Ultimate Guide to Prepare CCRN-Pediatric with Accurate PDF Questions [Jun 30, 2026]
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NEW QUESTION # 74
A child has fever, chills, back pain, elevated WBC and ESR, and abnormal urinalysis. After IV fluids and antibiotics, what procedure should be anticipated?
- A. Upper GI
- B. KUB
- C. Renal ultrasound
- D. Chest x-ray
Answer: C
Explanation:
These findings are consistent withpyelonephritisor another upper urinary tract infection. Arenal ultrasound is a non-invasive test used to evaluate forstructural abnormalities, abscess, or obstruction, especially in a febrile child with a urinary tract infection.
"Renal ultrasound is indicated after diagnosis of febrile UTI to evaluate renal anatomy and rule out complications like abscess." (Referenced from CCRN Pediatric - Direct Care: Renal, Urinary Tract Infections and Imaging)
NEW QUESTION # 75
A mother asks the school nurse as her school age child has Encopresis. The nurse advised the mother to:
- A. Have her child clean his soiled pants
- B. Not let a child wear clothes with elastic bandages
- C. Have the child wear buttoned pants
- D. Give as much attention as you can to the bowel habits
Answer: A
Explanation:
Explanation: Let the child over six take responsibility for cleaning their soiled pants. It is not a punishment, but a way to help a child learn to take responsibility for his actions and motivate him to listen to his body signals.
NEW QUESTION # 76
Signs of cold stress that the nurse must be alert when caring for a Newborn is:
- A. Increased Respirations
- B. Hypothermia
- C. Decreased activity level
- D. Shaking
Answer: A
Explanation:
Explanation: A newborn will increase its respirations because the newborn will need more oxygen because of too much activity. Hypothermia is inaccurate because normally, temperature of a newborn drop, also a child under cold stress will kick and cry to increase the metabolic rate thereby increasing heat so B isn't a good choice. A newborn doesn't have the ability to shiver.
NEW QUESTION # 77
A primary school age boy was diagnosed with Myelogenous Leukemi
a. He is about to begin Chemotherapy and tells the nurse "I'm already 12 years old and I think I have the right to refuse the treatment". The nurse's most therapeutic response is:
- A. Your father already gave his consent so we need to go on with the treatment".
- B. Because you're under 18 years old, it means you don't have the capacity to refuse.
- C. "You are old enough. You're also old enough to understand that you need the Chemotherapy.
- D. "You seem afraid. Let me talk to you about it".
Answer: D
Explanation:
Explanation: In a case, the nurse finds out the boy is disinterested, "You seem afraid. Let me talk to you about it" is the best response because it permits exploration of the child's feelings. If the child starts to discuss feelings, there may not be a need to inform him that he is too young to refuse the treatment.
NEW QUESTION # 78
Which of the following immunizations would the nurse expect to administer to a child who is HIV (+) and severely immunocompromised:
- A. IPV
- B. MMR
- C. Rotavirus
- D. DTaP
Answer: A
Explanation:
Explanation: IPV or Inactivated polio vaccine does not contain live micro organisms which can be harmful to an immunocompromised child. Unlike OPV, IPV is administered via IM route.
NEW QUESTION # 79
A 15-year-old patient with a history of anxiety is experiencing palpitations, dizziness, nausea, diaphoresis, and tachypnea. This is most likely:
- A. Due to caffeine consumption
- B. An asthma exacerbation
- C. A panic attack
- D. Supraventricular tachycardia
Answer: C
Explanation:
Panic attacksare common in adolescents and present withsympathetic overdrivesymptoms-palpitations, dyspnea, dizziness, chest discomfort, nausea, and diaphoresis. A history of anxiety strongly supports this diagnosis, especially in the absence of objective cardiac or respiratory findings.
"Panic attacks in adolescents can mimic cardiopulmonary emergencies. The presence of a prior anxiety disorder and resolution of symptoms without intervention support the diagnosis." (Referenced from CCRN Pediatric - Direct Care: Psychosocial, Mental Health Emergencies)
NEW QUESTION # 80
When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember:
- A. Infant has greater body surface area than adults
- B. Infants have more intracellular water that adult do
- C. Infant can concentrate urine at an adult level
- D. The metabolic rate of an infant is slower than in adults
Answer: A
Explanation:
Explanation: Infants have greater body surface area than adult, increasing their risk to F&E imbalances.
Also infants can't concentrate a urine at an adult level and their metabolic rate, also called water turnover, is 2 to 3 times higher than adult. Plus more fluids of the infants are at the ECF spaces not in the ICF spaces.
NEW QUESTION # 81
Barbie is suspected with developmental dysplasia of the hip. During an assessment, the nurse expects that:
- A. there is a narrowing of the perineum
- B. there is inability to palpate movement of the femoral head.
- C. there is shortening of one leg.
- D. there is inability to adduct the affected leg.
Answer: C
Explanation:
Explanation: A developmental dysplasia of the hip would reveal that the affected leg appears shorter due to the femoral head being displaced upward.
NEW QUESTION # 82
Britney, a mother of a child who was diagnosed with Guillain-Barre syndrome, asks the nurse about the treatment plan for her child. The nurse is aware that:
- A. therapies will lessen the severity of the illness and speed the recovery in most patients.
- B. the child will be given loading dose of antibiotics.
- C. surgical treatment will be discuss by the doctor once cardio-pulmonary clearance is done.
- D. the child needs several blood transfusion to prevent shock.
Answer: A
Explanation:
Explanation: Currently, plasmapheresis and high-dose immunoglobulin therapy are used to lessen the severity of the illness and speed the recovery in most patients. Plasmapheresis is a method by which whole blood is removed from the body and processed so that the red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins that, in small quantities, the immune system uses naturally to attack invading organisms
NEW QUESTION # 83
A 5-month-old infant, weighing 15 lbs, is admitted with a diagnosis of diarrhea with moderate dehydration. The doctor ordered oral rehydration therapy of 40-50 ml/kg of pedialyte over 4 hours.
What would be the appropriate amount of fluid that the infant should ingest during the 4 hour period:
- A. 400 ml
- B. 330 ml
- C. 360 ml
- D. 250 ml
Answer: B
Explanation:
Explanation: 15 lbs is about 7 kg; at 40 ml/kg x 4 hours = 280 ml; at 50ml/kg x 4 hours = 350 ml; 330ml is within these parameters.
NEW QUESTION # 84
A child is postoperative day 2 following a heart transplant. Which of the following suggests that the complications are likely related to prolonged clamping of the aorta?
- A. Increased heart rate
- B. Increased central venous pressure
- C. Decreased urine output
- D. Decreased blood pressure
Answer: C
Explanation:
Prolonged aortic cross-clampingcan impairrenal perfusion, especially during cardiac surgery.Decreased urine outputpostoperatively may be a sign ofacute kidney injury (AKI)secondary to hypoperfusion during the clamping phase.
"Renal hypoperfusion during prolonged aortic cross-clamping may manifest postoperatively as oliguria or anuria, indicating renal compromise." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Postoperative Transplant Complications)
NEW QUESTION # 85
To lead a unit-based initiative to decrease central line-associated bloodstream infections, which of the following is the most appropriate approach?
- A. participate, decide, state, amend
- B. plan, develop, start, assess
- C. participate, do, study, assess
- D. plan, do, study, act
Answer: D
Explanation:
ThePlan-Do-Study-Act (PDSA)cycle is the most widely acceptedquality improvement methodologyin healthcare. It's iterative and promotes continuous improvement:
* Plan: Identify a goal and create an intervention
* Do: Implement the intervention on a small scale
* Study: Analyze the data and assess the outcome
* Act: Adopt, adjust, or abandon the intervention based on the findings
"PDSA methodology supports quality improvement in healthcare, especially in infection prevention initiatives such as reducing CLABSIs." (Referenced from CCRN Pediatric - Professional Caring & Ethical Practice: Evidence-Based Practice and Quality Improvement)
NEW QUESTION # 86
High lead levels present a medical emergency because they are associated with the development of:
- A. Lethal hypokalemia, due to lead binding with potassium
- B. Irreversible encephalopathy
- C. Severe hemolytic anemia
- D. Impaired O#-transport capacity
Answer: B
Explanation:
Lead toxicity is particularly dangerous in young children due to their developing central nervous systems.
Irreversible encephalopathyis a known severe consequence ofacute or chronic lead exposure, and it may present withseizures, altered mental status, and developmental regression. It requiresimmediate chelation therapyand environmental remediation.
"High lead levels, especially >70 mcg/dL, are associated with irreversible neurologic damage such as encephalopathy, cerebral edema, and seizures." (Referenced from CCRN Pediatric - Direct Care: Neurological, Toxic Encephalopathy and Heavy Metal Poisoning)
NEW QUESTION # 87
Which of the following would require careful monitoring in the child with ADHD who is receiving Methylphenidate (Ritalin):
- A. Excessive appetite
- B. Height and weight
- C. Mouth dryness
- D. Dental health
Answer: B
Explanation:
Explanation: Ritalin can affect the child's Growth and development. Dental problems are more likely to occur in children under going TCA therapy. Mouth dryness is an expected side effect of Ritalin since it activates the SNS. Also loss of appetite is more likely to happen, not increase in appetite.
NEW QUESTION # 88
One hour after receiving naloxone, a child becomes lethargic again and has a RR of 6. The nurse should anticipate:
- A. Administration of naloxone (Narcan)
- B. Intubation
- C. Administration of glucose
- D. Nasal BiPAP
Answer: A
Explanation:
Naloxone has ashorter half-lifethan many opioids. After the initial reversal, the opioid's effects canresurge, leading torespiratory depressionand sedation. This is calledre-sedationoropioid re-narcotization. Re- dosing or initiating analoxone infusionmay be required.
"Recurrent sedation or respiratory depression after naloxone administration suggests opioid duration outlasting naloxone's half-life. Repeat dosing or continuous infusion may be necessary." (Referenced from CCRN Pediatric - Direct Care: Multisystem, Opioid Toxicity and Naloxone Pharmacology)
NEW QUESTION # 89
A 7 year-old child was rushed at the ER after a sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, fever, leaning forward while in a sitting position, protruding tongue, salivation and suprasternal retractions. What should the nurse do first?
- A. assess the throat
- B. Have the child undergo an upper airway x-ray
- C. have the sputum sent to laboratory for testing
- D. notify the doctor about the current status
Answer: D
Explanation:
Explanation: These findings suggest a medical emergency and may be due to epiglottises. Any child with an acute onset of an inflammatory response in the mouth and throat should receive immediate medical attention in a hospital equipped with Intubation or a Tracheostomy in the event of further or complete obstruction.
NEW QUESTION # 90
A recently deceased patient's family begins arriving to the ICU, visibly distraught and wailing. What is the nurse's first action?
- A. Seek assistance from the chaplain
- B. Ask about funeral arrangements
- C. Keep the family in the waiting room until they are calmer
- D. Provide the family access to the patient
Answer: D
Explanation:
Immediate access to the deceased patient supportsgrief processingandfamily-centered care. Presence at the bedside allows the family to begin saying goodbye and mayreduce psychological traumaassociated with sudden loss.
"Grief support includes prompt access to the deceased loved one. Delaying this can intensify distress and negatively affect family outcomes." (Referenced from CCRN Pediatric - Direct Care: Psychosocial, End-of-Life and Bereavement Support)
NEW QUESTION # 91
A child's ABG reveals pH 7.58, PaCO# 40, HCO# 30. What electrolyte change is expected?
- A. Serum magnesium will increase
- B. Ionized calcium will increase
- C. Serum potassium will increase
- D. Serum potassium will decrease
Answer: D
Explanation:
The ABG shows aprimary metabolic alkalosis(elevated HCO## and high pH). In alkalosis,hydrogen ions shift out of cells, andpotassium shifts into cells, leading tohypokalemia. This intracellular shift reduces serum potassiumlevels.
"Metabolic alkalosis results in intracellular potassium shifting, causing serum hypokalemia, which may lead to arrhythmias or muscle weakness." (Referenced from CCRN Pediatric - Direct Care: Endocrine, Acid-Base Balance and Electrolyte Implications)
NEW QUESTION # 92
An adolescent with type 1 diabetes has been admitted due to ketoacidosis. The nurse expects that the child will exhibit:
- A. Bradycardia
- B. Hypercapnia
- C. Fever
- D. Hypertension
Answer: B
Explanation:
Explanation: Hypercpnia is an attempt by the respiratory system to eliminate too much carbon dioxide.
It is a compensatory mechanism associated with metabolic acidosis.
NEW QUESTION # 93
When is the best time to do a corrective surgery for an infant with hypospadias:
- A. 6-18 months of age.
- B. 72 hours after birth
- C. Within few months after birth
- D. Anytime during pre school age
Answer: A
Explanation:
Explanation: 6-18 months is the preferred age to do a corrective surgery for an infant with hypospadias because fear of castration and body image is not yet developed. It can't be performed shortly after birth because the phallus is not developed enough. Fear of bodily mutilation is present during pre school age.
NEW QUESTION # 94
A 3-year-old heart transplant patient is experiencing signs of rejection. Which of the following best supports this?
- A. Bilaterally diminished breath sounds
- B. HR of 145 and urine output of 0.5/kg/hr
- C. Serum glucose of 230 mg/dL and LDL of 184
- D. BP of 98/55 and RR of 34
Answer: B
Explanation:
Tachycardiaanddecreased urine outputare early clinical signs ofcardiac allograft rejectionin pediatric transplant recipients. Because transplanted hearts aredenervated,tachycardiais often thefirst compensatory responseto decreased cardiac output, while low urine output reflectsend-organ hypoperfusion.
"Rejection may present subtly with signs like persistent tachycardia, fatigue, or poor perfusion. Urine output is a sensitive measure of systemic perfusion." (Referenced from CCRN Pediatric - Direct Care: Cardiovascular, Heart Transplant Rejection Indicators)
NEW QUESTION # 95
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