Free Pediatric CCRN Practice Questions

Free Pediatric CCRN Practice Questions Related

Review Free Pediatric CCRN Practice Questions related questions and content

A client with ascites has a paracentesis, and 1500 ml of fluid is removed. Immediately following the procedure it is most important for the nurse to observe for:

  • A. A rapid, thready pulse
  • B. Decreased peristalsis .
  • C. Respiratory congestion
  • D. An increased in temperature
Correct Answer: C

Rationale: Following a paracentesis procedure where a large amount of ascitic fluid is removed, there is a risk of developing a fluid shift and a potential complication known as "paracentesis-induced circulatory dysfunction" (PICD). This may cause a sudden increase in central blood volume due to rapid re-distribution of fluid, leading to respiratory congestion, dyspnea, and hypoxemia. Therefore, it is crucial for the nurse to monitor the client closely for signs of respiratory distress or congestion immediately after the procedure to prevent any respiratory complications. A rapid, thready pulse (choice A) may indicate hypovolemia, but it is not the most important immediate concern in this case. Decreased peristalsis (choice B) and an increased temperature (choice D) are not typically associated with the immediate post-paracentesis period and are therefore lower priorities compared to monitoring for signs of respiratory congestion.

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What is an early clinical manifestation of bilirubin encephalopathy in the newborn?

  • A. Cognitive impairment
  • B. Absence of stooling
  • C. Lethargy or irritability
  • D. Increased or decreased temperature
Correct Answer: C

Rationale: An early clinical manifestation of bilirubin encephalopathy in a newborn is lethargy or irritability. Bilirubin encephalopathy, also known as kernicterus, is a serious condition that occurs when high levels of unconjugated bilirubin build up in the brain tissues. Initially, the baby may become lethargic or irritable due to the toxic effects of bilirubin on the central nervous system. As the condition progresses, symptoms may include poor feeding, high-pitched crying, muscle tone abnormalities, and eventually may lead to more severe consequences such as seizures and irreversible neurological damage. Prompt recognition and treatment of bilirubin encephalopathy are crucial to prevent long-term complications.

A client with lung cancer develops Homer's when the tumor invades the ribs and affects the sympathetic nerve ganglia. When assessing for signs and symptoms of this syndrome, the nurse should note:

  • A. Miosis, partial eyelid ptosis, and anhidrosis on the affected side of the face.
  • B. Chest pain, dyspnea, cough, weight loss, and fever.
  • C. Arm and shoulder pain and atrophy of arm and hand muscles both on the affected side.
  • D. Hoarseness and dysphagia.
Correct Answer: A

Rationale: Homer's syndrome, also known as Horner's syndrome, is a rare condition that occurs when the sympathetic nerve supply to the eye and face is disrupted. In the case of lung cancer invading the ribs and affecting the sympathetic nerve ganglia, it can lead to Homer's syndrome. The classic triad of symptoms in Homer's syndrome includes miosis (constriction of the pupil), partial eyelid ptosis (drooping of the upper eyelid), and anhidrosis (lack of sweating) on the affected side of the face. These symptoms result from the disruption of sympathetic nerve pathways affecting the pupillary dilator muscle, the Müller muscle responsible for eyelid elevation, and sweat glands on one side of the face. Therefore, when assessing for signs and symptoms of Homer's syndrome in this client, the nurse should focus on looking for these specific manifestations.

Which manifestation is more specific to occur in anaplastic large cell lymphoma (ALCL) than other types of non-Hodgkin lymphoma?

  • A. primary bone marrow involvement
  • B. intestinal involvement
  • C. CNS involvement
  • D. primary mediastinal involvement
Correct Answer: D

Rationale: Primary mediastinal involvement is a hallmark feature of ALCL.

Which of the following disorders results from a deficiency of factor VIII?

  • A. Sickle cell disease
  • B. Christmas disease
  • C. Hemophilia A
  • D. Hemophilia B
Correct Answer: C

Rationale: Hemophilia A, also known as classic hemophilia, is a genetic bleeding disorder caused by a deficiency or dysfunction of clotting factor VIII. Factor VIII is crucial for the blood clotting process, and its deficiency leads to prolonged bleeding episodes, even from minor injuries. Christmas disease, mentioned in the options, refers to Hemophilia B, which results from a deficiency in clotting factor IX, not factor VIII. Therefore, the disorder resulting from a deficiency of factor VIII is Hemophilia A.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is

  • A. fibroblastic
  • B. chondroblastic
  • C. parosteal
  • D. periosteal
Correct Answer: D

Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.

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