Pass the AACN CCRN CCRN-Pediatric Questions and answers with ExamsMirror

Small pneumothoraces (<10%) are oftenmanaged conservativelyin hemodynamically stable pediatric patients. The body's natural reabsorption of intrapleural air typically resolves the conditionwithout invasive intervention, provided that the patient is monitored closely.

“Observation is appropriate for small pneumothoraces (less than 10%) in stable pediatric patients. Serial chest radiographs and clinical assessments are used to monitor for progression. Chest tube insertion is generally reserved for larger or symptomatic pneumothoraces.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary Trauma and Chest Injury)

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)

This presentation is concerning fordeep vein thrombosis (DVT)orinfiltration/extravasationof vasoactive medications. Thefirst step is to elevate the limb, which reduces venous pressure and minimizes further tissue damage.Massaging or compressing the area is contraindicateddue to risk of embolization or tissue injury.

“Suspected venous obstruction or extravasation requires elevation of the affected limb and notification of the provider. Avoid massage or compression until diagnosis is confirmed.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Vascular Access Complications)

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)

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)

Elevated serum ammoniais often associated withhepatic encephalopathyor metabolic disturbances.Lactuloseis the standard treatment to reduce ammonia levels by promoting ammonia excretion via the GI tract.

“Lactulose lowers serum ammonia levels by converting ammonia into ammonium, which is then excreted in stool. It is a cornerstone in the treatment of encephalopathy caused by hyperammonemia.”

(Referenced from CCRN Pediatric – Direct Care: Gastrointestinal, Hepatic Failure and Encephalopathy)

Pediatric ICU delirium is a common but underdiagnosed condition in critically ill children, especially those on prolonged ventilation. Hallmarks includedisorientation, sleep disturbance, agitation, and altered attention.

“Delirium should be suspected in pediatric ICU patients showing new or worsening behavioral symptoms, altered sleep-wake cycles, and fluctuating mental status. Prolonged sedation and critical illness are risk factors.”

(Referenced from CCRN Pediatric – Direct Care: Neurologic Dysfunction and ICU Delirium)

An acid-fast bacillus (AFB) is strongly associated withMycobacterium tuberculosis (TB). TB is ahighly contagious airborne disease, and infection control standards require immediate placement in anegative-pressure roomto prevent spread to other patients and healthcare workers.

“Suspected or confirmed pulmonary tuberculosis in a mechanically ventilated patient necessitates immediate airborne isolation using a negative-pressure room. Infection control must be prioritized prior to confirmation of diagnosis.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary Infections and Airborne Isolation Protocols)

In asthma management, patient education andself-management skills, including proper use of an inhaler, are crucial to preventing readmission. School-aged children are often capable of learning and demonstrating proper technique, which should be assessed prior to discharge.

“Before discharge following asthma exacerbation, nurses should assess the child’s ability to self-administer inhaled medications, understand controller vs. rescue medications, and demonstrate correct technique.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Asthma Management and Discharge Planning)

Septic shockin pediatric patients requiresearly goal-directed therapy, including:

Fluid resuscitationto restore perfusion,

Antibioticswithin the first hour to treat the underlying infection, and

Inotropesif shock persists after fluids.

“Early interventions for pediatric septic shock include aggressive fluid resuscitation, timely administration of broad-spectrum antibiotics, and initiation of vasopressors or inotropes if hypotension remains.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Sepsis Management)