100+ Free CCRN-K Pediatric Practice Questions

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A pediatric clinical educator is reviewing knee-chest positioning with PICU staff. Why is this position the priority intervention during a hypercyanotic 'tet' spell in Tetralogy of Fallot?

It increases venous return and right ventricular preload

It increases systemic vascular resistance and reduces right-to-left shunting

It decreases pulmonary vascular resistance directly

It opens the ductus arteriosus mechanically

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2026 Statistics

Key Facts: CCRN-K Pediatric Exam

150

Total Items

AACN CCRN-K Pediatric handbook

125 + 25

Scored + Unscored

AACN CCRN-K Pediatric handbook

Exam Time

AACN CCRN-K Pediatric handbook

~88

Passing Cut Score

AACN standard-setting (approx 70%)

80/20

Clinical Judgment / Professional Caring

AACN CCRN-K Pediatric test plan

$255/$370

Member/Nonmember Fee

AACN CCRN-K Pediatric handbook

CCRN-K Pediatric uses the same 150-item exam (125 scored + 25 unscored, 3 hours) and blueprint as CCRN Pediatric: Clinical Judgment 80% and Professional Caring & Ethical Practice 20%. Within Clinical Judgment: Cardiovascular 14%, Respiratory 13%, Multisystem 13%, Neurologic 10%, Endocrine 6%, Gastrointestinal 6%, Renal 6%, Hematology/Immunology 4%, Musculoskeletal 4%, Behavioral/Psychosocial 4%. Eligibility requires influence hours, not direct bedside hours.

Sample CCRN-K Pediatric Practice Questions

Try these sample questions to test your CCRN-K Pediatric exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A pediatric clinical educator is reviewing knee-chest positioning with PICU staff. Why is this position the priority intervention during a hypercyanotic 'tet' spell in Tetralogy of Fallot?

A.It increases venous return and right ventricular preload

B.It increases systemic vascular resistance and reduces right-to-left shunting

C.It decreases pulmonary vascular resistance directly

D.It opens the ductus arteriosus mechanically

Explanation: Knee-chest position increases systemic vascular resistance (SVR), which reduces right-to-left shunting across the VSD and increases pulmonary blood flow. Educators should reinforce this as the immediate, no-cost first step before oxygen, morphine, fluids, or phenylephrine.

2During a unit-based council, a CCRN-K candidate is asked which lesion is the most common cyanotic congenital heart defect presenting in infancy. What is the correct answer?

A.Ventricular septal defect

B.Patent ductus arteriosus

C.Tetralogy of Fallot

D.Coarctation of the aorta

Explanation: Tetralogy of Fallot is the most common cyanotic congenital heart defect. VSD, PDA, and coarctation are acyanotic lesions. Knowledge Professionals teaching new PICU staff should differentiate cyanotic vs acyanotic lesions to anchor pathophysiology discussions.

3A PICU manager is reviewing a sentinel event involving a neonate with hypoplastic left heart syndrome whose ductus arteriosus closed before stage I palliation. Which medication keeps the ductus open preoperatively?

A.Indomethacin

B.Prostaglandin E1 (alprostadil)

C.Furosemide

D.Digoxin

Explanation: Prostaglandin E1 (alprostadil) maintains ductal patency in ductal-dependent lesions like HLHS, TGA, and critical coarctation. Indomethacin closes the ductus. Apnea is a key adverse effect that PICU leaders should ensure staff anticipate.

4A clinical nurse specialist is teaching SVT recognition. What is the typical heart rate range for SVT in an infant?

A.100-150 bpm

B.150-180 bpm

C.220-300 bpm

D.Greater than 350 bpm

Explanation: Infant SVT typically presents at 220-300 bpm with narrow QRS and absent or abnormal P waves. Sinus tachycardia in infants rarely exceeds 220. This rate threshold is a high-yield teaching point for new PICU nurses.

5Which intervention is appropriate FIRST for a stable infant in SVT?

A.Synchronized cardioversion at 0.5-1 J/kg

B.Vagal maneuvers (ice to face)

C.Adenosine 0.1 mg/kg rapid IV push

D.Amiodarone infusion

Explanation: For stable SVT, vagal maneuvers (ice to the face in infants, Valsalva in older children) are first-line. If unsuccessful, adenosine 0.1 mg/kg rapid IV push follows. Cardioversion is reserved for unstable patients. PALS algorithm sequencing is core CCRN-K content.

6A QI leader is auditing post-operative care for a child following Norwood procedure. The Norwood is stage I palliation for which lesion?

A.Tetralogy of Fallot

B.Transposition of the great arteries

C.Hypoplastic left heart syndrome

D.Truncus arteriosus

Explanation: The Norwood procedure is stage I palliation for HLHS, followed by Glenn (stage II) and Fontan (stage III). Knowledge Professionals overseeing pediatric cardiac programs must understand the staged single-ventricle pathway.

7Which sign is the EARLIEST and most sensitive indicator of compensated shock in a child?

A.Hypotension

B.Tachycardia

C.Bradycardia

D.Decreased urine output

Explanation: Tachycardia is the earliest sign of compensated pediatric shock. Children maintain blood pressure until late decompensation, so hypotension is a LATE sign. Educators must teach staff that 'children crash from a cliff' — recognize tachycardia early.

8What is the recommended initial fluid bolus for a child in hypovolemic shock per current PALS guidance?

A.5 mL/kg of normal saline over 60 minutes

B.10 mL/kg of D5W over 30 minutes

C.20 mL/kg of isotonic crystalloid over 5-10 minutes

D.40 mL/kg of albumin over 10 minutes

Explanation: PALS recommends 20 mL/kg of isotonic crystalloid (NS or LR) given over 5-10 minutes for pediatric hypovolemic and septic shock, reassessing after each bolus. Up to 60 mL/kg may be required in the first hour.

9A PICU educator reviews CVP interpretation. Central venous pressure (CVP) primarily reflects which parameter?

A.Left ventricular afterload

B.Right ventricular preload

C.Pulmonary capillary wedge pressure

D.Systemic vascular resistance

Explanation: CVP reflects right ventricular preload (right atrial pressure). PCWP estimates left atrial pressure (LV preload). SVR represents afterload. This distinction guides hemodynamic decision-making in PICU.

10After Glenn (bidirectional cavopulmonary anastomosis) procedure, which factor most improves pulmonary blood flow?

A.High PEEP

B.Permissive hypercapnia

C.Maintaining sinus rhythm and adequate preload

D.Aggressive diuresis

Explanation: After Glenn, pulmonary blood flow is passive. Maintaining sinus rhythm and adequate preload supports passive flow into the pulmonary arteries. High PEEP and excessive diuresis impair flow. This is critical knowledge for PICU educators.

About the CCRN-K Pediatric Exam

CCRN-K Pediatric is AACN's Knowledge Professional credential for nurses who INFLUENCE the care of acutely/critically ill pediatric patients without providing direct bedside care. The exam content blueprint mirrors CCRN Pediatric; CCRN-K differs only by eligibility pathway and is designed for educators, managers, APRNs in non-bedside roles, quality/safety leaders, and clinical research nurses who shape PICU practice.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

88 out of 125 scored items (approx 70%)

Exam Fee

$255 AACN members / $370 non-members (AACN Certification Corporation / PSI)

CCRN-K Pediatric Exam Content Outline

14%

Cardiovascular

Pediatric shock recognition, congenital heart defects (TOF, TGA, HLHS), dysrhythmias, heart failure, and post-cardiac surgery care that influencers oversee

13%

Respiratory

Pediatric respiratory failure, mechanical ventilation, airway management, ABG interpretation, and bronchiolitis/RDS escalation pathways

13%

Multisystem

Pediatric sepsis, septic shock, SIRS, MODS, trauma, burns, and resuscitation prioritization across PICU teams

10%

Neurologic

TBI management, ICP monitoring, status epilepticus, meningitis/encephalitis, and pediatric GCS application

Endocrine

DKA, hypoglycemia, adrenal crisis, thyroid dysfunction, and pediatric glycemic management

Gastrointestinal

NEC, intussusception, dehydration, GI bleeding, and acute liver failure

Renal

Acute kidney injury, CRRT in children, nephrotic syndrome, and electrolyte management

Hematology/Immunology

Sickle cell crisis, oncologic emergencies, coagulopathies, transfusion reactions, and immunodeficiencies

Musculoskeletal

Pediatric fractures, compartment syndrome, scoliosis, and muscular dystrophies relevant to PICU care

Behavioral/Psychosocial

Pediatric mental health crises, developmental considerations, and family-centered intensive care

20%

Professional Caring & Ethical Practice

AACN Synergy Model, advocacy, collaboration, education and quality improvement leadership, ethics, and end-of-life decision support

How to Pass the CCRN-K Pediatric Exam

What You Need to Know

Passing score: 88 out of 125 scored items (approx 70%)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: $255 AACN members / $370 non-members

Keys to Passing

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

CCRN-K Pediatric Study Tips from Top Performers

1Even in non-bedside roles, master pediatric normal vitals/labs across age groups so you can mentor and audit care

2Study the AACN Synergy Model deeply — CCRN-K candidates often see more leadership, education, and QI scenarios in the 20% professional practice domain

3Review congenital heart defect pathophysiology and post-op cardiac priorities as they appear on educator competency assessments

4Practice pediatric shock recognition and weight-based fluid resuscitation calculations (mL/kg) to coach bedside teams

5Use timed full-length simulations to build endurance for the 3-hour appointment

Frequently Asked Questions

How is CCRN-K Pediatric different from CCRN Pediatric?

Same 150-item exam and same content blueprint. The difference is eligibility: CCRN-K is for nurses who INFLUENCE the care of acutely/critically ill pediatric patients (educators, managers, APRNs in non-bedside roles, quality leaders), while CCRN Pediatric requires direct bedside care hours.

Who should take the CCRN-K Pediatric pathway instead of CCRN Pediatric?

Pediatric clinical nurse educators, PICU nurse managers and directors, advanced practice nurses in non-bedside influence roles, clinical nurse specialists, quality and safety leaders, and clinical research nurses whose work shapes pediatric critical care delivery.

How many questions are on the CCRN-K Pediatric exam?

150 items total: 125 scored and 25 unscored pretest items, identical to CCRN Pediatric per AACN's handbook.

How long is the CCRN-K Pediatric exam?

AACN allows a 3-hour appointment for CCRN-K Pediatric, the same as CCRN Pediatric.

What score is needed to pass CCRN-K Pediatric?

Approximately 88 correct out of 125 scored items (about 70%), based on AACN's standard-setting process for the shared blueprint.

What are the eligibility requirements for CCRN-K Pediatric?

Current unrestricted RN/APRN license plus 1,750 indirect/influence hours in the past 2 years (875 in the most recent year) OR 2,000 hours in the past 5 years (144 in the most recent year), in roles that influence the care of acutely/critically ill pediatric patients.

What is the CCRN-K Pediatric exam fee?

$255 for AACN members and $370 for non-members for the initial application, matching CCRN Pediatric pricing.