Pediatric CCRN Exam Pediatric CCRN Neonatal 5

Question 1

A neonate with suspected sepsis has cultures drawn and empiric antibiotics are started. Blood culture results at 48 hours show no growth. The neonate has been clinically improving. The BEST course of action is:

Accepted Answer

Discontinue antibiotics if clinical status is good and CRP trending down

Answer

In clinically improving neonates with negative cultures and normalizing inflammatory markers, antibiotic de-escalation at 48 hours is recommended to reduce antibiotic-associated complications.

Question 2

A NICU nurse notes that a 29-week neonate's endotracheal tube (ETT) has migrated. Chest X-ray shows the tube tip at the level of the carina. The MOST immediate action is:

Accepted Answer

Withdraw the ETT 1-2 cm and confirm placement

Answer

An ETT at the carina risks right mainstem intubation or atelectasis; the tube should be immediately withdrawn to the correct position (T2-T3) and placement confirmed.

Question 3

A term neonate has Apgar scores of 2 at 1 minute and 4 at 5 minutes. During neonatal resuscitation, positive pressure ventilation is initiated. After 30 seconds with adequate chest rise, heart rate remains 55 bpm. The NEXT step is:

Accepted Answer

Begin chest compressions at a 3:1 compression-to-ventilation ratio

Answer

Per NRP guidelines, chest compressions are initiated when heart rate remains <60 bpm despite 30 seconds of effective PPV, using a 3:1 compression-to-ventilation ratio.

Question 4

A nurse is caring for a neonate with gastroschisis immediately post-delivery. Which nursing intervention has the HIGHEST priority?

Accepted Answer

Covering exposed bowel with warm saline-soaked dressing and plastic wrap

Answer

Exposed bowel in gastroschisis must be immediately covered with warm saline-soaked gauze and a plastic wrap or bowel bag to prevent heat loss, fluid evaporation, and infection.

Question 5

A 34-week neonate with respiratory distress syndrome (RDS) is on mechanical ventilation. The nurse notes increasing peak inspiratory pressures with decreased breath sounds on the left. The MOST likely cause is:

Accepted Answer

Left-sided pneumothorax

Answer

Sudden increase in PIP with unilateral decreased breath sounds and hemodynamic instability in a ventilated neonate is most consistent with pneumothorax requiring emergency treatment.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Neonatal 5