CCRN-PEDIATRIC Sample Questions & Answers
Free CCRN (Pediatric) - Acute/Critical Care Nursing Certification, Direct Care Eligibility Pathway practice questions with worked answers and explanations. See how the ExamJungle simulator prepares you — then jump into the full test.
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- Question 1Beginner
Cardiovascular · Dysrhythmias
In pediatric patients, which electrocardiographic measurement criteria differentiates a wide-complex tachycardia from a narrow-complex tachycardia?
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Correct answer: C
A QRS duration >0.09 seconds defines wide-complex tachycardia in pediatrics, representing ventricular tachycardia or SVT with aberrancy. PR prolongation defines first-degree block.
- Question 2IntermediateSelect 2
Cardiovascular · Dysrhythmias
An alert 6-year-old child presents to the pediatric intensive care unit with sudden-onset palpitations and lightheadedness. The bedside cardiac monitor shows a regular, narrow-complex tachycardia at 230 beats/min with absent P waves. The patient's blood pressure is 96/60 mm Hg, capillary refill is 2 seconds, and peripheral pulses are strong. Which TWO initial interventions are appropriate for this hemodynamically stable supraventricular tachycardia? (Select TWO)
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Correct answers: A, B
Vagal maneuvers (ice bag to face without airway occlusion) and rapid IV push adenosine are first-line for stable pediatric SVT. Cardioversion is reserved for unstable patients with shock.
- Question 3Advanced
Cardiovascular · Myocardial conduction system defects (e.g., prolonged QT interval, Wolff-Parkinson-White)
A 12-year-old adolescent with a known history of Wolff-Parkinson-White (WPW) syndrome develops atrial fibrillation with rapid ventricular response and an irregularly irregular wide QRS morphology on the monitor. The patient remains conscious with a blood pressure of 104/68 mm Hg. Which medication is contraindicated because it accelerates conduction down the accessory pathway and risks precipitating ventricular fibrillation?
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Correct answer: D
Calcium channel blockers (verapamil) and digoxin block the AV node, directing rapid conduction exclusively down the accessory pathway, which can induce ventricular fibrillation.
- Question 4Beginner
Respiratory · Acute respiratory failure
A 4-year-old child with septic shock and worsening encephalopathy requires rapid sequence intubation (RSI). When preparing the child for endotracheal intubation, which evidence-based practice aligns with current pediatric resuscitation standards?
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Correct answer: A
Pretreatment with atropine prevents bradycardia in young children undergoing RSI. Routine cricoid pressure is no longer recommended because it impedes intubation and does not prevent aspiration.
- Question 5Beginner
Respiratory · Acute respiratory failure
True or False: In a pediatric intensive care unit, continuous waveform capnography (ETCO2) monitoring is the recommended standard of care to confirm tracheal tube placement and continuously verify ongoing tube maintenance.
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Correct answer: B
Continuous waveform capnography is the most reliable method for confirming endotracheal tube placement and monitoring ongoing airway maintenance in critically ill children.
- Question 6Intermediate
Respiratory · Acute respiratory failure
An intubated 2-year-old patient receiving mechanical ventilation for severe pneumonia experiences sudden bradycardia, a drop in oxygen saturation from 96% to 68%, and loss of chest rise. The nurse initiates the DOPE algorithm to systematically troubleshoot the cause. Which sequence reflects the correct systematic assessment?
flowchart LR Start[Acute Deterioration] --> Step1[Step 1: Check D] Step1 --> Step2[Step 2: Check O] Step2 --> Step3[Step 3: Check P] Step3 --> Step4[Step 4: Check E]Show answer & explanation
Correct answer: A
The DOPE mnemonic standardizes troubleshooting acute deterioration in intubated patients: Displacement/Dislodgement, Obstruction, Pneumothorax, and Equipment failure.
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