frequent checking for ticks will prevent infection"
- C. "tell me more about your fears"
- D. " just think of all the fun that you're going to miss if you will not go on camping"
Answer: B
Explanation:
Explanation: The nurse's best response would be "frequent checking for ticks will prevent infection." It identifies the concern and presents an appropriate protective intervention. Frequent and prompt removal of ticks decreases the chance of spread of Lyme disease to humans.
NEW QUESTION # 71
A child is postoperative day 2 following a heart transplant. Which of the following suggests that the complications are likely related to prolonged clamping of the aorta?
- A. Increased heart rate
- B. Decreased urine output
- C. Decreased blood pressure
- D. Increased central venous pressure
Answer: B
Explanation:
Prolonged aortic cross-clampingcan impairrenal perfusion, especially during cardiac surgery.Decreased urine outputpostoperatively may be a sign ofacute kidney injury (AKI)secondary to hypoperfusion during the clamping phase.
"Renal hypoperfusion during prolonged aortic cross-clamping may manifest postoperatively as oliguria or anuria, indicating renal compromise." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Postoperative Transplant Complications)
NEW QUESTION # 72
A patient on peritoneal dialysis has high blood glucose. Most likely cause is:
- A. Decreased pancreatic function
- B. Systemic corticosteroids
- C. Glucose in the dialysate
- D. Increased glucagon release
Answer: C
Explanation:
Peritoneal dialysis usesdialysate fluid that contains glucoseto create an osmotic gradient for fluid removal.
This glucose can beabsorbed into the bloodstream, especially with prolonged dwell times, resulting in hyperglycemia, particularly in pediatric patients with small body mass.
"Glucose in peritoneal dialysis solutions may be systemically absorbed, causing elevated serum glucose levels, particularly in pediatric and insulin-sensitive patients." (Referenced from CCRN Pediatric - Direct Care: Endocrine/Renal, Dialysis Complications)
NEW QUESTION # 73
Charlie, an 8-month-old infant, had a clubfoot. A boot cast was applied to correct the problem. Which of the following assessment could not be determined while the boot cast is in place:
- A. Pedal pulse
- B. blanching
- C. warmth
- D. color
Answer: A
Explanation:
Explanation: Pedal pulse is obviously not measurable while the boot cast is in place.
NEW QUESTION # 74
An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:
- A. Hypertrophic cardiomyopathy
- B. Kawasaki disease
- C. Rheumatic heart disease
- D. Pericarditis
Answer: B
Explanation:
Kawasaki disease is an acute vasculitis that primarily affects children under 5 and presents with classic signs:
fever, rash, conjunctivitis, strawberry tongue, and extremity changes. It may also causecoronary artery aneurysmsandconduction abnormalities, such as PR prolongation.
"Kawasaki disease presents with mucocutaneous inflammation, and cardiac complications may include myocarditis and conduction delays, such as first-degree AV block." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Inflammatory Heart Disease)
NEW QUESTION # 75
A toddler admitted to the hospital has malabsorption syndrome and later develops signs and symptoms of tetany. The nurse is aware that this is due to insufficient absorption of:
- A. Calcium
- B. Sodium
- C. Potassium
- D. Zinc
Answer: A
Explanation:
Explanation: Muscle contraction and relaxation cycle needs normal serum calcium: phosphorous ratio.
The reduction of the ionized serum calcium level associated with malabsorption syndrome causes spastic muscle spasms.
NEW QUESTION # 76
An infant was diagnosed of Tetralogy of Fallot. The nurse assessed that the infant is underweight. What could be the reason behind this problem:
- A. deficient caloric intake due to activity intolerance.
- B. recurrent respiratory infections due to pulmonary hypertension.
- C. Polycythemia brought by a decreased in the level of arterial PO2.
- D. Cerebral changes due to cyanosis.
Answer: A
Explanation:
Explanation: Inadequate weight gain happens because the infant tires very easily, sufficient calories cannot be ingested to meet the nutritional needs. Other options do occur but they are indirectly related to weight gain.
NEW QUESTION # 77
Which of the following would a nurse expect to observe in a pediatric client who has a tentative diagnosis of Acute lymphocytic Leukemia:
- A. Anorexia and Insomnia
- B. Anorexia and Petechiae
- C. Alopecia and Petechiae
- D. Alopecia and swollen gums
Answer: B
NEW QUESTION # 78
A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?
- A. HR is 180
- B. Systolic BP greater than or equal to 78 mm Hg
- C. Systemic vascular resistance is 1820 dynes/sec/cm##
- D. Urine output is 7 cc/hr
Answer: C
Explanation:
Nitroprusside is used invasodilatory shockto reduce afterload andlower systemic vascular resistance (SVR)
. A persistently elevated SVR (normal: ~800-1200 dynes/sec/cm##) indicatesineffective vasodilation, necessitating an increase in dosage to optimize cardiac output.
"SVR is an essential parameter in the management of septic shock. Nitroprusside is titrated to decrease SVR and improve tissue perfusion. A persistently high SVR suggests inadequate response to therapy." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular Shock and Hemodynamic Monitoring)
NEW QUESTION # 79
A 9-year-old child is attending a new school in Manitoba. Her teachers assess her behavior over 6 months and then reported it to the school nurse. The nurse suspects that the child shows behaviors related to ADHD. This adaptation would include:
- A. hatred and hostility
- B. increased mental ability
- C. restlessness and impulsivity
- D. good peer relationship
Answer: C
Explanation:
Explanation: Maladaptive behavior for at least 6 months duration characterized by inattention, impulsiveness, and over activity are the criteria for attention deficit hyperactivity disorder.
NEW QUESTION # 80
An adolescent patient presents with altered mental status following ingestion of unknown substances at a party. Lab values include an elevated serum ammonia. The nurse should anticipate an order for which of the following?
- A. Acetylcysteine
- B. Ipecac syrup
- C. Lactulose
- D. Vitamin K
Answer: C
Explanation:
Elevated serum ammoniais often associated withhepatic encephalopathyor metabolic disturbances.
Lactuloseis the standard treatment to reduce ammonia levels by promoting ammonia excretion via the GI tract.
"Lactulose lowers serum ammonia levels by converting ammonia into ammonium, which is then excreted in stool. It is a cornerstone in the treatment of encephalopathy caused by hyperammonemia." (Referenced from CCRN Pediatric - Direct Care: Gastrointestinal, Hepatic Failure and Encephalopathy)
NEW QUESTION # 81
The plan of care for a toddler with Kawasaki Disease should be based on the risk for development of which medical problem:
- A. coronary artery aneurysm
- B. embolism
- C. blood vessel occlusion
- D. vessel plaque formation
Answer: A
Explanation:
Explanation: Kawasaki Disease involves all the small and medium-sized blood vessels. There is progressive inflammation of the small vessels which progresses to the medium-sized muscular arteries, potentially damaging the walls and leading to coronary artery aneurysms.
NEW QUESTION # 82
A nurse enters the room of Daniel, 2 and a half year old, to administer an oral medication. When he the nurse asked if he is ready to take his medicine, he says, "No!" What would be the most appropriate action?
- A. Leave the room and return after 5 minutes then give the medicine
- B. Explain to Daniel that the medicine must be taken now
- C. Give the medication to the mother and request her to give it
- D. Mix the medication with ice cream or apple juice
Answer: A
Explanation:
Explanation: Since the nurse gave the child a choice about taking the medication, the nurse should comply with the child's answer in order to build or maintain trust. Remember that toddlers do not have an accurate sense of time, leaving the room and coming back later is another episode to the toddler.
NEW QUESTION # 83
After arterial switch surgery, an infant shows ST elevation, low oxygen saturation, and frothy secretions. Most likely cause?
- A. Left ventricular dysfunction
- B. Endotracheal tube obstruction by secretions
- C. Symptoms of bronchiolitis due to RSV
- D. Right to left shunting through a residual VSD
Answer: D
Explanation:
ST segment elevationindicatesmyocardial ischemia, andfrothy secretions + desaturationsuggest pulmonary edemaor shunting. Aresidual ventricular septal defect (VSD)post-surgery can lead toright-to- left shunting, bypassing the lungs and resulting inhypoxemiadespite adequate ventilation.
"Residual intracardiac shunts, especially VSDs, can lead to desaturation and heart failure symptoms post arterial switch. ST changes suggest myocardial ischemia secondary to hypoxia." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Postoperative Congenital Heart Disease Complications)
NEW QUESTION # 84
Which of the following is true about Mongolian Spots?
- A. Are indicative of parental abuse
- B. Are linked to pathologic conditions
- C. Disappears in about a year
- D. Are managed by tropical steroids
Answer: C
Explanation:
Explanation: Mongolian spots are stale grey or bluish patches of discoloration commonly seen across the sacrum or buttocks due to accumulation of melanocytes and they disappear in 1 year. They are not linked to steroid use and pathologic conditions.
NEW QUESTION # 85
Following a MVC with prolonged entrapment of the legs, a 7-year-old has:
* BP: 75/40
* HR: 145
* K#: 5.9 mEq/L
* Hypocalcemia
* Elevated CK
What urine output should the nurse expect?
- A. Anuria
- B. >4 cc/kg of clear, colorless urine
- C. Yellow urine with clots of blood
- D. Red-brown "tea" color urine
Answer: D
Explanation:
This is consistent withrhabdomyolysis, which causesmuscle breakdown and release of myoglobininto the bloodstream.Myoglobinuriaresults indark red-brown or "tea-colored" urine, and is nephrotoxic, contributing to acute kidney injury.
"Crush injuries and elevated CK levels are hallmarks of rhabdomyolysis. Myoglobinuria presents as dark, tea-colored urine, and requires prompt fluid management to prevent renal damage." (Referenced from CCRN Pediatric - Direct Care: Renal, Electrolyte Imbalances and Rhabdomyolysis)
NEW QUESTION # 86
A nurse is aware that a child with AIDS is more prone to infection than an adult with AIDS because:
- A. child with AIDS is exposed to more pathogen than an adult with AIDS.
- B. the AIDS virus attacks child's immune systems through a different mechanisms
- C. the immune system of a child is incapable of producing antibodies.
- D. a child has fewer circulating antibodies resulting from a lack of previous exposure to pathogens.
Answer: D
Explanation:
Explanation: Adults have higher levels of antibodies than children because over time they have been exposed to more pathogens. Other options are incorrect because in comparison, they do not differ.
NEW QUESTION # 87
A 1-month-old presents with a 3-day history of fever, nausea, and vomiting. On assessment:
* Pink, warm, dry skin
* Slightly sunken fontanel
* BP: 80/40
* HR: 120
* RR: 42
Which of the following changes indicate deterioration?
- A. Hypoventilation and decreased level of consciousness
- B. Hyperventilation and increased BP
- C. Hyperventilation and decreased level of consciousness
- D. Hypoventilation and increased BP
Answer: A
Explanation:
In neonates and young infants,hypoventilationanddecreased level of consciousness (LOC)are late and critical signs ofdecompensationin systemic infection or shock. A progression from normal respiratory rate to hypoventilation, especially with altered LOC, indicatesimpending respiratory failure or septic shock.
"Hypoventilation and changes in mental status (such as lethargy or decreased LOC) are indicators of deterioration in infants with sepsis or dehydration. Immediate intervention is required to prevent arrest." (Referenced from CCRN Pediatric - Direct Care: Multisystem, Pediatric Sepsis and Deterioration Cues)
NEW QUESTION # 88
On assessment, the nurse notes that a 10-month-old child searches for and retrieves toys that disappear from view. Based on Piaget's stages of cognitive development, the nurse would recommend which of the following toys or games?
- A. Nesting toys
- B. Peek-a-boo
- C. Rattle
- D. Throw and retrieve
Answer: A
Explanation:
Explanation: A nesting toy makes a good toy for a 10-month-old infant. At 8 to 12 months, or during the coordination of secondary reactions, the child begins to learn that objects in the environment are permanent. That is why the child searches for and retrieves toys that disappear from view. It is also during this time that infants experience separation anxiety.
NEW QUESTION # 89
In a 3-year-old diagnosed with hemolytic uremic syndrome, which of the following findings requires immediate intervention?
- A. ECG showing PR interval of 0.12 sec
- B. Positive guaiac test and 3+ protein in the urine
- C. Weight gain of 2 kg in 24 hours
- D. ECG showing peaked, tented T waves
Answer: D
Explanation:
Peaked T waveson ECG are a hallmark ofhyperkalemia, which is a life-threatening electrolyte imbalance commonly seen inhemolytic uremic syndrome (HUS)due to acute kidney injury. This requiresimmediate interventionto prevent cardiac arrhythmias.
"In patients with HUS, hyperkalemia is a critical electrolyte disturbance. Peaked T waves are a warning sign of impending cardiac complications and demand emergent treatment." (Referenced from CCRN Pediatric - Direct Care: Renal, Hemolytic Uremic Syndrome and Electrolyte Emergencies)
NEW QUESTION # 90
The nurse assesses delayed gross motor development for Daniel who is 3 years old. Daniel's inability to do which action confirms this finding:
- A. ride a small bicycle
- B. catch a small basketball
- C. stand using 1 foot
- D. skip on alternate feet
Answer: C
Explanation:
Explanation: At this age, gross motor development allows a child to balance on 1 foot.
NEW QUESTION # 91
A nurse is caring for a toddler with atopic dermatitis. The nurse should instruct the mother to:
- A. wrap the baby's hands in mittens or socks to prevent scratching
- B. dress the child warmly to avoid chilling
- C. clean the affected areas with tepid water and detergent
- D. keep the baby away from other children while rashes are present.
Answer: A
Explanation:
Explanation: A child with atopic dermatitis needs to have short fingernails and covered so the child will not be able to scratch the lesions, thereby causing new lesions and possible a secondary infection.
NEW QUESTION # 92
A child has a fever, moderate hypertension, petechiae, decreased urinary output, and bloody diarrhea.
A nurse should suspect:
- A. Hepatorenal syndrome
- B. Nephrotic syndrome
- C. Acute glomerulonephritis
- D. Hemolytic uremic syndrome
Answer: D
Explanation:
Hemolytic uremic syndrome (HUS)is commonly preceded by a diarrheal illness, often caused byE. coli O157:H7. Classic triad:microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury
-often with petechiae, hypertension, and decreased urine output.
"HUS presents in children as a post-infectious complication, typically following bloody diarrhea. It manifests with renal failure, anemia, thrombocytopenia, and neurologic or hypertensive symptoms." (Referenced from CCRN Pediatric - Direct Care: Renal Dysfunction and Hematologic Disorders)
NEW QUESTION # 93
Dustin, a 3-year-old boy, was admitted to the hospital with nephritic syndrome. The nurse should assign a roommate who is:
- A. a 3-year-old girl with conjunctivitis
- B. a 3-year-old girl with thalassemia
- C. a 3-year-old boy with impetigo
- D. a 3-year-old boy with pneumonia
Answer: B
Explanation:
Explanation: A 3-year-old boy with nephritic syndrome could be assigned a roommate like a 3-year-old girl with thalassemia. A child with nephotic syndrome is at high risk for infection due to the lowered resistance. The child with thalassemia will be a best roommate because it is not communicable.
NEW QUESTION # 94
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