Pediatric CCRN Exam Pediatric CCRN Ultimate 3

Question 1

A 4-year-old on mechanical ventilation has a plateau pressure of 32 cmH₂O and peak pressure of 48 cmH₂O. What does the difference indicate?

Accepted Answer

Increased airway resistance

Answer

A large gradient between peak and plateau pressure reflects high airway resistance, commonly caused by bronchospasm, secretions, or a kinked ETT.

Question 2

A 7-year-old with RSV bronchiolitis has an SpO2 of 88% on 2 L/min nasal cannula and increased work of breathing. What is the BEST next step?

Accepted Answer

Trial high-flow nasal cannula (HFNC) therapy

Answer

HFNC reduces work of breathing, improves oxygenation, and can avert the need for intubation in moderate bronchiolitis.

Question 3

A mechanically ventilated child has a sudden drop in SpO2 with right-sided breath sounds absent. Which immediate action is CORRECT?

Accepted Answer

Withdraw the ETT 1–2 cm and reassess breath sounds

Answer

Unilateral absent breath sounds after intubation suggest right mainstem bronchus intubation; withdrawing the ETT slightly should restore bilateral ventilation.

Question 4

Which arterial blood gas pattern is consistent with acute respiratory acidosis in a pediatric patient?

Accepted Answer

pH 7.28, PaCO2 58, HCO3 25

Answer

Acute respiratory acidosis shows a low pH with elevated PaCO2 and a normal or minimally elevated bicarbonate (no time for metabolic compensation).

Question 5

A 2-year-old with epiglottitis arrives in significant respiratory distress. Which action takes highest priority?

Accepted Answer

Allow the child to remain in a position of comfort and prepare for controlled intubation in the OR

Answer

Epiglottitis airway management is safest in the OR with anesthesia and ENT present; agitating the child can precipitate complete obstruction.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Ultimate 3