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

In the GCS motor subscale, a score of 6 indicates the patient obeys commands, which is the highest possible motor response and indicates intact voluntary motor function.

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

After TBI, secondary brain injury from hypoxia, hypotension, hyperthermia, and elevated ICP causes most preventable deaths; maintaining CPP and oxygenation is the top priority.

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

Pediatric TBI guidelines recommend maintaining CPP between 40–65 mmHg (age-dependent), with 50–60 mmHg generally appropriate for school-age children to ensure adequate brain perfusion.

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

After two failed benzodiazepine doses, status epilepticus is refractory; second-line therapy with IV fosphenytoin or levetiracetam should be given per established treatment algorithms.

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

Uncal herniation compresses CN III, causing ipsilateral pupil dilation and loss of reactivity, while the herniated brain displaces the contralateral motor tract, producing contralateral weakness.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Neurological