Pediatric CCRN Exam Pediatric CCRN Neurological

Question 1

A 4-year-old in the PICU has a Glasgow Coma Scale (GCS) score of 8. Which component of the pediatric GCS is CORRECTLY described?

Accepted Answer

Best motor response: 6 = obeys commands

Answer

Eye opening: 4 = opens to verbal command

Answer

Verbal response: 5 = oriented, coos/babbles appropriately for age

Answer

Motor response: 6 = withdraws from pain

Question 2

Which intervention is HIGHEST priority in the first hour of management of severe traumatic brain injury in a child?

Accepted Answer

Prevent secondary injury by maintaining adequate CPP and avoiding hypoxia/hypotension

Answer

Obtain MRI of the brain

Answer

Administer high-dose steroids

Answer

Initiate hypertonic saline prophylactically

Question 3

What is the TARGET cerebral perfusion pressure (CPP) range recommended for a 6-year-old with severe TBI?

Accepted Answer

50–60 mmHg

Answer

30–40 mmHg

Answer

40–50 mmHg

Answer

70–80 mmHg

Question 4

A 2-year-old has continuous focal seizure activity for 20 minutes unresponsive to two doses of benzodiazepines. What is the NEXT pharmacologic step?

Accepted Answer

Load IV fosphenytoin or levetiracetam

Answer

Administer a third dose of lorazepam

Answer

Start a midazolam infusion immediately

Answer

Perform emergent EEG only

Question 5

Which clinical sign indicates transtentorial (uncal) herniation in a child with elevated ICP?

Accepted Answer

Ipsilateral fixed and dilated pupil with contralateral hemiplegia

Answer

Bilateral pinpoint pupils

Answer

Bilateral fixed midposition pupils

Answer

Bilateral hyperreflexia

Question 6

A 3-year-old has an intracranial pressure (ICP) of 28 mmHg with a mean arterial pressure of 65 mmHg. What is the calculated cerebral perfusion pressure (CPP)?

Accepted Answer

37 mmHg

Answer

93 mmHg

Answer

28 mmHg

Answer

65 mmHg