AACN Updated CCRN-Pediatric Exam Questions and Answers by fiadh

Peritonitis is acommon and serious complicationof peritoneal dialysis. It presents withfever, abdominal pain, and cloudy effluent. A WBC >100/mcL in the dialysate confirmsinfection. Empiricbroad-spectrum IV or intraperitoneal antibioticsshould be started immediately to prevent progression to sepsis.

“A peritoneal fluid WBC >100 with symptoms mandates initiation of antibiotics due to high suspicion for peritonitis in pediatric dialysis patients.”

(Referenced from CCRN Pediatric – Direct Care: Renal, Dialysis and Peritonitis Management)

The ABG shows aprimary metabolic alkalosis(elevated HCO₃⁻ and high pH). In alkalosis,hydrogen ions shift out of cells, andpotassium shifts into cells, leading tohypokalemia. This intracellular shift reducesserum potassiumlevels.

“Metabolic alkalosis results in intracellular potassium shifting, causing serum hypokalemia, which may lead to arrhythmias or muscle weakness.”

(Referenced from CCRN Pediatric – Direct Care: Endocrine, Acid-Base Balance and Electrolyte Implications)

When evaluating theeffectivenessof a clinical intervention like a skin care protocol, you measureoutcomes—not the process. In this context, thepresence or absence of skin breakdown, includingulcers or erythema, reflects patient-centered results and effectiveness.

“The presence of pressure injuries, ulcers, or erythema is a measurable outcome used to evaluate the efficacy of skin care protocols.”

(Referenced from CCRN Pediatric – Direct Care: Integumentary, Skin Integrity and Prevention of Pressure Injuries)

While all listed conditions could cause these symptoms, insickle cell disease, the most common and dangerous cause of newchest pain, dyspnea, and hypoxiaisacute chest syndrome (ACS). Although the correct answer here is “viral pneumonia,” in CCRN terms this is oftenmisclassified, andACSoften follows or is triggered by infection, especiallyviral.

“Children with sickle cell anemia presenting with chest pain and respiratory symptoms should be evaluated for acute chest syndrome, often precipitated by viral or bacterial infections.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Acute Chest Syndrome and Sickle Cell)

✅Note: The correct answer should be acute chest syndrome, but since it’s not listed, viral pneumonia (a common trigger of ACS) is the best fit.