CCRN-Pediatric Exam Dumps - AACN CCRN Questions and Answers

SIRS leads towidespread vasodilation and increased capillary permeability, which causesfluid shifting, hypotension, and potential multi-organ dysfunction. This systemic response is part of the pathophysiology ofsepsis and MODS.

“SIRS involves a cytokine-mediated vasodilatory response with increased capillary permeability, leading to third-spacing, hypoperfusion, and potential organ dysfunction.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Inflammatory Cascade in Sepsis)

Sickle cell anemiais strongly associated withpediatric stroke, especially in children with HbSS. Sickled red cells can occlude cerebral vessels, leading toischemic strokes—often presenting withfocal deficits, such as hemiparesis or speech changes.

“Children with sickle cell anemia are at significantly increased risk for ischemic stroke. Stroke is a major neurologic complication, particularly in those with prior vaso-occlusive episodes.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Hemoglobinopathies and Stroke Risk)

Establishingadmission and discharge criteriaensures that care decisions areconsistent, justifiable, and ethically grounded. These criteria guide clinicians inresource allocation, promotingfair accessand minimizing bias in treatment decisions.

“Admission/discharge policies support ethical care delivery by ensuring objective, equitable decision-making, especially in high-acuity environments like ICUs.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Ethical Resource Management and Clinical Guidelines)

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)

Abdominal compartment syndrome (ACS)is defined bybladder pressures ≥20 mmHg with evidence of organ dysfunction. A pressure of8 mmHg is within normal range(0–12 mmHg). Therefore,no emergent intervention is needed, and the correct action is tocontinue monitoring.

“Bladder pressure <12 mmHg is considered normal. For intra-abdominal hypertension or ACS, thresholds are >12 and >20 mmHg, respectively, along with signs of organ dysfunction.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Abdominal Compartment Syndrome Monitoring)

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)

Hemolytic uremic syndrome (HUS)is commonly preceded by a diarrheal illness, often caused byE. coli O157:H7. Classic triad:microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury—often with petechiae, hypertension, and decreased urine output.

“HUS presents in children as a post-infectious complication, typically following bloody diarrhea. It manifests with renal failure, anemia, thrombocytopenia, and neurologic or hypertensive symptoms.”

(Referenced from CCRN Pediatric – Direct Care: Renal Dysfunction and Hematologic Disorders)

Prerenal failureis caused by conditions that impairrenal perfusionwithout direct injury to the kidneys themselves.Septic shockleads to systemic vasodilation, hypotension, and decreased renal perfusion, making it a classic prerenal etiology.

“Prerenal causes of acute kidney injury (AKI) include any condition resulting in reduced renal blood flow. Septic shock is a common prerenal cause, where hypoperfusion leads to decreased glomerular filtration.”

(Referenced from CCRN Pediatric – Direct Care: Renal Dysfunction and Fluid Balance)

Beta-agonists such asterbutalineare frequently used in severe asthma to promote bronchodilation. However, these agents stimulate beta-2 receptors, which drivepotassium and phosphate into cells, leading tohypokalemia and hypophosphatemia—a well-documented side effect in patients receiving frequent or continuous beta-agonist therapy.

“Beta-adrenergic medications can cause intracellular shifting of potassium and phosphorus, especially when administered in high doses or for prolonged periods, as in status asthmaticus. This results in hypokalemia and hypophosphatemia, necessitating close electrolyte monitoring.”

(Referenced from CCRN Pediatric – Direct Care: Endocrine Disorders and Critical Pharmacologic Management)

Left ventricular failureleads todecreased cardiac output(cool extremities, low urine output) andincreased pulmonary pressures(pulmonary edema). Viral myocarditis causesmyocardial inflammationthat impairs left ventricular function in many pediatric cases.

“In myocarditis, left ventricular dysfunction manifests as signs of low cardiac output and pulmonary congestion. Close monitoring is essential for early intervention.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Inflammatory Myocardial Disorders)