Pediatric CCRN Exam Pediatric CCRN Pharmacology

Question 1

A 10 kg child requires an epinephrine infusion at 0.1 mcg/kg/min. Using the rule of 6, how many mg of epinephrine should be added to 100 mL of D5W to run at 1 mL/hr?

Accepted Answer

0.6 mg

Answer

Rule of 6: weight (kg) × 0.6 = mg to add to 100 mL; for 10 kg: 10 × 0.06 = 0.6 mg, resulting in a concentration where 1 mL/hr delivers 0.1 mcg/kg/min.

Question 2

Which opioid is CONTRAINDICATED in a child with renal failure requiring pain management in the PICU?

Accepted Answer

Meperidine

Answer

Meperidine's active metabolite normeperidine accumulates in renal failure, causing CNS excitation, tremors, and seizures, making it contraindicated in patients with impaired renal function.

Question 3

A 5-year-old receives IV vancomycin for MRSA bacteremia. Which monitoring parameter is MOST important to prevent toxicity?

Accepted Answer

AUC/MIC ratio via Bayesian pharmacokinetic monitoring

Answer

Current ASHP/IDSA guidelines recommend AUC/MIC-guided vancomycin dosing using Bayesian pharmacokinetic monitoring to optimize efficacy while minimizing nephrotoxicity.

Question 4

What is the CORRECT dose of IV atropine to treat symptomatic bradycardia in a 20 kg child?

Accepted Answer

0.02 mg/kg = 0.4 mg

Answer

The pediatric atropine dose for bradycardia is 0.02 mg/kg IV (minimum 0.1 mg, maximum 0.5 mg per dose); for a 20 kg child: 0.02 × 20 = 0.4 mg.

Question 5

A child in the PICU receives a continuous midazolam infusion for 5 days. When the infusion is weaned, the child develops agitation, tremors, and diaphoresis. This presentation is MOST consistent with:

Accepted Answer

Benzodiazepine withdrawal syndrome

Answer

Prolonged benzodiazepine infusions cause physical dependence; abrupt weaning produces a withdrawal syndrome with CNS excitability, autonomic instability (diaphoresis, tachycardia), and tremors.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Pharmacology