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PICU Practice Exam: Pediatric Critical Care Questions and Answers, Exams of Nursing

Chamberlain College of NursingNursing

Practice questions and verified answers for pediatric intensive care unit (PICU) procedures, covering emergency response, respiratory failure, electrolyte imbalances, and post-operative care. Each question includes a rationale for enhanced understanding. Designed for healthcare professionals preparing for certification or improving clinical skills in pediatric critical care. Key concepts include Broselow tape usage, respiratory distress signs, and interventions for pediatric conditions. Addresses patient management aspects like fluid resuscitation, medication administration, and neurological assessments. Ideal for nurses, medical students, and other healthcare providers seeking PICU expertise.

Typology: Exams

2024/2025

Available from 06/30/2025

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PROPHECY RN PEDIATRIC ICU PICU
PRACTICE EXAM 2 QUESTIONS AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2025
1. What is the primary reason for using a Broselow tape in a pediatric
emergency?
A. To calculate medication concentration
B. To estimate weight for drug dosing and equipment sizing
C. To determine blood glucose levels
D. To measure respiratory rate
The Broselow tape provides a quick, color-coded estimation of a child’s
weight based on length, which is essential for accurate medication dosing
and equipment sizing in emergencies.
2. Which sign is most concerning for impending respiratory failure in a 3-
year-old?
A. Tachypnea
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Download PICU Practice Exam: Pediatric Critical Care Questions and Answers and more Exams Nursing in PDF only on Docsity!

PROPHECY RN PEDIATRIC ICU PICU

PRACTICE EXAM 2 QUESTIONS AND

CORRECT ANSWERS (VERIFIED

ANSWERS) PLUS RATIONALES 2025

  1. What is the primary reason for using a Broselow tape in a pediatric emergency? A. To calculate medication concentration B. To estimate weight for drug dosing and equipment sizing C. To determine blood glucose levels D. To measure respiratory rate The Broselow tape provides a quick, color-coded estimation of a child’s weight based on length, which is essential for accurate medication dosing and equipment sizing in emergencies.
  2. Which sign is most concerning for impending respiratory failure in a 3- year-old? A. Tachypnea

B. Nasal flaring C. Decreased level of consciousness D. Mild intercostal retractions A decreased LOC indicates poor oxygenation to the brain and is a late, serious sign of respiratory failure.

  1. A 6-month-old infant in the PICU has a HR of 65 bpm. What is the nurse’s first action? A. Continue monitoring B. Start chest compressions C. Administer oxygen D. Obtain a 12-lead ECG In infants, a heart rate under 60 with signs of poor perfusion is an indication for immediate CPR.
  2. What is the appropriate fluid for initial resuscitation of a pediatric patient in septic shock? A. 0.9% Normal Saline B. D5W C. 0.45% NS D. Albumin 25% Isotonic crystalloids like NS are first-line for fluid resuscitation in pediatric septic shock.
  3. A child has a PaO2 of 55 mmHg on ABG. What condition does this reflect?

B. Sepsis C. Hypoxia D. Medication overdose In children, bradycardia is typically secondary to hypoxia.

  1. A nurse notes muffled heart sounds, distended neck veins, and hypotension in a child. What is the likely condition? A. Cardiac tamponade B. Asthma C. Pneumonia D. Sepsis These are classic signs of Beck’s triad, indicating cardiac tamponade.
  2. A 4-year-old post-op tonsillectomy patient is swallowing excessively. What should the nurse do? A. Encourage fluids B. Assess for bleeding C. Elevate the head D. Administer analgesia Frequent swallowing is a key sign of bleeding, which requires immediate assessment.
  3. Which finding in a child with bronchiolitis requires immediate intervention? A. Apnea

B. Rhinorrhea C. Coughing D. Wheezing Apnea episodes in infants with bronchiolitis can indicate severe respiratory compromise.

  1. For a pediatric patient with a tracheostomy, the nurse should always have what at the bedside? A. IV fluids B. Spare trach tube (same and one size smaller) C. Feeding tube D. Extra pulse oximeter Tracheostomy tubes can become dislodged; a replacement tube is essential.
  2. A child with a congenital heart defect presents with clubbing and polycythemia. This indicates: A. Anemia B. Chronic hypoxemia C. Dehydration D. Malnutrition Clubbing and polycythemia are compensatory responses to long-term hypoxia.
  3. A nurse administers IV morphine to a child. What is the priority assessment?

D. Epinephrine Flumazenil is the specific antagonist for benzodiazepines.

  1. What is a key concern in a child receiving total parenteral nutrition (TPN)? A. Hyperactivity B. Constipation C. Infection risk D. Weight gain Central lines used for TPN increase risk of bloodstream infections.
  2. What does a high-pitched cry in an infant potentially indicate? A. Hunger B. Neurological irritation C. Normal behavior D. GERD A high-pitched cry is a sign of increased ICP or neurologic pathology.
  3. Which sign is most indicative of pain in a non-verbal toddler? A. Sleeping B. Staring C. Bradycardia D. Facial grimacing Facial expressions, especially grimacing, are reliable indicators of pain in toddlers.
  1. In the event of a code in a pediatric ICU, what is the preferred vascular access? A. Intraosseous access B. Peripheral IV C. Umbilical vein D. Central line insertion IO access is rapidly available and effective in emergencies when IV is not immediately accessible.
  2. A neonate is hypothermic and hypoglycemic. What should the nurse assess next? A. Umbilical cord status B. Sepsis risk C. Bilirubin level D. APGAR score Cold stress and hypoglycemia may indicate underlying neonatal sepsis.
  3. A nurse is caring for a child with Kawasaki disease. Which medication is expected? A. Ibuprofen B. Acetaminophen C. IVIG and high-dose aspirin D. Prednisone IVIG and aspirin reduce inflammation and prevent coronary artery complications.
  1. A child is post-op from spinal surgery. What is a critical nursing intervention? A. Ambulation within 4 hours B. Encourage high-fiber diet C. Neurovascular checks of lower extremities D. Checking bowel sounds every hour Post-spinal surgery, frequent neurovascular assessments ensure spinal cord integrity.
  2. A 2-year-old is receiving albuterol. What side effect should the nurse monitor for? A. Tachycardia B. Bradypnea C. Hypothermia D. Hypoglycemia Albuterol stimulates beta receptors, often causing increased heart rate.
  3. What is the primary concern in a child with nephrotic syndrome? A. Hypertension B. Infection risk C. Hyperglycemia D. Anemia Loss of protein in urine impairs immune response, increasing susceptibility to infections.
  1. A child with burns is ordered Parkland formula fluids. When should the first half be infused? A. Over 24 hours B. Over the first 8 hours C. In the last 12 hours D. Over 16 hours The first half of total fluid volume is given in the first 8 hours from time of burn.
  2. A pediatric patient has a GCS score of 7. What is the priority action? A. Insert an NG tube B. Prepare for intubation C. Place in high Fowler’s position D. Apply seizure precautions A GCS ≤8 indicates risk for airway compromise—prepare to secure the airway.
  3. What is a serious side effect of prolonged corticosteroid therapy in children? A. Weight loss B. Growth suppression C. Hyperpigmentation D. Dehydration

Epiglottitis can cause sudden airway blockage—securing the airway is the top priority.

  1. A nurse hears stridor in a pediatric patient. What is the most likely cause? A. Upper airway obstruction B. Lower airway spasm C. Bronchospasm D. Lung consolidation Stridor is a high-pitched sound from turbulent airflow in the upper airway, often due to obstruction.
  2. Which lab value would be most concerning in a child with tumor lysis syndrome? A. Potassium 6.5 mmol/L B. Sodium 135 mmol/L C. Calcium 9.2 mg/dL D. BUN 12 mg/dL Hyperkalemia from tumor lysis can lead to life-threatening cardiac arrhythmias.
  3. Which intervention is appropriate for a child with increased ICP? A. Encourage coughing B. Minimize environmental stimuli C. Lay flat

D. Increase fluid intake Reducing stimulation helps prevent spikes in ICP from increased sensory input.

  1. What is the priority assessment in a pediatric patient after a seizure? A. Time of last meal B. Respiratory status C. Pain level D. Activity level Postictal respiratory assessment is critical to ensure the airway is protected and breathing is adequate.
  2. A child with a VP shunt is lethargic and vomiting. What should the nurse suspect? A. Infection B. Constipation C. Shunt malfunction D. GERD These are classic signs of increased ICP, likely from a blocked VP shunt.
  3. Which pain scale is best for a non-verbal 10-month-old? A. Numeric B. FLACC C. Wong-Baker
  1. Which sign is most specific to meningitis in infants? A. Bulging fontanelle B. Vomiting C. Dry skin D. Hypotension Bulging fontanelle is a hallmark of increased ICP in infants with meningitis.
  2. What complication can occur from rapid correction of hyponatremia? A. Central pontine myelinolysis (osmotic demyelination) B. Seizures C. Renal failure D. Hyperglycemia Rapid sodium correction can cause brain cell shrinkage and demyelination.
  3. What is the priority action for an intubated child with decreasing SpO and coarse breath sounds? A. Increase FiO B. Silence alarms C. Suction the airway D. Reintubate Suctioning may remove secretions blocking airflow and improve oxygenation.
  4. A patient is receiving continuous sedation. What is the most important nursing action?

A. Offer PO fluids B. Turn every 2 hours C. Monitor for hypotension and respiratory depression D. Provide distraction techniques Continuous sedation increases the risk of cardio-respiratory compromise.

  1. What is the preferred method of temperature measurement in a critically ill pediatric patient? A. Axillary B. Oral C. Rectal or core temperature D. Tympanic Core temperature gives the most accurate readings in critical illness.
  2. A pediatric patient with sickle cell crisis is in severe pain. What should the nurse do first? A. Offer fluids B. Administer prescribed opioids C. Start antibiotics D. Apply cold packs Pain control is a priority in sickle cell crisis, often requiring opioid analgesia.
  3. A nurse is preparing to give IV potassium. What is the safest practice? A. Administer as IV push

C. Urinalysis D. Electrolytes CSF analysis from the shunt is essential to diagnose shunt infections.

  1. A child receiving vancomycin develops red flushing and hypotension. What is the likely cause? A. Allergic reaction B. Septic shock C. Red man syndrome D. Hypoglycemia Red man syndrome is a histamine reaction from rapid infusion of vancomycin.
  2. A nurse is caring for a child receiving propofol. Which complication is the nurse most concerned about? A. Hypoglycemia B. Respiratory depression C. Tachycardia D. Agitation Propofol is a sedative-hypnotic that can cause significant respiratory depression and hypotension.
  3. What is the most appropriate intervention during a febrile seizure? A. Place a tongue blade in the mouth B. Immediately start antiepileptic medications

C. Protect the child from injury and monitor airway D. Apply ice packs to head and neck The key action is ensuring safety and monitoring the airway; most febrile seizures are self-limiting.

  1. A pediatric patient receiving high-frequency ventilation should be closely monitored for: A. Metabolic alkalosis B. Barotrauma C. Dehydration D. Hypernatremia High-frequency ventilation uses rapid small tidal volumes which can increase risk of barotrauma.
  2. Which lab value should be closely monitored in a child receiving furosemide? A. Sodium B. Potassium C. Chloride D. Calcium Furosemide can cause significant potassium loss, risking arrhythmias.
  3. A 2-year-old has suspected croup. What medication is most appropriate? A. Racemic epinephrine B. Albuterol