CCRN Pediatric Practice Exam Questions

CCRN Pediatric Practice Exam Questions from AACN Questions With Complete Solutions To promote effective grieving in a 6-year-old sibling following

the death of an infant, the nurse should:

• Recommend that the sibling not attend the infant's

memorial service

• Encourage the parents to minimize their expression of

grief with the sibling

• Explain to the sibling that the infant went to heaven
• Explain to the sibling that thoughts and wishes did not

cause the infant's death - Correct Answers ✅Answer: D)

Explain to the sibling that thoughts and wishes did not cause

the infant's death: At age 6, children may take words literally

and because of their egocentrism, they believe that thoughts are all-powerful. They may truly believe they caused the death of their sibling. A simple, honest explanation of why the sibling died is indicated. This intervention is consistent with Caring Processes.

• Recommend that the sibling not attend the infant's

memorial service: This intervention is not a solution to the

problem and will not promote effective grieving for the sibling. It is not consistent with Caring Processes.

• Encourage the parents to minimize their expression of

grief with the sibling: This intervention will lead to ineffective

grieving for the sibling and is not consistent with Caring Processes

C) Explain to the sibling that the infant went to heaven: This

intervention will not address the sibling's problem 1 / 4

CCRN Pediatric Practice Exam Questions from AACN Questions With Complete Solutions A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at four weeks of age is admitted with increased somnolence, decreased appetite, and increased complaints of headache. This morning the child vomited

twice. The nurse should anticipate:

• The physician ordering lumbar puncture and blood and

urine cultures

• the patient having a CT scan followed by possible shunt

revision

• Administering mannitol or hypertonic saline
• Administering phenytoin (Dilantin) or fosphenytoin

(Cerebyx) - Correct Answers ✅Answer: B) The patient

having a CT scan followed by possible shunt revision: This

patient is demonstrating signs of increased intracranial pressure. The most likely etiology is malfunction of the VP shunt as a result of blockage or disconnection, which is particularly likely over time as the child grows. The definitive diagnosis is made by a CT scan and a shunt series. Surgical intervention for a shunt revision would be indicated.

• The physician ordering lumbar puncture and blood and

urine cultures: These interventions will not address the most

likely primary problem, which is suspected VP shunt malfunction. Additionally, lumbar puncture is contraindicated in the presence of increased intracranial pressure, because downward herniation of the brainstem can occur.

C) Administering mannitol or hypertonic saline: These

medication are indicated for the medical management of increased intracranial pressure, of which this patient has 2 / 4

CCRN Pediatric Practice Exam Questions from AACN Questions With Complete Solutions symptoms. However, they will not address the most likely primary problem, which is suspected VP shunt malfunction.

• Administering phenytoin (Dilantin) or fosphenytoin

(Cerebyx): These medications are indicated for seizure

management and would not address the patient's most likely primary problem, which is suspected increased intracranial pressure as a result of VP shunt malfunction An adolescent trauma patient is complaining of left upper quadrant abdominal pain radiating to the left shoulder. Blood pressure has dropped to 80/50. Which condition is most likely?

• Small Bowel Injury
• Cardiac Contusion
• Splenic Laceration

D) Pulmonary Embolism - Correct Answers ✅Answer: C)

Splenic laceration: Kehr's sign, which is referred pain to the

left shoulder during compression of the left upper abdominal quadrant, is an indication of splenic injury. Additional symptoms include tachycardia, hypotension, and leukocytosis

A) Small bowel injury: Signs of small bowel injury may include

progressive abdominal distension, not referred left shoulder pain.

B) Cardiac Contusion: Signs of cardiac contusion include

chest pain, arrhythmias, and other indicators of myocardial dysfunction, such as elevated cardiac isoenzymes. Upper 3 / 4

CCRN Pediatric Practice Exam Questions from AACN Questions With Complete Solutions quadrant abdominal pain with radiation to the left shoulder is not consistent with a cardiac contusion

D) Pulmonary Embolism: Symptoms of pulmonary embolism

include chest pain and dyspnea on exertion, not left shoulder pain An infant has been admitted with encephalitis. The nurse

should first assess the patient's:

• Pupillary response
• Blood glucose level
• Level of consciousness

D) Airway Patency - Correct Answers ✅Answer: D) Airway

Patency: The first priority after admitting an infant with

encephalitis is to assess the patient's ability to maintain airway patency. Such patients can develop rapid neurologic deterioration, and the nurse must be prepared to support the airway, oxygenation, and ventilation as needed.

A) Pupillary Response: The infant with encephalitis should be

monitored for changes in neurologic status, including pupillary response. However, assessing the patient;s ability to maintain airway patency is the first priority.

B) Blood Glucose Level: The infant with encephalitis will need

blood glucose levels monitored, especially if unable to maintain adequate oral intake. However, assessing the patient's ability to maintain airway patency is the first priority.

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