Pediatric CCRN Exam Pediatric CCRN Sample 2

Question 1

A 3-year-old presents with inspiratory stridor, a barking cough, and low-grade fever. Which intervention is the priority?

Accepted Answer

Administer nebulized racemic epinephrine

Answer

Nebulized racemic epinephrine rapidly reduces subglottic edema in croup, providing immediate airway relief.

Question 2

A 7-year-old with known asthma has an SpO2 of 88%, accessory muscle use, and a silent chest on auscultation. What does the silent chest indicate?

Accepted Answer

Airflow is so severely obstructed that breath sounds are absent

Answer

A silent chest in asthma signals near-complete airflow obstruction—a life-threatening finding requiring immediate aggressive intervention.

Question 3

Which hemodynamic pattern is most consistent with septic shock in a 5-year-old in the early (warm) phase?

Accepted Answer

High CO, low SVR, warm extremities

Answer

Early septic shock (warm shock) is characterized by vasodilation (low SVR) and compensatory high cardiac output with warm, flushed extremities.

Question 4

A 10-year-old post-cardiac surgery has a sudden drop in BP, muffled heart sounds, and JVD. The nurse should suspect:

Accepted Answer

Cardiac tamponade

Answer

Beck's triad (hypotension, muffled heart sounds, JVD) is the classic presentation of cardiac tamponade following cardiac surgery.

Question 5

When calculating maintenance IV fluids using the Holliday-Segar method for a 25 kg child, how many mL/hour should be administered?

Accepted Answer

65 mL/hr

Answer

Holliday-Segar: 100 mL/kg for first 10 kg (1000) + 50 mL/kg for next 10 kg (500) + 20 mL/kg for remaining 5 kg (100) = 1600 mL/day ÷ 24 = ~65 mL/hr.

Pediatric CCRN Exam Practice Test