Free AACN CCRN-Pediatric Practice Exam with Questions & Answers | Set: 5

Restrictive cardiomyopathyis characterized byimpaired ventricular fillingdue to stiff ventricular walls. The primary issue isdiastolic dysfunction, not contractility. As a result, the focus is onreducing myocardial oxygen demand and workload, often with activity restriction, beta blockers, and afterload reduction.

“Management of restrictive cardiomyopathy centers on decreasing cardiac workload and optimizing preload, as the heart cannot relax properly. Inotropic agents are not typically effective.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Cardiomyopathies)

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.

Wolff-Parkinson-White (WPW) syndromeis characterized by anaccessory conduction pathway, resulting inshort PR interval, narrow QRS complexes, and delta waves. Tachycardia in neonates with WPW is oftenparoxysmal supraventricular tachycardia (PSVT).

“WPW is a pre-excitation syndrome seen in neonates and children, diagnosed by ECG findings of delta waves, and is associated with recurrent tachyarrhythmias.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Pediatric Arrhythmias)

Inborn errors of metabolism (IEM)often present within thefirst few days of lifewithnonspecific symptomslike poor feeding, vomiting, lethargy,metabolic acidosis, and seizures. These disorders impair the body's ability to metabolize proteins, fats, or carbohydrates, leading totoxic metabolite accumulation.

“Infants with inborn errors of metabolism commonly present in the first week of life with lethargy, vomiting, seizures, and metabolic acidosis. Prompt recognition is critical.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Metabolic Disorders and Acute Presentations)

Pulse oximetry (SpO₂)is inaccurate incarbon monoxide (CO) poisoningbecause itcannot differentiate between oxyhemoglobin and carboxyhemoglobin. SpO₂ may appear falsely normal despitesevere hypoxia. Direct measurement withco-oximetryis required for accurate oxygen saturation.

“In CO poisoning, SpO₂ readings are falsely elevated due to inability to distinguish carboxyhemoglobin from oxyhemoglobin. Co-oximetry is needed to assess true oxygenation.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Toxic Inhalation and Oxygenation Monitoring)