Pediatric CCRN Exam Pediatric CCRN Critical Care 4

Question 1

A 9-month-old infant presents with inspiratory stridor, a barking cough, and a steeple sign on neck X-ray. What is the most appropriate initial treatment?

Accepted Answer

Racemic epinephrine and dexamethasone

Answer

Croup (laryngotracheobronchitis) is treated with nebulized racemic epinephrine for acute relief and dexamethasone to reduce airway edema.

Question 2

A 12-year-old with status asthmaticus is not responding to maximum bronchodilator therapy. Arterial blood gas shows pH 7.28, PaCO2 58, PaO2 62. Which indicates imminent respiratory failure requiring intubation?

Accepted Answer

Rising PaCO2 with respiratory acidosis despite maximal therapy

Answer

A rising PaCO2 (hypercapnia) with respiratory acidosis in a child with status asthmaticus signals respiratory muscle fatigue and imminent respiratory arrest.

Question 3

A 7-year-old receives a blood transfusion and develops fever, chills, back pain, and hemoglobinuria within 30 minutes. What type of transfusion reaction is occurring?

Accepted Answer

Acute hemolytic transfusion reaction

Answer

Acute hemolytic transfusion reactions present with fever, chills, flank/back pain, and hemoglobinuria due to ABO incompatibility causing intravascular hemolysis.

Question 4

A 3-year-old is suspected of having nonaccidental trauma. Which fracture pattern is MOST specific for child abuse?

Accepted Answer

Spiral fracture of the femur in a non-ambulatory child

Answer

Metaphyseal corner (classic metaphyseal lesion) and spiral fractures in non-ambulatory infants are highly suspicious for nonaccidental trauma.

Question 5

A PICU nurse is titrating a dopamine infusion for a child in cardiogenic shock. At which dose range does dopamine primarily exert beta-1 adrenergic (inotropic) effects?

Accepted Answer

2-10 mcg/kg/min (beta-adrenergic range)

Answer

At 2-10 mcg/kg/min, dopamine primarily stimulates beta-1 receptors, increasing heart rate and contractility (inotropic effect).

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Critical Care 4