Pediatric CCRN Exam Pediatric CCRN Critical Care 2

Question 1

A 3-year-old with bacterial meningitis develops a petechial rash, hypotension, and purpura fulminans. Which organism is most likely responsible?

Accepted Answer

Neisseria meningitidis

Answer

Neisseria meningitidis is classically associated with purpura fulminans and septic shock due to its endotoxin-mediated cascade.

Question 2

An infant is admitted with supraventricular tachycardia (SVT) at a rate of 240 bpm with signs of poor perfusion. What is the first-line treatment?

Accepted Answer

Synchronized cardioversion at 0.5-1 J/kg

Answer

Synchronized cardioversion is indicated for unstable SVT with hemodynamic compromise; the starting dose is 0.5–1 J/kg.

Question 3

A 7-year-old on mechanical ventilation has a sudden increase in peak airway pressure and decreased breath sounds on the left. The trachea is deviated to the right. What is the priority action?

Accepted Answer

Perform needle thoracostomy on the left

Answer

Clinical signs of tension pneumothorax (tracheal deviation, absent breath sounds, rising airway pressure) require immediate needle decompression without waiting for imaging.

Question 4

When calculating maintenance IV fluids using the Holliday-Segar method for a 25 kg child, how many mL/hour should be given?

Accepted Answer

75 mL/hr

Answer

Using Holliday-Segar: 100 mL/kg for first 10 kg + 50 mL/kg for next 10 kg + 20 mL/kg for remaining 5 kg = 1500 mL/24 hr = 62.5, rounded to 65; standard formula gives 1500 mL/day ÷ 24 = 62.5; for 25 kg: 1500 mL/day = 62.5 mL/hr, closest is 65.

Question 5

A 10-year-old with ARDS is on mechanical ventilation. Which lung-protective ventilation strategy is recommended?

Accepted Answer

Tidal volume 6-8 mL/kg IBW, plateau pressure <30 cmH2O

Answer

Lung-protective ventilation uses low tidal volumes (6-8 mL/kg IBW) and limits plateau pressure to <30 cmH2O to prevent ventilator-induced lung injury.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Critical Care 2