CCRN Pediatric Nurse Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q21A pediatric intensive care unit (PICU) nurse is caring for an 8-week-old infant diagnosed with patent ductus arteriosus (PDA). Which of the following assessment findings would the nurse expect for this infant?
✓ Correct answer: D. Continuous murmur, shortness of breath, poor feeding, and failure to thrive
Answer: Continuous murmur, shortness of breath, poor feeding, and failure to thrive A Patent Ductus Arteriosus (PDA) is a persistent opening between the aorta and the pulmonary artery, which remains open after birth. This condition causes increased pulmonary circulation and can lead to symptoms such as shortness of breath, a continuous murmur, poor feeding, and failure to thrive. Strong femoral pulses, higher blood pressure in arms than legs, and cool lower extremities are associated with Coarctation of the Aorta. Feeding intolerance, diaphoresis, poor peripheral pulses, and acrocyanosis are linked to severe pulmonary stenosis. Decreased appetite, shortness of breath, and cyanosis can be seen in conditions such as Transposition of the Great Arteries (TGA).
Q22In pediatric patients, Kawasaki disease can lead to serious cardiovascular complications. Which of the following combinations of signs and symptoms would be indicative of Kawasaki disease?
✓ Correct answer: C. Fever for at least 5 days and polymorphous rash
Answer: Fever for at least 5 days and polymorphous rash Kawasaki disease is diagnosed based on clinical criteria. The child must have a fever lasting at least 5 days along with at least four of the following principal clinical features: Clinical Features Details Bilateral conjunctival injection without exudate Oral mucous membrane changes such as injected or fissured lips, injected pharynx, or strawberry tongue Peripheral extremity changes such as erythema of the palms or soles, edema of the hands or feet, and periungual desquamation Polymorphous rash typical of the disease Cervical lymphadenopathy with at least one lymph node greater than 1.5 cm in diameter
Q23All the following are appropriate diagnostic studies for a pediatric patient suspected of having Kawasaki disease, EXCEPT:
✓ Correct answer: A. Pulmonary function tests (PFTs)
Answer: Pulmonary function tests (PFTs) Kawasaki disease is an acute febrile illness of unknown etiology that primarily affects children under the age of 5. It is characterized by inflammation of blood vessels throughout the body (vasculitis) and can lead to coronary artery aneurysms. Diagnostic studies include echocardiograms, electrocardiograms (ECGs), blood tests such as C-reactive protein (CRP) to measure inflammation, and complete blood count (CBC). Pulmonary function tests (PFTs) measure lung function and are not used in the diagnosis of Kawasaki disease.
Q24A pediatric patient is experiencing severe hypoxemia secondary to acute respiratory distress syndrome (ARDS) and is being treated with nitric oxide (NO). What is the primary therapeutic mechanism of nitric oxide in this condition?
✓ Correct answer: D. Pulmonary vasodilation and improvement of oxygenation
Answer: Pulmonary vasodilation and improvement of oxygenation ARDS is characterized by widespread inflammation in the lungs and can lead to severe hypoxemia. The inflammation results in increased capillary permeability, leading to fluid accumulation in the alveolar spaces, thereby impairing gas exchange. In critically ill pediatric patients with ARDS, treatment with inhaled nitric oxide is used to selectively dilate pulmonary vessels in well-ventilated areas of the lung, reducing pulmonary artery pressure and improving oxygenation without causing systemic hypotension. Symptoms of ARDS include hypoxemia, dyspnea, tachypnea, and cyanosis. The therapeutic goal of using nitric oxide in ARDS is to achieve selective pulmonary vasodilation, enhancing blood flow to better-ventilated alveoli and thus improving oxygenation.
Q25Which of the following antihypertensive agents, indicated in the management of pediatric hypertension, has a common side effect of hyperkalemia?
✓ Correct answer: C. Lisinopril
Answer: Lisinopril Lisinopril is an ACE inhibitor, which can increase potassium levels, causing hyperkalemia as a potential side effect. It is often used in the management of hypertension in pediatric patients. Atenolol, hydrochlorothiazide, and amlodipine typically do not cause hyperkalemia and are associated with other side effects.
Q26A pediatric patient in the ICU has been administered digoxin (Lanoxin) for the treatment of heart failure. Which assessment finding indicates a potential complication related to this medication?
✓ Correct answer: B. Visual disturbances
Answer: Visual disturbances Digoxin is a cardiac glycoside used to improve the strength and efficiency of the heart, or to control the rate and rhythm of the heartbeat. Visual disturbances can be a sign of digoxin toxicity, a serious complication. Other signs of toxicity may include nausea, vomiting, and arrhythmias.
Q27During which phase of acute rheumatic fever do children typically present with carditis, polyarthritis, and erythema marginatum?
✓ Correct answer: D. Acute phase
Answer: Acute phase Acute rheumatic fever is a systemic inflammatory disease that may develop after a group A Streptococcus infection. It affects the heart, joints, skin, and brain. The cause of this disease is an abnormal immune response to a streptococcal throat infection. The disease has three phases: the acute phase, subacute phase, and convalescent phase. The acute phase (weeks 0-2) presents with symptoms such as carditis, polyarthritis, erythema marginatum (a type of skin rash), Sydenham's chorea, and subcutaneous nodules. The subacute phase features residual symptoms and potential cardiac complications, while the convalescent phase involves the resolution of symptoms and recovery. The latent phase is not associated with acute rheumatic fever.
Q28Which of the following interventions is NOT included in the treatment plan for a child with cyanide poisoning?
✓ Correct answer: C. Activated charcoal
Activated charcoal is NOT used in the treatment of cyanide poisoning because cyanide is not effectively adsorbed by activated charcoal. The treatment of cyanide poisoning includes the use of hydroxocobalamin (Cyanokit), sodium thiosulfate, and amyl nitrite to neutralize the cyanide and enhance its excretion.
Q29A pediatric patient has been diagnosed with Kawasaki disease. During which phase of the disease are coronary artery aneurysms most likely to develop?
✓ Correct answer: D. Subacute phase
Answer: Subacute phase Kawasaki disease is an acute febrile illness of unknown etiology that primarily affects children younger than 5 years of age. It causes inflammation in the walls of some blood vessels in the body. The disease typically progresses through three phases: acute, subacute, and convalescent. The subacute phase occurs about 2 to 4 weeks after the onset of fever and is characterized by peeling of the skin on hands and feet, thrombocytosis, and the highest risk of coronary artery aneurysms. Close monitoring of cardiac function during this phase is crucial to manage potential complications.
Q30A 3-year-old female with severe congenital heart disease is nearing the end of her life. The cardiology team has informed the parents that there are no further curative treatments available. The palliative care team has consulted with the family, and they have decided not to pursue additional aggressive interventions. When a child is receiving end-of-life care, which intervention may be continued?
✓ Correct answer: A. Intravenous access
Answer: Intravenous access During end-of-life care, also known as palliative or comfort care, aggressive medical interventions are ceased. This includes stopping invasive procedures such as frequent measurement of blood pressure, nutritional supplements via NG tube, and continuous monitoring. However, intravenous access is often maintained for the administration of medications aimed at providing comfort, alleviating pain, and ensuring the child does not suffer.
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