Pediatric CCRN Exam Pediatric CCRN from AACN 5

Question 1

A 7-year-old post-liver transplant develops tacrolimus toxicity. Which finding is MOST expected?

Accepted Answer

Nephrotoxicity with rising creatinine and hypertension

Answer

Tacrolimus (a calcineurin inhibitor) commonly causes nephrotoxicity, presenting with rising creatinine and hypertension, requiring dose adjustment and close monitoring of drug levels.

Question 2

A 5-year-old with suspected non-accidental trauma (child abuse) has multiple bruises in various stages of healing. The nurse's LEGAL obligation is to:

Accepted Answer

Report the suspicion to child protective services (CPS) and document findings

Answer

Nurses are mandatory reporters and are legally obligated to report suspected child abuse to CPS regardless of confirmation; documentation of objective findings is essential.

Question 3

A 12-year-old with acute kidney injury (AKI) has oliguria and a rising BUN/creatinine ratio >20:1. This pattern MOST suggests:

Accepted Answer

Prerenal azotemia from volume depletion

Answer

A BUN:creatinine ratio >20:1 with oliguria indicates prerenal azotemia, where decreased renal perfusion causes urea retention disproportionate to creatinine.

Question 4

An 8-year-old post-cardiopulmonary bypass develops junctional ectopic tachycardia (JET). Which intervention is MOST appropriate?

Accepted Answer

Induce mild hypothermia to 35–36°C and correct electrolytes

Answer

JET post-cardiac surgery is managed with cooling to 35–36°C, correcting electrolytes (especially magnesium and potassium), and reducing catecholamines, as adenosine and cardioversion are ineffective.

Question 5

A neonate has SpO2 of 75% in the right hand and 95% in the right foot. This differential saturation pattern MOST suggests:

Accepted Answer

Transposition of the great arteries with patent ductus arteriosus

Answer

In transposition of great arteries with a PDA, oxygenated pulmonary blood flows right-to-left through the duct to the descending aorta, causing higher SpO2 in the lower body (post-ductal) than in the pre-ductal upper body.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN from AACN 5