FREE Pediatric CCRN Sample Question and Answers

Question 1

Which of the following electrolyte problems should a nurse monitor when administering an exchange transfusion to a sickle cell patient?

Accepted Answer

Hypocalcemia

Answer

Exchange transfusions involve replacing the patient's blood with donor blood, which is typically preserved with citrate. Citrate acts as an anticoagulant by binding to calcium. When large amounts of citrated blood are infused rapidly during an exchange transfusion, the citrate can chelate the patient's circulating calcium, leading to a significant drop in serum calcium levels (hypocalcemia). Therefore, monitoring and potentially supplementing calcium are crucial during this procedure.

Question 2

Which of the following does positive end-expiratory pressure (PEEP) aim to accomplish?

Accepted Answer

Increase functional residual capacity

Answer

Positive end-expiratory pressure (PEEP) is a ventilatory maneuver that maintains a positive pressure in the airways at the end of exhalation. Its primary goal is to prevent alveolar collapse (atelectasis) and recruit collapsed alveoli, thereby increasing the functional residual capacity (FRC). By keeping alveoli open, PEEP improves oxygenation, reduces the work of breathing, and optimizes gas exchange.

Question 3

What desired outcome is achieved when amrinone lactate (Inocor) is administered?

Accepted Answer

Vasodilation

Answer

Amrinone lactate (Inocor) is a phosphodiesterase inhibitor that increases intracellular cyclic AMP (cAMP) in both cardiac and vascular smooth muscle cells. In the heart, this leads to increased contractility (positive inotropy). In vascular smooth muscle, increased cAMP causes relaxation, resulting in systemic and pulmonary vasodilation, which reduces afterload. This dual action improves cardiac output by both strengthening contractions and reducing the resistance the heart pumps against.

Question 4

After taking prenatal vitamins with iron, a 5-year-old is receiving treatment in the PICU. The nurse assumes all of the following EXCEPT:

Accepted Answer

Administration of activated charcoal

Answer

The question asks what the nurse assumes *EXCEPT* when treating iron poisoning. Activated charcoal is generally ineffective in binding iron and is therefore not recommended for iron overdose. Iron is poorly adsorbed by charcoal, making it an unsuitable decontamination method. In contrast, whole bowel irrigation, gastric lavage (if early and large ingestion), and sometimes ipecac syrup (though less common now) are methods that might be considered for decontamination in severe iron poisoning, depending on the clinical situation and timing.

Question 5

Which of the following group of children might have a hypertensive crisis as shown by acidosis, hypothermia, and alveolar hypoxia?

Accepted Answer

Those with reactive pulmonary vascular bed

Answer

A reactive pulmonary vascular bed is prone to vasoconstriction, leading to increased pulmonary vascular resistance and pulmonary hypertension. This can cause a hypertensive crisis in the pulmonary circulation, resulting in poor gas exchange, alveolar hypoxia, and subsequent metabolic acidosis. Hypothermia can also be a consequence of severe physiological stress and poor perfusion in such critical states.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

FREE Pediatric CCRN Sample Question and Answers