Pediatric CCRN Exam Pediatric CCRN Renal 3

Question 1

A 3-year-old with nephrotic syndrome (albumin 1.2 g/dL) develops sudden respiratory distress and decreased left-sided breath sounds. What complication has most likely occurred?

Accepted Answer

Pleural effusion

Answer

Severe hypoalbuminemia in nephrotic syndrome reduces plasma oncotic pressure, causing transudative fluid to accumulate in the pleural space and produce a pleural effusion.

Question 2

Which medication is considered FIRST-LINE treatment for minimal change disease, the most common cause of nephrotic syndrome in children?

Accepted Answer

Corticosteroids (prednisone)

Answer

Corticosteroids (prednisone) are the first-line treatment for minimal change disease, achieving remission in over 90% of pediatric patients.

Question 3

A child with AKI has a K+ of 6.8 mEq/L with peaked T-waves on ECG. After calcium gluconate is given, what is the NEXT pharmacological step?

Accepted Answer

Insulin with dextrose

Answer

After membrane stabilization with calcium, insulin (with glucose to prevent hypoglycemia) is administered to shift potassium intracellularly, rapidly and transiently lowering serum potassium.

Question 4

In which clinical situation is the use of NSAIDs MOST dangerous and contraindicated due to risk of precipitating AKI in children?

Accepted Answer

Septic shock with hypotension

Answer

In septic shock with hypotension, renal perfusion depends on vasodilatory prostaglandins; NSAIDs inhibit prostaglandin synthesis and can precipitate AKI by critically reducing renal blood flow.

Question 5

A 12-year-old (40 kg) on CVVH has an effluent rate of 2,000 mL/hr. What is the CRRT dose in mL/kg/hr?

Accepted Answer

50 mL/kg/hr

Answer

CRRT dose = effluent rate ÷ body weight = 2,000 mL/hr ÷ 40 kg = 50 mL/kg/hr, which falls within the recommended pediatric CRRT dosing range.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Renal 3