Pediatric CCRN Exam Pediatric CCRN Sample 3

Question 1

A 4-year-old with diabetic ketoacidosis (DKA) receives IV fluid resuscitation. Four hours later, the child complains of headache and becomes lethargic. The nurse's priority concern is:

Accepted Answer

Cerebral edema from rapid fluid shifts

Answer

Cerebral edema is the most feared complication of pediatric DKA treatment, presenting with altered mental status hours into fluid resuscitation.

Question 2

Which finding on a neonatal cardiac assessment most strongly suggests a ductal-dependent congenital heart lesion?

Accepted Answer

Differential oxygen saturation (preductal > postductal)

Answer

Preductal SpO2 higher than postductal SpO2 indicates right-to-left shunting through the ductus arteriosus, characteristic of ductal-dependent lesions like coarctation.

Question 3

A PICU nurse is preparing to administer a blood transfusion to a 2-year-old. What is the standard weight-based volume for a packed red blood cell transfusion in pediatrics?

Accepted Answer

10–15 mL/kg

Answer

The standard pediatric PRBC transfusion dose is 10–15 mL/kg, infused over 2–4 hours, to raise hemoglobin by approximately 2–3 g/dL.

Question 4

A 9-year-old on a ventilator has peak airway pressures of 42 cm H2O and plateau pressures of 20 cm H2O. What is the most likely cause?

Accepted Answer

Increased airway resistance from bronchospasm or secretions

Answer

A high peak pressure with a normal plateau pressure indicates increased resistance in the airways (bronchospasm, mucus), not reduced compliance.

Question 5

Which electrolyte imbalance is most likely in a child with prolonged nasogastric suctioning?

Accepted Answer

Hypokalemia and metabolic alkalosis

Answer

Gastric fluid loss via NG suctioning depletes hydrochloric acid, potassium, and sodium, resulting in hypokalemic, hypochloremic metabolic alkalosis.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Sample 3