Pediatric CCRN Exam Pediatric CCRN Sample 5

Question 1

A 6-year-old on ECMO develops sudden loss of the ECMO flow waveform, circuit chattering, and hypotension. The nurse's first action should be:

Accepted Answer

Clamp the ECMO circuit and notify the ECMO specialist

Answer

Circuit chattering with flow loss suggests volume deficit or suction events; clamping the circuit and alerting the ECMO specialist prevents air entrainment and allows safe assessment.

Question 2

A 9-year-old with sickle cell disease presents with acute chest syndrome. Which set of interventions is most appropriate?

Accepted Answer

Supplemental O2, IV hydration, analgesics, and exchange transfusion if severe

Answer

Acute chest syndrome is managed with supplemental oxygen, careful hydration, analgesia, antibiotics, and exchange transfusion for severe hypoxemia.

Question 3

A 7-year-old post-operative Fontan procedure has a central venous pressure of 22 mmHg, low urine output, and hepatomegaly. The nurse suspects:

Accepted Answer

Fontan failure with elevated systemic venous pressure

Answer

Elevated CVP, hepatomegaly, and oliguria after Fontan indicate elevated systemic venous pressures secondary to Fontan circuit obstruction or failure.

Question 4

A nurse is titrating norepinephrine for a child in septic shock. Which clinical endpoint best indicates adequate perfusion has been restored?

Accepted Answer

Age-appropriate MAP, capillary refill < 2 seconds, and normal urine output (1 mL/kg/hr)

Answer

Perfusion adequacy in pediatric septic shock is assessed with age-appropriate MAP targets, capillary refill time, and urine output, not a single adult threshold.

Question 5

A premature neonate has abdominal distension, bloody stools, and pneumatosis intestinalis on X-ray. These findings are consistent with:

Accepted Answer

Necrotizing enterocolitis (NEC)

Answer

Pneumatosis intestinalis (air in the bowel wall) is pathognomonic for NEC, a life-threatening intestinal emergency in premature neonates.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Sample 5