Pediatric CCRN Exam Pediatric CCRN Critical Care 3

Question 1

A 6-year-old with acute liver failure develops asterixis, confusion, and an elevated ammonia level. Which dietary modification is part of hepatic encephalopathy management?

Accepted Answer

Protein restriction to 0.5-1 g/kg/day

Answer

Moderate protein restriction (0.5-1 g/kg/day) reduces ammonia production while preventing catabolism in hepatic encephalopathy.

Question 2

During assessment of a child in septic shock, you note a capillary refill time of 4 seconds, cool mottled extremities, and weak peripheral pulses. This presentation is consistent with which type of shock?

Accepted Answer

Cold (vasoconstricted) septic shock

Answer

Cool extremities, prolonged capillary refill, and weak peripheral pulses indicate cold septic shock with high systemic vascular resistance, common in children.

Question 3

A 2-year-old is admitted with 40% TBSA burns. Using the Parkland formula, what is the total fluid volume to be given in the first 24 hours if the child weighs 12 kg?

Accepted Answer

1920 mL

Answer

Parkland formula: 4 mL × kg × % TBSA = 4 × 12 × 40 = 1920 mL in the first 24 hours (half given in first 8 hours).

Question 4

A 14-year-old with type 1 diabetes is admitted in DKA with a blood glucose of 540 mg/dL, pH 7.1, and bicarbonate of 8 mEq/L. The initial fluid of choice is:

Accepted Answer

0.9% Normal saline (isotonic saline)

Answer

Initial resuscitation in DKA uses isotonic saline (0.9% NS) to restore intravascular volume before transitioning to hypotonic fluids.

Question 5

A child with severe traumatic brain injury has an ICP of 28 mmHg and a MAP of 65 mmHg. What is the cerebral perfusion pressure (CPP)?

Accepted Answer

37 mmHg

Answer

CPP = MAP – ICP = 65 – 28 = 37 mmHg; a CPP <40-50 mmHg in children indicates inadequate cerebral perfusion.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Critical Care 3