Pediatric CCRN Exam Pediatric CCRN Cardiovascular 2

Question 1

A 4-year-old post-Fontan procedure has rising lactate and falling mixed venous oxygen saturation. The MOST likely cause is:

Accepted Answer

Low cardiac output syndrome

Answer

Rising lactate and falling SvO2 are hallmarks of low cardiac output syndrome, indicating tissues are extracting more oxygen due to inadequate delivery.

Question 2

Which vasoactive agent is MOST appropriate as first-line therapy for a child in septic shock with poor cardiac contractility?

Accepted Answer

Dobutamine

Answer

Dobutamine is a beta-1 agonist that increases myocardial contractility, making it the preferred agent when septic shock is accompanied by poor cardiac function.

Question 3

A 10-year-old develops complete heart block after surgical repair of an AV canal defect. What is the immediate intervention?

Accepted Answer

Initiate temporary epicardial pacing

Answer

Epicardial pacing wires are routinely placed during open-heart surgery; activating temporary epicardial pacing is the immediate treatment for postoperative complete heart block.

Question 4

In a child with hypoplastic left heart syndrome (HLHS) after stage I Norwood repair, a rising SaO2 to 95% MOST likely indicates:

Accepted Answer

Excessive pulmonary blood flow stealing from systemic circulation

Answer

In single-ventricle physiology, an SaO2 >85% suggests excessive pulmonary blood flow that is 'stealing' from systemic circulation, threatening vital organ perfusion.

Question 5

Which hemodynamic parameter BEST reflects preload in a pediatric patient on mechanical ventilation?

Accepted Answer

Stroke volume variation (SVV)

Answer

Stroke volume variation dynamically assesses fluid responsiveness and preload in mechanically ventilated patients and is more reliable than static pressures like CVP.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Cardiovascular 2