Pediatric CCRN Exam Pediatric CCRN Respiratory

Question 1

A 2-year-old with bronchiolitis on high-flow nasal cannula has worsening work of breathing. What parameter BEST indicates the need to escalate to non-invasive ventilation?

Accepted Answer

Respiratory rate of 60 with subcostal retractions and poor feeding

Answer

Increasing work of breathing with retractions, tachypnea, and poor feeding despite high-flow oxygen signals impending respiratory failure requiring escalation to CPAP or BiPAP.

Question 2

Which ventilator strategy is recommended for pediatric ARDS to minimize ventilator-induced lung injury?

Accepted Answer

Low tidal volumes (4–6 mL/kg) with permissive hypercapnia

Answer

Lung-protective ventilation using low tidal volumes (4–6 mL/kg IBW) with permissive hypercapnia minimizes volutrauma and barotrauma in pediatric ARDS.

Question 3

A 7-year-old post-op with a right-sided chest tube has sudden respiratory distress, absent breath sounds on the left, and tracheal deviation to the right. The MOST likely diagnosis is:

Accepted Answer

Left-sided tension pneumothorax

Answer

Absent left breath sounds, tracheal deviation away from the left, and sudden respiratory distress indicate a left-sided tension pneumothorax compressing mediastinal structures.

Question 4

What is the MOST common trigger for status asthmaticus requiring PICU admission in children?

Accepted Answer

Viral upper respiratory infection

Answer

Viral URIs (most commonly rhinovirus) are the predominant trigger for acute severe asthma exacerbations requiring pediatric intensive care unit admission.

Question 5

A 4-year-old with croup (laryngotracheobronchitis) has a Westley croup score of 8. Which intervention is MOST appropriate?

Accepted Answer

Nebulized racemic epinephrine and parenteral dexamethasone with observation

Answer

A Westley score of 8 indicates moderate-to-severe croup; nebulized racemic epinephrine provides rapid relief while systemic dexamethasone reduces airway inflammation and edema.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Respiratory