CCRN PEDS AACN Exam Questions and Answers, Exams of Pediatrics

Download CCRN PEDS AACN Exam Questions and Answers and more Exams Pediatrics in PDF only on Docsity! CCRN PEDS AACN Exam Questions And Answers 1. In caring for a patient with salicylate intoxication, the critical care nurse would anticipate which of the following as a primary treatment measure? A. Administration of protamine sulfate B. Administration of glucose C. Transfusion of packed RBCs D. Replacement of fluid and electrolytes correct answer D. Replacement of fluid and electrolytes 2. An adolescent with the developmental age of a 4-year-old requires placement of a chest tube. The best way to prepare the patient for this procedure is to A. Use short simple sentences and limit descriptions to concrete explanations. B. Show the patient a chest tube and explain how it will feel. C. Explain in detail why a chest tube is needed and how it works. D. Tell the parents what will be done so they can explain it to their child. correct answer Use short simple sentences and limit descriptions to concrete explanations. CCRN PEDS AACN Exam Questions And Answers 3. A child admitted with a gunshot wound to the head, accidentally inflicted by an older sibling. The parents are overcome with grief and appear to be ignoring the following statements made by the older sibling: "It was an accident; I didn't mean to do it; I'm sorry!" Which of the following actions by the nurse would be most appropriate? A. Discuss the importance of gun safety with the older sibling while the parents are at the bedside. B. Seek additional support for the parents for ways they can assist the older sibling C. Tell the parents that they need to provide support for the older sibling D. Tell the older sibling, "Accidents happen; I know you didn't mean to do it." correct answer Seek additional support for the parents for ways they can assist the older sibling 4. Which of the following laboratory findings is indicative of the syndrome of inappropriate ADH secretion (SIADH)? A. Serum sodium = 148 mEq/L B. Decreased serum osmolality C. Blood urea nitrogen (BUN) = 28 mg/dl D. Serum potassium = 5.1 mEq/L correct answer Decreased serum osmolality CCRN PEDS AACN Exam Questions And Answers D. A linear skull fracture correct answer Retinal hemorrhage 1. A 1-month-old infant presents with poor feeding, vomiting and diarrhea since birth. The infant is lethargic and in mild respiratory distress. The mother reports having another infant with the same symptoms who died at 2 months of age. Which finding would cause the nurse to suspect an inborn error of metabolism? A. micrognathia B. microglossia C. petite facial features D. abnormal urine odor correct answer abnormal urine odor 2. Cardiac defects associated with increased pulmonary blood flow place the patient at greatest risk for A. heart failure. B. systemic air emboli. C. hypoxemia. D. syncope. correct answer heart failure 3. Which ventilator parameters would be weaned first in a patient with bronchopulmonary dysplasia (BPD)? CCRN PEDS AACN Exam Questions And Answers A. VT and FiO2 B. peak inspiratory pressure and IMV C. FiO2 and IMV D. FiO2 and peak inspiratory pressure correct answer FiO2 and peak inspiratory pressure 4. Amrinone lactate (Inocor) produces which of the following effects? A. vasodilation B. phospholipid inhibition C. decreased myocardial contractility D. antagonism to other catecholamines correct answer vasodilation 5. Which of the following procedures would be most valuable in aiding management of a child requiring PEEP of 14 cm of water? A. ECMO therapy B. placement of a thoracostomy tube C. placement of a pulmonary artery catheter D. high-frequency ventilation correct answer high-frequency ventilation CCRN PEDS AACN Exam Questions And Answers 6. A 15-year-old patient underwent a classic Fontan repair of tricuspid atresia 12 hours ago. The patient is cool, diaphoretic, restless, mottled peripherally, with no pedal pulses and faint femoral pulses. Vital signs are: HR 140 MAP 60 mm Hg CVP 20 mm Hg Cardiac Index 2.1 L/min/m2 SVR 2000 dynes/sec/cm-5 The nurse should suspect A. a pulmonary embolus. B. cardiac tamponade. C. cardiogenic shock. D. hypovolemic shock. correct answer cardiogenic shock. 7. The nurse is providing patient education for a family whose child has cerebral palsy and will be receiving a Baclofen (Lioresal) pump to control spasticity. Which of the following is most important for the nurse to include in the discussion? A. The drug acts to inhibit the neurotransmitter gamma-amniobutyric acid (GABA). B. Parents can be taught to regulate the dosage based on symptoms. CCRN PEDS AACN Exam Questions And Answers C. Decreasing pulmonary flow and increasing systemic vascular resistance (SVR). D. Increasing systemic flow and relaxing the left ventricular outflow tract. correct answer Increasing pulmonary flow and relaxing the infundibulum. During surgery on a 2-month-old with Tetralogy of Fallot, a trans- thoracic PA catheter was placed. Upon removal of this line, the PA pressure is 29 mm Hg systolic. As the line is 'pulled back' into the right ventricle, the pressure measures 72 mm Hg systolic. RA Sat=72, PA Sat=72. This change in measurement may indicate a/an A. right bundle branch block. B. residual VSD. C. incompetent pulmonic valve. D. residual right ventricular outflow obstruction correct answer residual right ventricular outflow obstruction A 4-year-old has been admitted twice in the past six months for status asthmaticus. The parents smell of smoke when they come to the hospital, CCRN PEDS AACN Exam Questions And Answers but state they don't smoke in the house. The most appropriate discharge planning intervention would be to A. discuss with the parents how to avoid asthma triggers at home. B. give the parents literature about smoking cessation treatment and support groups. C. call Child Protective Services to report a medically unsafe home environment. D. remind parents they shouldn't smoke around the child. correct answer give the parents literature about smoking cessation treatment and support groups. A 4-year-old presents with a chief complaint of blood in her urine. A review of the medical records shows multiple admissions for the same symptom. No etiology has been found. The patient is symptomatic only when the mother is present. The most appropriate diagnosis for this patient would be A. Munchausen syndrome by proxy. B. non-accidental trauma. C. physical abuse CCRN PEDS AACN Exam Questions And Answers D. sexual abuse. correct answer Munchausen syndrome by proxy A 13-year-old male with diabetes is admitted after collapsing in class. On admission, he is tachycardic, has shallow respirations, dilated pupils, and is hyperreflexic. The plan of care would be to administer A. glucagon IM. B. naloxone (Narcan IV). C. 50% dextrose IV. D. regular insulin SQ. correct answer 50% dextrose IV. The initial therapy for children at risk for pulmonary embolus related to venous thromboembolism from a central venous line (CVL) is A. placement of an inferior vena cava filter. B. administration of anticoagulants. C. immediate removal of the CVL. D. thrombectomy by a surgeon. correct answer administration of anticoagulants CCRN PEDS AACN Exam Questions And Answers D. stridor and bronchospasm correct answer wheezing and agitation 21. Respiratory therapists, physical therapists, occupational therapists and nurses are all responsible for discharge teaching, with each discipline currently documenting on its own flow sheet. The best way to coordinate teaching would be to have A. daily care conferences to review and discuss patient teaching and the flow sheets. B. each discipline distribute copies of its flow sheets to each team member. C. nurses review the flow sheets of all disciplines during shift change. D. all disciplines document patient teaching on the same flow sheet. correct answer all disciplines document patient teaching on the same flow sheet A 10-day-old infant is admitted with a suspected congenital heart defect, a history of poor feeding, and sudden onset of respiratory distress and cyanosis. Initial assessment shows: CCRN PEDS AACN Exam Questions And Answers HR 180 pH 7.28 RR 72 pCO2 30 BP 48/Doppler pO2 48 CRT greater than 5 sec. HCO3 16 The patient is intubated and placed on mechanical ventilation at a rate of 20; PIP/PEEP=24/4 cm water; FiO2=100%. Subsequent ABG results show: pH 7.27 pCO2 28 pO2 50 HCO3 15 The most probable etiology of the patient's cardiopulmonary status is A. Tetralogy of Fallot. B. hypoplastic left heart syndrome. C. persistent pulmonary hypertension. D. diaphragmatic hernia. correct answer hypoplastic left heart syndrome CCRN PEDS AACN Exam Questions And Answers A teenager post cardiac arrest has a new diagnosis of hypertrophic cardiomyopathy. The parents are concerned about what to do if their son collapses again. The nurse's best response would be A. "Now that your son has been diagnosed and treated, you need not worry." B. "Would teaching you CPR help ease your anxieties?" C. "Do you know how to access the EMS system?" D. "I will have your son's cardiologist talk to you." correct answer "Would teaching you CPR help ease your anxieties?" A child is admitted after sustaining a head injury. The most important aspect of the nurse's continuing neurological assessment is A. level of consciousness. B. papillary response. C. motor response. D. assessment of the cranial nerves. correct answer level of consciousness CCRN PEDS AACN Exam Questions And Answers A. decreased activity. B. hypothermia. C. the radiant warmer. D. sedation. correct answer the radiant warmer The primary objective in the treatment of an infant with persistent pulmonary hypertension is to A. maintain the pH level at less than 7.40. B. dilate the pulmonary vascular bed. C. dilate the systemic vascular bed. D. constrict the pulmonary vascular bed. correct answer dilate the pulmonary vascular bed 31. A 26-week-gestation infant with multiple congenital abnormalities dies shortly after admission to the NICU. The parents saw the infant briefly in the delivery room, but decline to come to the NICU. The nurse should first CCRN PEDS AACN Exam Questions And Answers A. Take the infant to the parents. B. Refer the parents to a genetic counselor. C. Prepare a memory box for the parents. D. Take an instant photo of the infant to the parents. correct answer Take an instant photo of the infant to the parents. For an acetaminophen level of 140 mcg/mL, the treatment choice is A. activated charcoal. B. N-acetylcysteine (Acetadote). C. deferoxamine (Desferal). D. pralidoxime chloride (Protopam). correct answer N-acetylcysteine (Acetadote). 33. Which of the following actions would be appropriate after the administration of desmopressin (DDAVP) to a patient with diabetes insipidus? A. Decreasing IV fluid rate B. Maintaining current fluid rate C. Increasing sodium intake D. Decreasing glucose intake correct answer Decreasing IV fluid rate CCRN PEDS AACN Exam Questions And Answers 34. A 15-year-old with acute myelogenous leukemia has undergone multiple rounds of chemotherapy. One night, the patient tells the nurse, "I'm tired of all the chemo and I want to stop." The nurse should A. Explain the adolescent patients cannot legally make healthcare decisions B. Encourage the patient to, "express these feelings to your parents." C. Arrange for the patient to discuss the treatment plan with the physicians D. Ask the patient, "Do you realize you could die if you stop chemotherapy?" correct answer Encourage the patient to, "express these feelings to your parents." 35. A 9-year-old presents with recurrent episodes of intermittent palpitations associated with weakness. Physical examination is unremarkable. An ECG reveals a heart rate of 125 beats per minute, a shortened PR interval and a slurred upstroke prior to each widened QRS complex. This slurred upstroke (Delta wave) can be explained by A. Atrial pre-excitation B. Atrial depolarization C. Ventricular repolarization D. Ventricular pre-excitation correct answer Ventricular pre-excitation CCRN PEDS AACN Exam Questions And Answers pH 7.31 pCO2 50 pO2 80 HCO3 22 O2 Sat 95% The blood gases reflect A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Metabolic acidosis correct answer Respiratory acidosis 41. A 4-year-old has been admitted following repair of coarctation of the aorta. The child's vital signs are: HR 80 BP 150/80 RR 20 CVP 10 The arterial blood gas results are: pH 7.32 CCRN PEDS AACN Exam Questions And Answers pCO2 42 pO2 96 HCO3 23 The child is comfortable and resting quietly. The most likely cause of the hypertension is A. Expected physiologic response to an aortic incision B. Excessive volume expansion during the surgical period C. Diminished baroreflex sensitivity to changes in arterial pressure D. Inadequate pain control following a thoracotomy correct answer Diminished baroreflex sensitivity to changes in arterial pressure 42. A 10-year-old is admitted for colitis. Eight hours after admission the patient develops respiratory distress, abdominal distension and capillary refill time greater than 4 seconds. The nurse should suspect A. Aspiration pneumonia B. Malabsorption syndrome C. Adhesions D. Bowel perforation correct answer Bowel perforation 43. A hospital's current policy states that medication drips should be changed within 24 hours after surgery. Nurses note that many postoperative cardiac patients develop blood pressure instability after CCRN PEDS AACN Exam Questions And Answers inotrope syringes are changed. The best approach to solving this problem is to A. Notify the physician of a patient's blood pressure instability B. Disregard the policy and wait for the syringes to empty C. Form a committee to examine the problem and look for solutions D. Give a bolus of inotrope immediately prior to changing a drip correct answer Form a committee to examine the problem and look for solutions 44. An acutely ill infant is born to a Vietnamese family. The father asks few questions about the infant's condition and the mother asks none. Both parents appear to be proficient in English. Which of the following would be the most useful resource for a nurse caring for this patient? A. Classes conducted by the primary nurse as the need arises B. An interpreter proficient in the parents' language C. Information about Vietnamese culture D. Ongoing classes addressing the cultural needs of the local community correct answer Information about Vietnamese culture 45. The pediatric patient with suspected asphyxia from smoke inhalation will typically present with CCRN PEDS AACN Exam Questions And Answers A. Recommend that the sibling not attend the infant's memorial service B. Encourage the parents to minimize their expression of grief when with the sibling C. Explain to the sibling that the infant went to heaven D. Explain to the sibling that thoughts and wishes did not cause the infant's death correct answer Explain to the sibling that thoughts and wishes did not cause the infant's death 51. A patient admitted with multiple trauma develops flank pain, hematuria and costovertebral-angle tenderness. The nurse would suspect the child has experienced injury to the A. Pancreas B. Kidney C. Liver D. Bladder correct answer Kidney 52. Common laboratory findings associated with acute renal failure include an increase in the blood urea nitrogen (BUN) level, as well as which of the following changes in the concentrations of potassium and creatinine? CCRN PEDS AACN Exam Questions And Answers Potassium Creatinine A. increased increased B. decreased increased C. increased decreased D. decreased decreased correct answer increased increased 53. Prior to the administration of digoxin (Lanoxin), the nurse assesses the heart rate and rhythm, as well as the A. Serum calcium level and QRS duration B. Serum potassium level and PR interval C. Serum calcium level and QT interval D. Serum potassium level and ST segment correct answer Serum potassium level and PR interval 54. Medications used in the medical management of a closure of a PDA include A. Prostaglandin (PGE1) B. Digoxin (Lanoxin) C. Indomethacin (Indocin) D. Lasix (Furosemide) correct answer Indomethacin (Indocin) CCRN PEDS AACN Exam Questions And Answers 55. A patient with receptive aphasia and dementia is to be enrolled in a clinical trial. How should the nurse proceed to ensure informed consent is ethically obtained? A. Involve the patient's legal guardian in the consent process B. Ensure that the investigator is aware of the patient's condition C. Inform the institutional review board (IRB) of the potential risk to the patient D. Obtain a copy of the consent form to place in the patient's chart correct answer Involve the patient's legal guardian in the consent process 56. A 5-year-old with a history of congenital hydrocephalus and VP shunt placement at 4 weeks of age is admitted. Over the last two days the child has been sleeping more, appetite has decreased and complains of a headache. This morning the child vomited twice. The nurse should anticipate A. The physician ordering lumbar puncture and blood and urine cultures B. The patient getting a CT scan followed by possible shunt revision C. Administering mannitol or hypertonic saline D. Administering a loading dose of phenytoin (Dilantin) correct answer The patient getting a CT scan followed by possible shunt revision CCRN PEDS AACN Exam Questions And Answers D. Brisk capillary refill, increased urine output, hypoxemia and hyperthermia correct answer Hyperthermia, warm, pink flushed extremities, capillary refill time less than 2 seconds and hypotension 62. In the pediatric patient with severe trauma, the progression of multiple organ dysfunction syndrome (MODS) is typically A. Respiratory failure, cardiovascular collapse, pulmonary embolism, liver failure and infection B. Circulatory collapse, renal failure, respiratory failure, GI tract and liver failure, and infection. C. Respiratory arrest, hepatic failure, renal failure, cardiac arrest and disseminated intravascular coagulation (DIC). D. Circulatory collapse, respiratory failure, GI tract and liver failure, renal failure and neurological dysfunction correct answer Circulatory collapse, respiratory failure, GI tract and liver failure, renal failure and neurological dysfunction 63. A 5-year-old has been admitted after a motor vehicle crash. The child is tachypneic, pale and hypotensive; nailbeds are dusky. Paradoxical chest movement is observed. These signs and symptoms are most indicative of a A. Compound rib fracture CCRN PEDS AACN Exam Questions And Answers B. Fractured sternum C. Flail chest D. Ruptured diaphragm correct answer Flail chest 64. The purpose of administering mannitol (Osmitrol) to a patient with a head injury is to A. Deplete water from the intravascular space B. Raise the patient's serum osmolality C. Decrease the patient's serum osmolality D. Increase the patient's cerebral blood flow correct answer Raise the patient's serum osmolality 65. Following bronchoscopy for removal of a foreign body, the patient becomes dyspneic, with retractions and stridor. This is most likely due to A. Hypoxia B. edema C. anxiety D. atelectasis correct answer edema CCRN PEDS AACN Exam Questions And Answers 66. Which of the following cardiovascular complications is an expected finding during the initial stage of spinal shock following a spinal cord injury? A. Tachycardia B. Hypertension C. Hyperthermia D. Hypotension correct answer Hypotension 67. A major trauma patient is transported from a rural hospital. The patient died before arrival of the family to the ICU. The nurse would best prepare for the arrival of the family by planning to A. Give them information about the local bereavement support group B. Escort them to the waiting room to await the physician's arrival C. Provide them with information about the care the patient received prior to death D. Accompany them to the morgue to see the patient correct answer Provide them with information about the care the patient received prior to death CCRN PEDS AACN Exam Questions And Answers A. Uncompensated respiratory acidosis B. Compensated metabolic acidosis C. Alveolar hypoventilation D. Alveolar hyperventilation correct answer Alveolar hypoventilation 73. Which of the following conditions occurs at the renal tubular cell to initiate acute tubular necrosis? A. Azotemia B. Hyperphosphatemia C. Ischemia D. Hyperkalemia correct answer Ischemia 74. A 2-year-old is admitted with a diagnosis of hemolytic uremic syndrome. The child presents with petechial rash, bloody stools and oliguria. In addition to an increased BUN and creatinine, expected laboratory values should be Hgb HCT Platelets K+ A. 7.1 19.5 90,000 5.5 B. 3.1 36.7 117,000 4.5 C. 7.5 19.8 200,000 5.2 CCRN PEDS AACN Exam Questions And Answers D. 14.4 44.7 47,000 3.8 correct answer 7.1 19.5 90,000 5.5 75. A 10-month-old is admitted to the hospital due to abdominal distention and poor weight gain. The nurse should be concerned if the infant A. Stopped an action in response to being told "no." B. Turned the head when name was called C. Cried when a nurse entered the room D. Avoided eye contact with the nurse correct answer Avoided eye contact with the nurse 76. Which complication is most common in infants with congenital diaphragmatic hernia? A. Alveolar-arterial ratio mismatch B. Inhibition of surfactant delivery C. Left-to-right shunting through patent ductus arteriosus D. Sever pulmonary hypertension correct answer Sever pulmonary hypertension 77. The parent of a mechanically ventilated patient is to be taught how to suction. When developing a teaching plan, the nurse must first CCRN PEDS AACN Exam Questions And Answers A. Obtain written information about the procedure B. Determine a schedule for demonstrating the technique C. Assess the knowledge and skills the parent needs to learn D. Encourage the parent to observe the procedure on other patients correct answer Assess the knowledge and skills the parent needs to learn 78. Which of the following findings is indicative of diabetes insipidus (DI)? Serum Na+ Urine Specific Gravity A. 155 1.002 B. 140 1.005 C. 130 1.015 D. 12 1.030 correct answer A. 155 1.002 79. A 2-month-old born with spina bifida is admitted with dehydration and sepsis. Before the infant was discharged from the hospital a month ago the parents had been instructed on the proper technique and importance of performing catheterization every six hours. While interviewing the parents, the nurse learns this was not done CCRN PEDS AACN Exam Questions And Answers B. Loss of capture C. Excessive capture D. Oversensing correct answer Understanding 84. A child being treated for diabetic ketoacidosis (DKA) becomes lethargic, is difficult to arouse and has vomited twice in the past hour. These occurrences could be interpreted as indications of A. Exhaustion due to lack of sleep B. The development of hypoglycemia C. Decreased intestinal motility D. Increased ICP correct answer Increased ICP 85. When planning care for an infant who presents in status epilepticus, it is important for the nurse to understand that A. Most seizures are a symptom of a problem, not a disease entity B. A focal seizure cannot progress to a generalized tonic-clonic seizure. C. Child abuse should be considered a causative factor of seizures only if no obvious signs of trauma are noted D. Prolonged seizures do not result in brain damage correct answer Most seizures are a symptom of a problem, not a disease entity CCRN PEDS AACN Exam Questions And Answers 86. A patient's family expresses anxiety regarding the meaning of numbers on the patient's monitor and asks the nurse for clarification. The nurse's most appropriate response should be A. "The numbers indicate when the patient is having problems." B. "The numbers help us determine the best treatment." C. "Which numbers on the monitor concern you?" D. "What don't you understand about the monitor?" correct answer "Which numbers on the monitor concern you?" 87. A child presents with fever, tachycardia, BP 60/42, weak pulses, warm and flushed skin. The first intervention should be A. 20 mL/kg normal saline fluid bolus B. Epinephrine infusion at 0.05 mcg/kg/min C. Oxygen via endotracheal tube D. Dopamine (Inotrope) infusion at 3 mcg/kg/min correct answer 20 mL/kg normal saline fluid bolus 88. A neutropenic patient is admitted showing signs of respiratory infection. Blood and sputum cultures are obtained. The nurse should anticipated CCRN PEDS AACN Exam Questions And Answers A. Beginning antibiotics immediately B. Immediate placement in strict isolation C. No intervention until the causative organism is identified D. Transbronchial biopsy correct answer Beginning antibiotics immediately 89. A child weighing 15 kg is admitted with chronic renal failure. Which of the following assessment findings should be reported immediately? A. Urine output of 2-5 mL/hr B. Elevated BUN, elevated creatinine C. Hyperalbuminemia D. Headache, nausea and vomiting correct answer Urine output of 2-5 mL/hr 90. A 4-month-old born at 26-weeks is admitted with respiratory distress. The patient was discharged from the NICU with minimal O2 and an apnea monitor. Three weeks after admission the patient fails extubation for the third time, and it is determined that a tracheostomy and home ventilator will be needed. The nurse should CCRN PEDS AACN Exam Questions And Answers A. Leukemic relapse B. Viral infection C. Bacterial infection D. Normal count correct answer Bacterial infection 93. The pathophysiology of asthma can best be explained by A. Airway narrowing and T-lymphocyte activation B. Mast cell migration, V/Q mismatch and mucosal drying C. Bronchospasm, mucosal edema and tenacious secretions D. Cilliary paralysis and prolonged inspiratory phase correct answer Bronchospasm, mucosal edema and tenacious secretions 94. To verify a diagnosis of DIC, a significant laboratory findings is an elevation in A. Fibrin split products B. Prothrombin C. Fibrinogen D. Platelets correct answer Fibrin split products CCRN PEDS AACN Exam Questions And Answers 95. Children with acute renal failure run the risk of developing acute uremic encephalopathy. The first sign of cerebral dysfunction is often A. Confusion B. Tetany C. Asterixis D. Hemiparesis correct answer Confusion 96. In a patient with herpes simplex encephalitis, anticipated findings would include normal serum glucose and which of the following CSF values? Protein Glucose A. 70 mg/dL 60 mg/dL B. 70 mg/dL 240 mg/dL C. 150 mg/dL 120 mg/dL D. 150 mg/dL 180 mg/dL correct answer 70 mg/dL 60 mg/dL 97. Initially unconscious, post motor vehicle crash, a child is admitted awake and responsive. The child develops a severe localized headache and shows signs of rapid deterioration. The most likely cause would be CCRN PEDS AACN Exam Questions And Answers A. Acute subdural hematoma B. Epidural hematoma C. Subacute subdural hematoma D. Cerebral contusion correct answer Epidural hematoma 98. A child is diagnosed with Guillain-Barre syndrome. It would be imperative for the nurse to inform the physician after observing which of the following? A. Increasing hoarseness B. Tingling in the hands C. Weak muscle tone in feet D. Weak muscle tone in legs correct answer Increasing hoarseness 99. The nurse is caring for a patient experiencing a fourth episode of heart failure. The patient states, "I cannot take it anymore. I wish I could end all of this." A priority when caring for this patient's response to stress is to A. Place the patient in a hospital gown or pajamas B. Explore suicidal intent with the patient CCRN PEDS AACN Exam Questions And Answers 104. The nurse is caring for a 14-year-old patient who is day one status post resection of a brain tumor. The nurse would report the following assessment finding immediately: A. CPP 40 B. SBP 120-130 C. ETCO2 35 D. MAP 65 correct answer CPP 40 105. An infant is admitted after unsuccessful reduction of an intussception. Further assessment reveals abdominal distention, fever and hypoactive bowel sounds. The nurse should immediately notify the surgeon if the patient has A. Abdominal erythema B. Hypertension C. Tachycardia D. White stools correct answer Tachycardia 106. A 6-year-old is admitted with a temporal lobe skull fracture. Which type of bleed is suspected? CCRN PEDS AACN Exam Questions And Answers A. Chronic subdural hematoma B. Subarachnoid hematoma C. Acute subdural hematoma D. Acute epidural hematoma correct answer Acute epidural hematoma 107. A child is admitted with a tricyclic antidepressant overdose. The most common arrhythmias seen are A. Atrial B. Sinus C. Heart blocks D. Ventricular correct answer Ventricular 108. A 4-year-old with sickle cell disease is admitted with confusion, aphasia and complaints of "head hurting." An order for IVF and one unit of PRBCs is to be administered prior to MRI with contrast. The nurse explains to the mother that this is done because can A. Cause cerebral hemorrhage B. Increase sickling of hemoglobin C. Cause severe allergic reaction CCRN PEDS AACN Exam Questions And Answers D. Decrease circulation to the brain correct answer Increase sickling of hemoglobin 109. Which one of the following is the first action to take in the case of a patient with a suspected tension pneumothorax? A. Administer a NaCl fluid bolus B. Assist with intubation C. Call for a chest radiograph D. Prepare for a needle thoracostomy correct answer Prepare for a needle thoracostomy 110. A 3-year-old is admitted after being found in the family swimming pool. The family does not know how long he was in the pool before they found him. He is intubated on mechanical ventilation with no spontaneous respirations and does not respond to painful stimuli. The most likely reason for this is A. Temporary depletion of ATP B. Reversible failure of the sodium potassium C. Concurrent head injury when he fell into the pool D. Sever cerebral injury with neuronal death due to hypoxemia correct answer Sever cerebral injury with neuronal death due to hypoxemia CCRN PEDS AACN Exam Questions And Answers A. Ventilator-associated pneumonia B. Anastomosis site leakage C. Pneumothorax D. Chylothorax correct answer Anastomosis site leakage 116. The best medication to improve gastric motility is A. Ranitidine (Zantac) B. Famotidine (Pepcid) C. Sucralfate (Carafate) D. Metoclopramide (Reglan) correct answer Metoclopramide (Reglan) 117. The nurse finds a 12-year-old postoperative spinal fusion patient restless and diaphoretic with HR 120, BP 110/80 and O2 Sat of 90%. Lab results reveal Hgb is 11.8 and Hemotocrit is 32.9. Primary intervention for this patient would be to A. Increase FiO2 via nasal cannula B. Obtain capillary blood gas C. Transfuse one unit of PRBCs CCRN PEDS AACN Exam Questions And Answers D. Adjust the settings on the PCA pump correct answer Adjust the settings on the PCA pump 118. Which of the following clinical manifestations is an indication of the need for an artificial airway in a 2-year-old with laryngotracheo- bronchitis? A. Respiratory alkalosis B. Increased production of mucus C. Metabolic acidosis D. Persistent agitation/lethargy correct answer Persistent agitation/lethargy 119. Medical management of Phenobarbital (Luminal) overdose includes A. Forced dieresis B. Fluid restriction C. Nitroprusside (Nitropress) infusion D. Naloxone (Narcan) administration correct answer Forced dieresis 120. An adolescent with a history of admissions for chronic status asthmaticus is being prepared for discharge. The nurse determines that CCRN PEDS AACN Exam Questions And Answers the patient has not been compliant with medications because doing so "makes him feel too different" from his peers. The nurse should A. Arrange for the patient's school nurse to monitor compliance B. Provide the patient with articles on the relationship of hospitalization and medication compliance C. Refer the patient to a support group for adolescents with asthma D. Advise the parents to withhold privileges if the patient remains non- compliant correct answer Refer the patient to a support group for adolescents with asthma 121. A 5-year-old with a new diagnosis of status asthmaticus is admitted. Initial assessment reveals severe wheezing and use of accessory muscles. Initial management of this patient should be A. Administration of inhaled corticosteroid B. Administration of nebulized albuterol C. Intubation and mechanical ventilation D. Observation and administration of oxygen to keep O2 concentration at 90% correct answer Administration of nebulized albuterol CCRN PEDS AACN Exam Questions And Answers D. Chronic renal correct answer Pre-renal 127. A patient is admitted to the PICU with nausea, vomiting and diarrhea. The nurse would call the physician immediately with which of the following venous lab results? K+ Na+ Cl- A. 5.4 132 100 B. 6.5 125 95 C. 3.0 160 90 D. 3.5 145 92 correct answer 6.5 125 95 128. A 6-month-old cries with diaper changes and does not interact with the mother or staff. The infant appears thin for height and has bruises on the lower arms. X-ray reveals a tibial fracture. The nurse suspects maltreatment. The most important portion of the workup and documentation would be the A. CT scan B. History given by the mother C. Growth chart from previous visits D. Complete blood count correct answer History given by the mother CCRN PEDS AACN Exam Questions And Answers 129. A 10-year-old non-English-speaking patient has arrived to the unit postoperatively. The nurse recognizes pain control will be a priority nursing intervention. The best tool for pain assessment would be A. Numeric pain scale B. Richmond agitation scale C. Visual analog scales D. FACES pain scale correct answer FACES pain scale 130. A nurse notices that there seems to be an increase in medication errors when medication infusions are started. The nurse's best course of action would be to A. Ask the nurse manager to remind all staff to be careful when hanging and checking medication infusions B. Keep a list of all nurses who have made errors and give it to the nurse manager C. Review the medication error rate, then offer to help revise the unit policy for checking medication drips D. Be more careful when hanging and checking medication infusions correct answer Review the medication error rate, then offer to help revise the unit policy for checking medication drips