AACN Updated CCRN-Pediatric Exam Questions and Answers by caiden

Bronchiolitis causeslower airway obstruction, air trapping, andhypoventilation. On chest radiographs,hypoinflation(low lung volumes) and peribronchial thickening are common. The ABG showsrespiratory acidosis and hypoxemia, consistent withbronchiolar obstructionand hypoinflation.

“In bronchiolitis, hypoinflation and peribronchial thickening are typical CXR findings. ABG shows respiratory acidosis with hypoxemia in severe cases requiring ventilation.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Bronchiolitis and Ventilatory Support)

This infant displays signs ofearly septic shock, includingtachycardia,fever,normal cap refill, andlow CVP. In thehyperdynamic early phase of septic shock, patients may initially havewarm, flushed skinandbounding pulses, with preserved perfusion before progressing to a decompensated state.

“Septic shock may present with increased HR, fever, and warm extremities in its compensated phase. CVP may be low due to vasodilation and capillary leakage.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Types of Shock and Sepsis Pathophysiology)

Initial management ofsevere pediatric sepsis and MODSfocuses onearly goal-directed therapy, includingfluid resuscitation,vasopressors for perfusion, andventilator support for respiratory failure. This aligns with Pediatric Advanced Life Support (PALS) andAACNsepsis management protocols.

“In children with sepsis-induced MODS, the priority is to restore tissue perfusion through fluid resuscitation and initiate vasopressors if shock persists. Ventilator support is implemented for respiratory compromise. These interventions are considered initial and lifesaving.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem Dysfunction and Sepsis Guidelines)

Chest physiotherapy (CPT)isnot recommended in asthmabecause it can lead tobronchospasm and increased airway resistance. Unlike conditions with excessive mucus production (e.g., cystic fibrosis), asthma management focuses onairway relaxation and inflammation reduction, not mechanical clearance.

“Chest physiotherapy is contraindicated in asthma due to the risk of increasing bronchospasm. Treatment should focus on bronchodilators and anti-inflammatory medications.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Asthma Management in Ventilated Patients)