AACN Updated CCRN-Pediatric Exam Questions and Answers by cara

In aventricular septal defect (VSD), blood shunts from theleft to the right ventricledue to higher systemic pressure. This leads toincreased pulmonary blood flow(left-to-right shunt), which can cause pulmonary overcirculation and heart failure if untreated.

“VSDs result in a left-to-right shunt that increases pulmonary circulation. This may cause pulmonary congestion, increased work of breathing, and failure to thrive in infants.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular Congenital Defects)

Pediatric ICU delirium is a common but underdiagnosed condition in critically ill children, especially those on prolonged ventilation. Hallmarks includedisorientation, sleep disturbance, agitation, and altered attention.

“Delirium should be suspected in pediatric ICU patients showing new or worsening behavioral symptoms, altered sleep-wake cycles, and fluctuating mental status. Prolonged sedation and critical illness are risk factors.”

(Referenced from CCRN Pediatric – Direct Care: Neurologic Dysfunction and ICU Delirium)

Classic CSF findings inbacterial meningitis:

Low glucose(<40 mg/dL) – due to bacterial consumption

High protein(>100 mg/dL) – from inflammation and blood-brain barrier disruption

High WBCs, particularlypolymorphonuclear cells(>1000/microliter) – indicating a strong immune response

These values are not consistent with viral meningitis or autoimmune disorders like Guillain-Barré.

“In bacterial meningitis, CSF typically reveals hypoglycorrhachia, elevated protein, and a predominance of neutrophilic leukocytosis.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Meningitis Diagnosis and Management)

These are classic symptoms ofICU delirium, especially in pediatric or neurologically impaired patients. The nurse shouldmodel supportive, calm behavior,reorient the patient, andeducate familyabout what they are witnessing. This helpsde-escalate tensionand provides therapeutic support.

“In managing ICU delirium, the nurse should support the patient, reduce stimuli, and help families understand and cope with the patient’s altered mental status.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Delirium and Cognitive Dysfunction)