Free Practice Questions for AACN CCRN-Pediatric Exam

Myeloablationprior to bone marrow transplantdestroys bone marrow cells, leading toprofound neutropenia and thrombocytopenia. As a result, patients are atextremely high risk for infection and bleeding, requiring close monitoring, isolation, and transfusion support.

“Pre-transplant conditioning regimens cause neutropenia and thrombocytopenia, making infection and bleeding the primary complications during marrow ablation.”

(Referenced from CCRN Pediatric – Direct Care: Hematology, Bone Marrow Transplantation and Myelosuppression)

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)

This child presents with classic signs ofacute appendicitispotentially progressing toperitonitis or perforation. The priority is toconsult pediatric surgery immediately, asdelaying surgical evaluation can lead to worsening complications, including sepsis.

“Clinical presentation of acute appendicitis includes right lower quadrant or peri-umbilical pain, nausea, fever, and rebound tenderness. Surgical consultation is the priority in suspected appendicitis.”

(Referenced from CCRN Pediatric – Direct Care: Gastrointestinal, Acute Abdomen and Surgical Emergencies)

When ethical dilemmas arise and thefamily is conflicted despite medical consensus, the institutional ethics committee should be involved to guide decision-making through astructured, neutral process.

“When disagreement persists about life-sustaining treatment, referral to the institutional ethics committee is recommended to facilitate discussion, evaluate values, and support consensus-building among the care team and family.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Ethical Decision-Making and End-of-Life Care)

While palliative care supports symptom relief, theethics committee is the appropriate avenue for addressing decisional conflictregarding the care plan.

Assessment of learner needsis the foundational step in developing a teaching plan. Understanding what the caregiver knows or is anxious about allows for a tailored, effective education approach.

“Before implementing education, the nurse should assess the family member’s baseline knowledge and learning needs to guide teaching and ensure competence in complex care procedures.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Family-Centered Teaching and Learning)

Febrile seizuresare the mostcommon cause of seizures in infants and young children, typically between 6 months and 5 years. They often occur with arapid rise in body temperature, even inthe absence of intracranial infection or metabolic disturbances.

“In infants, febrile seizures are the most likely cause of new-onset seizures. Tonic-clonic activity confined to extremities is typical. Evaluation focuses on identifying the febrile source.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Pediatric Seizure Disorders)

Lead poisoning and structural brain anomalies are less common and usually not the first consideration in an acute setting with fever.

Chest physiotherapy (CPT)isnot recommended in asthmabecause it can lead tobronchospasm and increased airway resistance. Unlike conditions with excessive mucus production (e.g., cystic fibrosis), asthma management focuses onairway relaxation and inflammation reduction, not mechanical clearance.

“Chest physiotherapy is contraindicated in asthma due to the risk of increasing bronchospasm. Treatment should focus on bronchodilators and anti-inflammatory medications.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Asthma Management in Ventilated Patients)

Rhabdomyolysisis characterized byelevated CK levels,tea-colored urine, and signs ofmyoglobinuriaafter muscle injury (such as crush injuries). This condition can lead toacute kidney injuryand electrolyte disturbances.

“Crush injuries can lead to rhabdomyolysis, evidenced by muscle pain, elevated creatine kinase,and dark urine due to myoglobin. Early identification and hydration are critical to prevent renal complications.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Trauma and Rhabdomyolysis)

Wolff-Parkinson-White (WPW)syndrome involves anaccessory conduction pathwaycausingreentrant tachycardias.Catheter ablationis thedefinitive treatment, especially in symptomatic children.Digoxin is contraindicatedin WPW as it may enhance conduction through the accessory pathway.

“Catheter ablation is the treatment of choice for recurrent or refractory supraventricular tachycardia in WPW. Digoxin should be avoided in pre-excitation syndromes.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Supraventricular Tachycardia and WPW Management)

Thefrontal lobeis responsible forexecutive function, behavior, and personality. Tumors in this area often causebehavioral changes, mood instability, andseizures—particularlygeneralized seizureslike tonic-clonic.

“Frontal lobe tumors are commonly associated with personality and behavioral changes and are a common site for seizure onset in pediatric brain tumors.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Brain Tumors and Seizure Presentation)