CPNP-AC Certified Pediatric Nurse Practitioner - Acute Care (CPNP-AC) Practice Questions

A 13-year-old child with an acute exacerbation of cystic fibrosis experiences sudden pleuritic chest pain and dyspnea. The CPNP-AC immediately performs thoracic point-of-care ultrasound (POCUS) at the bedside. Which sonographic finding definitively EXCLUDES a pneumothorax at the specific intercostal acoustic window being examined?

A 2-week-old previously healthy full-term infant presents to the pediatric emergency department with sudden-onset acute bilious (dark spinach-green) emesis, abdominal distension, and progressive lethargy. Which life-threatening diagnosis must be the primary consideration on the differential diagnosis until definitively excluded by emergency upper gastrointestinal imaging?

A 16-year-old adolescent presents to the emergency department following an intentional multi-substance overdose. Physical examination demonstrates marked delirium, severe agitation, core temperature 39.4°C (102.9°F), heart rate 146 bpm, widely dilated pupils (8 mm bilaterally) with sluggish light reflex, completely dry and flushed skin, absent bowel sounds, and acute urinary retention yielding 900 mL on catheterization. Which toxidrome is definitively characterized by this clinical presentation?

A 4-year-old child with spastic quadriplegic cerebral palsy, tracheostomy, and home mechanical ventilator dependence presents to the emergency department with acute hypoxemia and increased tracheal secretions. When obtaining the health history from the caregiver, which parameter is MOST critical for the Acute Care Pediatric Nurse Practitioner (CPNP-AC) to establish first to evaluate this acute deterioration?

A 2-month-old infant with a known history of an unrepaired large ventricular septal defect (VSD) is brought to the pediatric emergency department with acute respiratory distress, tachypnea, and diaphoresis during feeding. The infant was born at 38 weeks' gestation and had previously been tracking at the 25th percentile for weight, but has fallen below the 3rd percentile over the past 3 weeks.

The caregiver reports that over the past 24 hours, the infant has had frequent coughing episodes, takes nearly 45 minutes to finish a 2-ounce bottle, and develops profound perioral duskiness and irritability with crying. The infant has had no recorded fever, vomiting, diarrhea, or rash, but has required increasing layers of swaddling to remain comfortable.

On physical examination, the infant is tachypneic with subcostal retractions, has a holosystolic murmur at the left lower sternal border, hepatomegaly palpated 3.5 cm below the right costal margin, and cool peripheral extremities.

Which historical detail elicited during the health history provides the STRONGEST clinical indication that this infant has transitioned from compensated congestive heart failure to acute pulmonary overcirculation and physiological decompensation?

A 15-year-old adolescent admitted to the acute surgical step-down unit following an operative fixation of a pelvic fracture displays fluctuating affect and defensiveness during clinical rounds. The CPNP-AC administers the CRAFFT screening tool to evaluate health risks. The CRAFFT tool is validated specifically to identify which category of risk in adolescents?