Pediatric CCRN Exam Pediatric CCRN Neonatal 3

Question 1

A NICU nurse is caring for a neonate with persistent pulmonary hypertension of the newborn (PPHN). The physician orders inhaled nitric oxide (iNO). What is the primary mechanism of action?

Accepted Answer

Selective pulmonary vasodilation

Answer

Inhaled nitric oxide causes selective pulmonary vasodilation by stimulating cGMP production in pulmonary vascular smooth muscle without significant systemic effects.

Question 2

A 30-week neonate develops abdominal distension, bloody stools, and pneumatosis intestinalis on X-ray. Bell staging criteria place this neonate at Stage IIB. What intervention is MOST appropriate?

Accepted Answer

NPO, antibiotics, and abdominal decompression with bowel rest

Answer

NEC Stage IIB (moderate NEC) is managed medically with NPO status, nasogastric decompression, and broad-spectrum antibiotics for at least 14 days.

Question 3

A neonate born to a mother on methadone maintenance therapy is assessed using the Finnegan Neonatal Abstinence Scoring System. A score of 12 on two consecutive assessments should prompt:

Accepted Answer

Initiation of morphine or methadone pharmacotherapy

Answer

A Finnegan score ≥8 on two consecutive assessments or ≥12 on a single assessment indicates pharmacological treatment is needed for neonatal opioid withdrawal.

Question 4

During a blood transfusion, a neonate develops sudden cardiopulmonary deterioration with hypotension and desaturation. The nurse suspects transfusion-associated circulatory overload (TACO). The FIRST intervention should be:

Accepted Answer

Stop the transfusion and notify the physician

Answer

The first step in any suspected transfusion reaction, including TACO, is to immediately stop the transfusion and notify the physician for further assessment.

Question 5

A nurse is preparing to insert an umbilical arterial catheter (UAC) in a neonate. Which catheter tip position is considered the HIGH position and is preferred for most neonates?

Accepted Answer

T6-T9 (above the diaphragm)

Answer

The high UAC position (T6-T9) is above the diaphragm and is preferred as it avoids major branch vessels and reduces complication risks.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Neonatal 3