Pediatric CCRN Exam Pediatric CCRN Neonatal 2

Question 1

A 28-week premature neonate has a PaCO2 of 28 mmHg on mechanical ventilation. Which complication is most associated with this finding?

Accepted Answer

Periventricular leukomalacia

Answer

Hypocarbia (low PaCO2) causes cerebral vasoconstriction, reducing blood flow and increasing risk of periventricular leukomalacia in premature neonates.

Question 2

A neonate born at 34 weeks is noted to have a bluish-purple discoloration of the hands and feet with a pink central body. This finding is best described as:

Accepted Answer

Acrocyanosis

Answer

Acrocyanosis is a normal finding in newborns characterized by blue discoloration of hands and feet with a pink trunk, caused by peripheral vasoconstriction.

Question 3

A neonate with suspected hypoxic-ischemic encephalopathy (HIE) is being evaluated. Which clinical finding would support initiating therapeutic hypothermia?

Accepted Answer

Cord blood pH of 6.98 with base deficit of -14

Answer

Therapeutic hypothermia criteria include cord blood pH ≤7.0 or base deficit ≥16, or pH 7.01-7.15 with base deficit 10-15.9 plus additional clinical criteria.

Question 4

A term neonate is started on prostaglandin E1 (PGE1) for a suspected ductal-dependent cardiac lesion. Which side effect requires the MOST immediate intervention?

Accepted Answer

Apnea

Answer

Apnea is the most life-threatening side effect of PGE1 and requires immediate airway management and may necessitate intubation.

Question 5

When calculating total fluid requirements for a neonate on day 1 of life weighing 1.2 kg, which factor most significantly increases insensible water losses?

Accepted Answer

Use of radiant warmer

Answer

Radiant warmers significantly increase insensible water losses (up to 50-100%) compared to closed incubators, requiring adjustment in fluid calculations.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Neonatal 2