AACN Updated CCRN-Pediatric Exam Questions and Answers by mikolaj

Spinal cord edemais the most common and immediate cause ofneurological impairmentafter spinal trauma. Swelling can compress the cord and impede circulation, leading tosecondary injurybeyond the initial mechanical trauma.

“Cord edema is a leading cause of secondary neurologic damage following spinal injury. Early identification and management are critical to preserving function.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Spinal Cord Injury and Secondary Neurologic Injury)

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)

While patients with hypoplastic left heart syndrome (HLHS) typically have lower baseline oxygen saturations due to mixing of systemic and pulmonary blood flow,feverin this population is especially concerning due to theirimmunocompromised and pre-transplant status. Fever may signalinfection or sepsis, both of which can jeopardize transplant eligibility and lead to rapid decompensation.

“In patients awaiting heart transplantation, fever is a red flag for infection or systemic inflammatory response, both of which significantly increase mortality risk and complicate transplant candidacy. Prompt evaluation is required.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Pre-Transplant Management)

The correct approach in end-of-life and ethical situations is to useopen-ended, family-centered communicationthat exploresvalues, hopes, and goals. This response promotesshared decision-making, validates emotional experience, and begins an appropriate dialogue about care direction.

“Ask families open-ended questions to explore goals and values, especially in cases of poor neurologic prognosis. It guides ethical, supportive decision-making.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: End-of-Life Care, Family Communication)