Quality CCRN-Pediatric PDF Dumps - CCRN-Pediatric Exam Questions
Most UptoDate AACN CCRN-Pediatric Exam Dumps PDF 2025
NEW QUESTION # 22
An adolescent with recurrent leukemia expresses a desire to die peacefully. Weeks later, the patient is critically ill and the parents ask whether to escalate care. The nurse's most appropriate response is:
- A. "Legally you have the right to make that decision."
- B. "I will support whatever decision you decide upon."
- C. "Perhaps try one more day of treatment to see if there are any changes in condition."
- D. "As I remember, your child expressed a desire to die peacefully."
Answer: B
Explanation:
This situation represents a conflict betweenadolescent autonomyandparental authority. The nurse must maintain anonjudgmental, supportive role, allowing the family toexplore values and make informed decisionswithout imposing interpretation.
"In end-of-life situations, nurses should offer emotional support, facilitate shared decision-making, and respect family values. Supporting the decision-regardless of direction-is key." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: End-of-Life Ethics and Family- Centered Care)
NEW QUESTION # 23
An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant?
- A. Keeping the infant on bed rest to prevent energy loss
- B. Rotating caregivers to provide more stimulation
- C. Encouraging the infant to hold a bottle
- D. Maintaining a consistent, structured environment
Answer: D
Explanation:
Explanation: A nurse caring for an infant with nonorganic failure to thrive should maintain a consistent, structured environment that provides interaction with the infant to promote growth and development.
Encouraging the infant to hold a bottle would reinforce an uncaring feeding environment. The infant should receive social stimulation rather than be confined to bed rest. The number of caregivers should be minimized to promote consistency of care.
NEW QUESTION # 24
When assessing a newborn with cleft lip, the nurse would be alert which of the following will most likely be compromised:
- A. Locomotion
- B. GI function
- C. Respiratory status
- D. Sucking ability
Answer: D
Explanation:
Explanation: Because of the defect, the child will be unable to form the mouth adequately around the nipple thereby requiring special devices to allow feeding and sucking gratification. Respiratory status may be compromised when the child is fed improperly or during post op period.
NEW QUESTION # 25
A pediatric patient is admitted with severe sepsis and multi-organ dysfunction syndrome (MODS).
Which of the following treatments should a nurse anticipate initially?
- A. Continuous renal replacement therapy (CRRT), ventilator support, and chest physiotherapy(CPT)
- B. Vasopressors, chest physiotherapy (CPT), and total parenteral nutrition
- C. Vasopressors, fluid management, and ventilator support
- D. Vasodilators, continuous renal replacement therapy (CRRT), and parenteral nutrition
Answer: C
Explanation:
Initial management ofsevere pediatric sepsis and MODSfocuses onearly goal-directed therapy, including fluid resuscitation,vasopressors for perfusion, andventilator support for respiratory failure. This aligns with Pediatric Advanced Life Support (PALS) andAACNsepsis management protocols.
"In children with sepsis-induced MODS, the priority is to restore tissue perfusion through fluid resuscitation and initiate vasopressors if shock persists. Ventilator support is implemented for respiratory compromise.
These interventions are considered initial and lifesaving."
(Referenced from CCRN Pediatric - Direct Care: Multisystem Dysfunction and Sepsis Guidelines)
NEW QUESTION # 26
A patient asks the nurse to join in saying bedtime prayers. The nurse is not comfortable with this practice.
Which of the following is the nurse's most appropriate response?
- A. "Would you like me to call your chaplain?"
- B. "Let me call the social worker for you."
- C. "I'll stay with you while you pray."
- D. "Why don't you just pray by yourself?"
Answer: A
Explanation:
While respecting the patient's spiritual needs is critical, nurses are not required to participate in practices that conflict with their own beliefs. Offering to call the chaplain supports the patient's request while maintaining professional boundaries.
"Spiritual care includes recognizing the patient's right to religious support. If the nurse cannot participate, alternative arrangements, such as contacting the chaplain, must be offered to respect the patient's needs." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: Spiritual Support and Boundaries in Patient-Centered Care) Option D could falsely imply agreement to participate in prayer, which may be uncomfortable for the nurse.
Option C is both respectful and professionally appropriate.
NEW QUESTION # 27
For a patient with pulmonary aspiration, PEEP is used to:
- A. Decrease PIP
- B. Decrease functional residual capacity
- C. Improve oxygenation
- D. Decrease airway obstruction
Answer: C
Explanation:
Positive End-Expiratory Pressure (PEEP)helpskeep alveoli open at end-expiration, therebyincreasing functional residual capacityand improvinggas exchange. In aspiration-related lung injury, alveolar collapse and inflammation impair oxygenation, soPEEP is used to recruit alveoli and improve oxygenation.
"PEEP increases oxygenation by preventing alveolar collapse, especially important in aspiration pneumonitis and ARDS. It improves oxygen delivery while minimizing barotrauma." (Referenced from CCRN Pediatric - Direct Care: Pulmonary, Mechanical Ventilation Strategies)
NEW QUESTION # 28
A 3-year-old boy with Hemophilia is going to stat infusion of recombinant form of Factor VIII prophylactically three times a week. The nurse should advise the parents to administer the infusion on the days designated:
- A. before dinner
- B. in the morning
- C. after dinner
- D. after lunch
Answer: B
Explanation:
Explanation: Due to Hemophilia, Factor VIII should be given in the morning on designated days. The half- life is short. If it was given later in the day, protection would not be adequate when the child is most active and prone to bleeding.
NEW QUESTION # 29
Jessica, a 29-year-old mother, tells the nurse that her youngest son who is just 7-months-old can already sit without any support. The nurse should tell the mother that this:
- A. is a behavior which indicates that he is going to walk in the next 3 months.
- B. is an activity that shows the upper 10% of physical development.
- C. is a developmental milestone that is just expected at his age.
- D. could be a developmental delay which needs further evaluation.
Answer: C
Explanation:
Explanation: Sitting without support is an expected developmental milestone that is expected of a 7- month-old infant. It is done by extending the legs to the side and leaning forward on the hands. After a month, an infant is expected to sit steadily without the use of his hands or mother's support. Sitting alone cannot be a predictor of when the baby will start to walk.
NEW QUESTION # 30
A 7-year-old girl tells the nurse that several of her classmates teased her. The school nurse should responds correctly if she tells:
- A. "has this happened before"
- B. "Were they boys or girls"
- C. "tell me more about what happened"
- D. "This things happens to everyone"
Answer: C
Explanation:
Explanation: The school nurse will respond correctly is she tells "tell me more about what happened." The child has not stated why the teasing happened. Asking for clarification in a non threatening manner will be the first step of the assessment.
NEW QUESTION # 31
Which of the following nursing diagnosis would the nurse identify as the priority for a 4-month-old infant with heart failure and congenital heart disease:
- A. impaired mobility
- B. activity intolerance
- C. ineffective health maintenance
- D. risk for infection
Answer: B
Explanation:
Explanation: An infant with congenital heart disease and congestive heart failure tires very easily, leading to a priority nursing diagnosis of Activity Intolerance. Nursing care needs to focus on allowing the infant to have frequent rest periods. Infants with congenital heart disease and congestive heart failure are not necessarily at risk for more infections than other infants. Impaired Mobility usually is not a problem because an infant with congenital heart disease usually exhibits normal physical mobility.
Ineffective Health Maintenance usually is not a problem because these infants still need regular and routine health check-ups
NEW QUESTION # 32
On assessment, the nurse notes that a 10-month-old child searches for and retrieves toys that disappear from view. Based on Piaget's stages of cognitive development, the nurse would recommend which of the following toys or games?
- A. Throw and retrieve
- B. Peek-a-boo
- C. Nesting toys
- D. Rattle
Answer: C
Explanation:
Explanation: A nesting toy makes a good toy for a 10-month-old infant. At 8 to 12 months, or during the coordination of secondary reactions, the child begins to learn that objects in the environment are permanent. That is why the child searches for and retrieves toys that disappear from view. It is also during this time that infants experience separation anxiety.
NEW QUESTION # 33
During an exchange transfusion for sickle cell crisis, the patient becomes anxious and reports tingling and numbness around the mouth. The nurse should administer:
- A. Potassium
- B. Calcium
- C. Magnesium
- D. Lorazepam
Answer: B
Explanation:
Citrate, a preservative used in banked blood, binds withcalcium, causinghypocalcemia-a known complication ofrapid or large-volume transfusionslike exchange transfusion. Symptoms includeperioral tingling, numbness, muscle twitching, and anxiety. Administration ofIV calcium gluconate or calcium chlorideis indicated.
"Rapid transfusion of blood products can result in hypocalcemia due to citrate toxicity. Signs include tingling, muscle irritability, and anxiety. Calcium replacement is required." (Referenced from CCRN Pediatric - Direct Care: Hematology, Transfusion Reactions and Electrolyte Management)
NEW QUESTION # 34
The plan of care for a child with possible epiglottitis should include:
- A. An x-ray of the lateral neck
- B. ABG analysis
- C. A racemic epinephrine treatment
- D. Visualization of the airway
Answer: A
Explanation:
Epiglottitis is a life-threatening conditionoften caused by Haemophilus influenzae type B. It presents with stridor, drooling, and dysphagia. Direct visualization may provokelaryngospasm and complete airway obstruction, making itcontraindicated unless in a controlled OR environment. Alateral neck x-raymay reveal the "thumbprint sign" (swollen epiglottis) and is the safer diagnostic choice.
"For suspected epiglottitis, lateral neck radiographs are recommended prior to airway manipulation.
Visualization of the airway is avoided due to risk of precipitating obstruction." (Referenced from CCRN Pediatric - Direct Care: Pulmonary, Airway Emergencies)
NEW QUESTION # 35
Which of the following interventions is most effective in preventing pulmonary vasospasm in an infant with persistent pulmonary hypertension of the newborn (PPHN)?
- A. Aminophylline administration
- B. Minimal stimulation
- C. Alprostadil (Caverject) administration
- D. O# weaning
Answer: B
Explanation:
PPHNis a condition in which pulmonary vascular resistance remains abnormally high after birth. In this fragile state,handling or stresscan worsen pulmonary vasospasm.Minimal stimulation-such as reducing noise, light, and touch-is critical to preventing exacerbation.
"Infants with PPHN are highly sensitive to stress. Minimal stimulation reduces sympathetic discharge and prevents exacerbation of pulmonary vasoconstriction." (Referenced from CCRN Pediatric - Direct Care: Pulmonary, Neonatal Pulmonary Hypertension Management) Alprostadilis used in ductal-dependent congenital heart lesions, not in primary management of PPHN.
NEW QUESTION # 36
A patient is admitted with severe anemia requiring urgent intervention. The parents refuse the transfusion due to religious beliefs. The most appropriate action by the nurse is to:
- A. Immediately administer the transfusion to save the patient's life, regardless of the parents' wishes
- B. Consult the hospital's ethics committee and legal team while providing alternative treatments
- C. Respect the family's wishes to withhold the blood transfusion, and document their refusal
- D. Convince the parents to change their mind by emphasizing the severity and potential for fatality
Answer: B
Explanation:
When treatment is urgently required but parents refuse based onreligious beliefs, the nurse mustinvolve the ethics committee and legal team. This supports patient advocacy, honors familybeliefs, and ensures compliance with legal and ethical standards in pediatric care.
"In cases of refusal of life-saving treatment, the ethics team and legal counsel should be consulted. The nurse must not act unilaterally but advocate for the patient while respecting family beliefs." (Referenced from CCRN Pediatric - Professional Caring and Ethical Practice: Ethical Dilemmas and Legal Considerations in Pediatric Care)
NEW QUESTION # 37
A 2 year old boy was scheduled for an emergency surgery. It as noted that the mother is 16 year old and the father is 17 year old. The child's father and paternal grandfather, who care for the baby, are at the bedside. Informed consent should be signed by:
- A. the 17 year old father
- B. the 16 year old mother
- C. Paternal grandfather
- D. Surgeon and attending physician
Answer: A
Explanation:
Explanation: The child's father should be the one to sign the consent regardless of his age. In this case, parenthood confers the rights of an adult to the teenager. Informed consent can also signed by the mother if she is present. Option D is valid only if there's no relative that is present or if there's not enough time to obtain consent considering the condition of the patient.
NEW QUESTION # 38
Which of the following statements by the family of a child with asthma indicates a need for additional teaching:
- A. "We'll make sure he avoids exercise to prevent asthma attacks"
- B. "He is to use bronchodilator inhaler before steroid inhaler"
- C. "We need to identify what things triggers his attacks"
- D. "he should increase his fluid intake regularly to thin secretions"
Answer: A
Explanation:
Explanation: Asthmatic children don't have to avoid exercise. They can participate on physical activities as tolerated. Using a bronchodilator before administering steroids is correct because steroids are just anti-inflammatory and they don't have effects on the dilation of the bronchioles.
NEW QUESTION # 39
Which of these clients should the nurse assess first?
- A. A 3-year-old boy who had an episode of tonic-clonic seizure a day ago
- B. A 5-year-old child on a gluten-restricted diet initiated 48 hours ago
- C. A 10-year-old boy who is scheduled for a tonsillectomy in an hour
- D. A 6-month-old child sleeping quietly with bulging and tense anterior fontanel
Answer: D
Explanation:
Explanation: A bulging and tensed anterior fontanel is indicative of increased intracranial pressure, a serious medical problem. Increased pressure can damage the brain or the spinal cord; therefore, it should be the nurse's first priority. The child on a gluten-restricted diet would have adjusted to the diet and the child with an episode of seizure would have to be closely monitored. Though it is important to give preoperative preparations to the 10-year old for a tonsillectomy, it does not take priority over an infant with increased ICP.
NEW QUESTION # 40
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