Free AACN CCRN-Pediatric Practice Exam with Questions & Answers | Set: 2

Kawasaki disease is an acute vasculitis that primarily affects children under 5 and presents with classic signs:fever, rash, conjunctivitis, strawberry tongue, and extremity changes. It may also causecoronary artery aneurysmsandconduction abnormalities, such as PR prolongation.

“Kawasaki disease presents with mucocutaneous inflammation, and cardiac complications may include myocarditis and conduction delays, such as first-degree AV block.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Inflammatory Heart Disease)

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.

In neonates and infants, hypoglycemia is oftensymptomatically silentor presents withnonspecific signs, includinghypothermia, lethargy, and apnea. These can quickly progress to seizures or coma if not corrected.

“Hypoglycemia in infants may manifest as apnea, poor feeding, jitteriness, or hypothermia. Immediate intervention is required to prevent neurological injury.”

(Referenced from CCRN Pediatric – Direct Care: Endocrine Function and Metabolic Monitoring)

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)

Carbon monoxide (CO) poisoningresults in tissue hypoxia by binding to hemoglobin with greater affinity than oxygen, forming carboxyhemoglobin. The mostcommon early symptomsin children include:

Tachycardia(due to hypoxic compensatory response)

Confusion, dizziness, and headache(due to cerebral hypoxia)

Wheezing and bradycardia arenot typically early signs.

“Early signs of CO poisoning are neurologic (e.g., confusion) and cardiovascular (e.g., tachycardia) due to hypoxia, even when SpO₂ may appear falsely normal.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Inhalation Injury and Environmental Exposure)

The classic symptoms ofKawasaki Diseaseincludefever >5 days,mucocutaneous inflammation(strawberry tongue, conjunctivitis),lymphadenopathy, andelevated inflammatory markers. Standard treatment includesIVIGandhigh-dose aspirinto reduce coronary artery aneurysm risk.

“Kawasaki Disease is treated with IVIG and aspirin to control inflammation and reduce the risk of coronary artery aneurysms.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Inflammatory Syndromes in Children)

Cor pulmonalerefers toright ventricular hypertrophyand failure due tochronic pulmonary hypertension, a known complication of long-standingbronchopulmonary dysplasia (BPD)and chronic hypoxia in infants.

“Chronic hypoxia and pulmonary inflammation in BPD lead to vascular remodeling and increased pulmonary vascular resistance, resulting in right heart strain and cor pulmonale.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Chronic Lung Disease and Cardiac Effects)

Fresh frozen plasma (FFP)containsall coagulation factorsand is used in the treatment ofDIC, where widespread clotting consumes clotting factors and leads to bleeding. FFP replenishesmultiple depleted clotting factors, thereby stabilizing coagulation.

“FFP provides all clotting factors and is indicated in DIC to replace consumed factors and improve hemostasis. It is essential in active bleeding with prolonged PT, PTT, or low fibrinogen.”

(Referenced from CCRN Pediatric – Direct Care: Hematology, Coagulopathies and Transfusion Management)

While patients with hypoplastic left heart syndrome (HLHS) typically have lower baseline oxygen saturations due to mixing of systemic and pulmonary blood flow,feverin this population is especially concerning due to theirimmunocompromised and pre-transplant status. Fever may signalinfection or sepsis, both of which can jeopardize transplant eligibility and lead to rapid decompensation.

“In patients awaiting heart transplantation, fever is a red flag for infection or systemic inflammatory response, both of which significantly increase mortality risk and complicate transplant candidacy. Prompt evaluation is required.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Pre-Transplant Management)

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)