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100+ Free ca-cna-critical-care-pediatrics Practice Questions

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2026 Statistics

Key Facts: ca-cna-critical-care-pediatrics Exam

165

Exam Questions

CNA

4 hours

Exam Time Limit

CNA

$570 CAD

Member Fee

CNA 2026

5 years

Validity Period

CNA

3,900 hrs

Required Practice

CNA (or 1,950 hrs with specialty course)

WAT-1 / CAPD

Key PICU Scales

Canadian pediatric guidelines

The CNA CNCCP(C) exam features 165 multiple-choice questions over 4 hours, costing $570 CAD for CNA members and $756 CAD for non-members. It is the premier pediatric critical care nursing credential in Canada, requiring an active Canadian RN/NP license and 3,900 hours of specialty clinical practice (or 1,950 hours with a post-basic specialty certificate). Key focus areas include cardiovascular, respiratory, neurological, and multisystem pediatric critical care management, alongside professional practice and family-centered care.

Sample ca-cna-critical-care-pediatrics Practice Questions

Try these sample questions to test your ca-cna-critical-care-pediatrics exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1An infant with Tetralogy of Fallot becomes acutely agitated, cyanotic, and tachypneic during an IV insertion attempt. Which of the following should be the nurse's immediate action?
A.Administer a fluid bolus of 20 mL/kg of normal saline
B.Place the infant in a knee-chest position
C.Administer intravenous morphine sulfate
D.Prepare for endotracheal intubation
Explanation: Placing the infant in a knee-chest position is the immediate first-line intervention for a hypercyanotic spell ('tet spell'). This position increases systemic vascular resistance (SVR), which decreases the right-to-left shunt across the ventricular septal defect, forcing more blood flow into the pulmonary circulation. It also promotes venous return to the heart.
2A child is receiving a continuous infusion of milrinone post-cardiapulmonary bypass. Which of the following physiological effects should the nurse expect?
A.Increased systemic vascular resistance and increased contractility
B.Decreased myocardial contractility and decreased heart rate
C.Increased myocardial contractility and decreased systemic vascular resistance
D.Decreased pulmonary vascular resistance and decreased contractility
Explanation: Milrinone is a phosphodiesterase-3 (PDE-3) inhibitor that acts as an 'inodilator'. It increases intracellular calcium in cardiac myocytes, enhancing myocardial contractility (positive inotropy), while simultaneously promoting smooth muscle relaxation in blood vessels, leading to vasodilation (decreased systemic and pulmonary vascular resistance).
3A neonate with Hypoplastic Left Heart Syndrome (HLHS) is post-operative Day 1 from a Stage 1 Norwood procedure. The infant's pulse oximeter reads 95%. Which of the following is the most appropriate interpretation and nursing action?
A.This is an optimal SpO2 indicating excellent pulmonary function; maintain current settings.
B.This indicates pulmonary overcirculation and systemic hypoperfusion; notify the physician.
C.This indicates severe systemic hypoxia; increase the fraction of inspired oxygen (FiO2).
D.This indicates shunt occlusion; prepare for immediate surgical exploration.
Explanation: Post-Norwood target SpO2 is typically 75-85%. An SpO2 of 95% indicates pulmonary overcirculation (too much blood going to the lungs) at the expense of systemic circulation (systemic hypoperfusion, or 'systemic steal'). The nurse should notify the physician, as interventions to increase pulmonary vascular resistance (e.g., weaning FiO2, allowing mild hypercapnia) are needed to balance the Qp:Qs ratio.
4A neonate with suspected ductal-dependent congenital heart disease is started on a continuous infusion of Alprostadil (Prostaglandin E1). Which of the following must be available at the bedside?
A.Defibrillator pads and pacing cables
B.Airway management and intubation equipment
C.A syringe pump of calcium gluconate
D.Peritoneal dialysis catheter insertion kit
Explanation: Apnea is a well-known, dose-dependent side effect of Alprostadil (Prostaglandin E1) infusion, occurring in up to 10-12% of neonates, particularly in the first few hours of therapy. Therefore, airway management and intubation equipment must be immediately available at the bedside. Close respiratory monitoring is essential.
5The nurse is assessing a child who returned from cardiac surgery 4 hours ago. Which of the following signs is most indicative of cardiac tamponade?
A.Hypertension, bradycardia, and wide pulse pressure
B.Muffled heart sounds, hypotension, and elevated central venous pressure
C.Tachycardia, warm extremities, and increased chest tube drainage
D.Tachypnea, decreased central venous pressure, and hepatomegaly
Explanation: Beck's triad for cardiac tamponade includes muffled heart sounds, hypotension, and jugular venous distension (manifested as elevated central venous pressure / left atrial pressure in infants). A sudden cessation of chest tube drainage in the post-operative period is a common precipitating factor.
6The nurse is preparing to administer Digoxin to a 6-month-old infant in the PICU. Under which of the following circumstances should the nurse hold the dose and notify the physician?
A.The infant's heart rate is 84 beats per minute.
B.The infant's potassium level is 4.8 mmol/L.
C.The infant has an active respiratory rate of 38 breaths per minute.
D.The infant's PR interval is 0.11 seconds on the ECG.
Explanation: Generally, Digoxin should be held in an infant if the apical heart rate is less than 90 beats per minute (or less than 60 beats per minute in an adolescent/adult). Bradycardia is a primary sign of Digoxin toxicity, and administering the dose could further depress conduction through the AV node.
7A 5-year-old child is admitted to the PICU post-operative Day 0 from a bidirectional Glenn procedure (Superior Cavopulmonary Connection). Which of the following nursing interventions is most critical for optimizing venous return?
A.Keep the head of the bed flat to increase cerebral perfusion pressure.
B.Elevate the head of the bed to 30-45 degrees.
C.Maintain high positive-pressure ventilation settings.
D.Administer aggressive fluid boluses to maintain a CVP > 20 mmHg.
Explanation: After a Glenn shunt, blood flow to the lungs is passive, relying on venous pressure from the superior vena cava. Elevating the head of the bed to 30-45 degrees decreases superior vena cava pressure, facilitates gravitational drainage from the head and upper body through the shunt, and prevents SVC syndrome (facial edema, headache, increased ICP).
8A child with Transposition of the Great Arteries (TGA) is scheduled for a balloon atrial septostomy (Rashkind procedure). What is the primary purpose of this intervention?
A.To definitively repair the transposition by switching the great arteries
B.To close a patent ductus arteriosus to prevent pulmonary congestion
C.To create or enlarge an atrial communication to allow mixing of systemic and pulmonary blood
D.To relieve severe subpulmonic stenosis and improve right ventricular outflow
Explanation: In TGA, the systemic and pulmonary circulations run in parallel rather than in series, which is incompatible with life unless there is mixing of blood. A balloon atrial septostomy creates or enlarges an atrial septal defect, allowing oxygenated blood from the pulmonary circuit to mix with deoxygenated blood in the systemic circuit, temporarily stabilizing the patient until an arterial switch operation can be performed.
9To ensure accurate measurements when monitoring central venous pressure (CVP) in a supine pediatric patient, where should the nurse level the transducer?
A.At the level of the mid-clavicular line, second intercostal space
B.At the level of the phlebostatic axis (fourth intercostal space, mid-axillary line)
C.At the level of the sternal notch
D.At the level of the left atrium (fourth intercostal space, anterior axillary line)
Explanation: The phlebostatic axis, located at the fourth intercostal space at the mid-axillary line (representing the level of the right atrium), is the correct anatomical landmark for leveling the pressure transducer for CVP and arterial line monitoring. Incorrect leveling leads to hydrostatic pressure errors (transducer too low reads falsely high; transducer too high reads falsely low).
10A child with meningococcal meningitis is in septic shock with cool, pale extremities, capillary refill of 5 seconds, and narrow pulse pressure. The physician orders an epinephrine infusion. At lower clinical doses, which receptor profile is primarily targeted by epinephrine?
A.Pure alpha-1 adrenergic vasoconstriction
B.Primary beta-1 and beta-2 adrenergic stimulation with minimal alpha effect
C.Moderate dopaminergic receptor stimulation
D.Pure parasympathetic blockage
Explanation: At lower clinical doses (typically < 0.05-0.1 mcg/kg/min), epinephrine has predominant beta-1 (inotropic and chronotropic) and beta-2 (systemic vasodilation) adrenergic effects. At higher doses, alpha-1 adrenergic effects predominate, causing significant systemic vasoconstriction.

About the ca-cna-critical-care-pediatrics Exam

The Certified Nurse in Critical Care Pediatrics (Canada) — CNCCP(C) — certification is the national professional standard for pediatric critical care nursing excellence. Developed by the Canadian Nurses Association in partnership with the Canadian Association of Critical Care Nurses (CACCN), this credential validates advanced clinical judgment and expert skill in caring for critically ill children from birth to 18 years. The exam covers cardiovascular, respiratory, neurologic, gastrointestinal, renal, endocrine, and multisystem shock states, as well as pain/sedation management, withdrawal, delirium, and ethical/professional practice.

Assessment

165 multiple-choice questions (independent and case-based)

Time Limit

4 hours

Passing Score

Criterion-referenced scaled score

Exam Fee

$588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra. (Canadian Nurses Association (CNA))

ca-cna-critical-care-pediatrics Exam Content Outline

20%

Cardiovascular System

Congenital heart disease, post-op cardiac surgery management, hemodynamics, vasoactive drug titration, and arrhythmia management.

20%

Respiratory System

Mechanical ventilation, blood gas interpretation, ARDS, airway emergencies, and non-invasive ventilation.

15%

Neurologic System

ICP monitoring, TBI, status epilepticus, neurovascular assessments, and cerebral perfusion optimization.

15%

Pain, Agitation, Delirium, and Withdrawal

Pain/sedation scoring, withdrawal syndrome (WAT-1), delirium prevention and management, and comfort measures.

15%

Gastrointestinal, Renal, Endocrine & Metabolic Systems

AKI, peritoneal dialysis, DKA, SIADH, DI, nutrition support, and fluid/electrolyte balance.

10%

Multisystem & Shock

Sepsis guidelines, shock resuscitation, trauma, burns, toxic ingestions, and MODS.

5%

Professional Practice

Family-centered care, end-of-life care, ethics, organ donation protocols, and interprofessional collaboration.

How to Pass the ca-cna-critical-care-pediatrics Exam

What You Need to Know

  • Passing score: Criterion-referenced scaled score
  • Assessment: 165 multiple-choice questions (independent and case-based)
  • Time limit: 4 hours
  • Exam fee: $588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ca-cna-critical-care-pediatrics Study Tips from Top Performers

1Master the pediatric Glasgow Coma Scale (GCS) and cerebral perfusion pressure (CPP) calculations.
2Understand Congenital Heart Disease (CHD) physiology, specifically ductal-dependent lesions (e.g., HLHS, Coarctation) and post-op Care.
3Review pediatric ventilator settings, including lung-protective strategies for ARDS and high-frequency oscillatory ventilation (HFOV).
4Understand the pharmacology and titration of vasoactive drugs (e.g., epinephrine, milrinone, norepinephrine, dopamine).
5Review the WAT-1 (Withdrawal Assessment Tool-1) scoring and tapering protocols for iatrogenic opioid/benzodiazepine withdrawal.
6Know the pediatric sepsis resuscitation bundles, fluid administration limits (20 mL/kg boluses), and early antibiotic timing.
7Study family-centered care principles, including sibling presence in the PICU and ethical decisions regarding withdrawal of life support.

Frequently Asked Questions

What does the CNCCP(C) credential stand for?

CNCCP(C) stands for Certified Nurse in Critical Care Pediatrics (Canada). It is a specialty credential awarded by the Canadian Nurses Association (CNA) to registered nurses who meet advanced clinical hours and pass the national certification exam.

How long is the CNCCP(C) exam, and how many questions does it have?

The exam is 4 hours long and consists of approximately 165 multiple-choice questions. These include both stand-alone questions and case-based question sets where several questions refer to a single clinical scenario.

What are the eligibility requirements for the CNCCP(C) exam?

Candidates must hold an active Canadian RN or NP license and have completed either: 3,900 hours of clinical practice in pediatric critical care nursing within the past 5 years (plus 300 hours of continuing education), or 1,950 hours of practice if they have completed a recognized post-basic specialty program in pediatric critical care nursing.

How much does the CNA certification exam cost?

The exam fee is $570 CAD for CNA members and $756 CAD for non-members. These fees do not include taxes or the test center booking fees, which generally range between $85 and $110 CAD.

How do I maintain my CNCCP(C) certification?

CNA certification is valid for 5 years. To renew, you must either submit 100 continuous learning (CL) hours acquired during the 5-year cycle or rewrite the specialty certification exam.