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Clinical Nurse Specialist - Wellness through Acute Care (Pediatric) Practice Test

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Exam Code: ACCNS-P
Exam Name: Clinical Nurse Specialist - Wellness through Acute Care (Pediatric)
Exam format: Computer-based- linear (fixed form)
Number of Questions: 175 multiple choice questions
Number of scored items: 150 scored questions (25 are unscored “pretest” items used for statistical data)
Time allotted: 3½ hours (3.5 hours)
Passing score / cut score: 94 correct out of the 150 scored items
Certification valid for: 5 years

- Cardiovascular
- Acute inflammatory disease (e.g.- myocarditis-endocarditis- pericarditis- vasculitis-Kawasaki)
- Cardiac surgery
- Cardiac tamponade
- Cardiogenic shock
- Cardiomyopathies (e.g.- hypertrophic- dilated-restrictive- idiopathic)
- Dysrhythmias
- Heart failure (acute and chronic)
- Hypertension
- Hypertensive urgencies or emergencies
- Pulmonary edema
- Structural heart defects and disease (acquiredand congenital)
- Vasculitis

- Respiratory
- Acute lung injury (ALI)- acute respiratorydistress syndrome (ARDS)
- Acute pulmonary embolus
- Acute respiratory failure
- Air-leak syndromes (e.g.- pneumothorax-pulmonary interstitial emphysema-pneumopericardium- pneumomediastinum)
- Airway obstruction
- Aspiration
- Asthma/reactive airway disease
- Chronic lung disease (e.g.- bronchopulmonarydysplasia- exacerbation- interstitialpulmonary fibrosis)
- Congenital and acquired anomalies
- Cystic fibrosis
- Exacerbation of chronic lung disease
- Inhalation injuries
- Obstructive sleep apnea
- Pleural effusion
- Pulmonary hemorrhage
- Pulmonary hypertension
- Pulmonary infections
- Thoracic and pulmonary trauma and injuries
- Thoracic surgery (e.g.- lung reduction surgery-pneumonectomy- lobectomy- trachealsurgery)

Endocrine/Hematology/Gastrointestinal/Renal/Integumentary

- Endocrine
- Adrenal insufficiency
- Diabetes mellitus
- Diabetic ketoacidosis (DKA) andhyperglycemic hyperosmolar state (HHS)
- Hyperglycemia
- Hypoglycemia
- Inborn errors of metabolism
- Pituitary disorders
- Syndrome of inappropriate antidiuretichormone secretion
- Thyroid disorders

- Hematology/Immunology/Oncology
- Anemia
- Anticoagulation
- Autoimmune diseases
- Bleeding disorders
- Blood and blood-product transfusion
- Coagulopathies
- Congenital and acquired immunosuppression
- Hematologic and solid tumors
- Hyperbilirubinemia
- Myelosuppression (i.e.- neutropenia-thrombocytopenia)
- Organ and tissue transplantation andassociated problems
- Sickle cell disease
- Venous thromboembolism

- Gastrointestinal
- Abdominal trauma
- Bowel infarction/obstruction/perforation
- Gastroesophageal reflux
- GI infectious disorders
- GI abnormalities (congenital and acquired)
- GI hemorrhage
- GI motility disorders (congenital and acquired)
- GI surgeries
- Inflammatory bowel disease
- Liver disease (e.g.- hepatitis- hepatic failure)
- Malnutrition
- Nausea/vomiting
- Pancreatitis

- Renal/Genitourinary
- Acute kidney injury
- Chronic kidney disease (CKD)
- Renal/genitourinary abnormalities (congenitaland acquired)
- Nephrotoxic medication-associated kidneyinjury (NAKI)
- Electrolyte imbalances
- Fluid volume imbalances
- Incontinence
- Infections (e.g.- UTI- PID- STIs)
- Renal trauma

- Integumentary
- Dermatologic disorders (e.g.- incontinenceassociated dermatitis- impetigo- coxsackie-atopic dermatitis)
- Exfoliative skin disorders (e.g.- StevensJohnson- TEN- epidermolysis bullosa)
- Infectious skin disorders
- IV infiltration and extravasation
- Pressure injuries
- Wounds

Musculoskeletal/Neurology/Psychosocial

- Musculoskeletal
- Congenital anomalies
- Functional issues (e.g.- immobility- debility-falls- gait disorders- myopathies)
- Infections (e.g.- necrotizing fasciitis-osteomyelitis)
- Rhabdomyolysis
- Spinal disease (e.g.- scoliosis- kyphosis- discdisease)
- Sports injuries
- Fractures

- Neurology
- Brain death
- Cerebral salt wasting
- Congenital neurological abnormalities
- Encephalopathy
- Head and brain trauma/injury
- Hydrocephalus
- Intracerebral hemorrhage
- Intracranial hypertension
- Migraine headaches
- Neurologic infectious diseases
- Neuromuscular disorders
- Seizure disorders
- Space-occupying lesions
- Spinal cord injury
- Stroke
- Vascular malformation

- Psychosocial/Behavioral/Cognitive Health Issues
- Aggression
- Agitation
- Anxiety disorders (e.g.- PTSD- OCD- fears-phobias)
- Attention-deficit/hyperactivity disorder
- Autism spectrum disorders
- Delirium
- Developmental delays and regression
- Eating disorders
- Learning disabilities and disorders
- Maltreatment (e.g.- abuse and neglect)
- Medical nonadherence
- Mood disorders (e.g.- depression)
- Personality disorders (e.g.- antisocialbehaviors- schizophrenia)
- Post ICU syndrome
- Self-harm
- Sleep disorders
- Substance-use disorder
- Suicidal behavior

Multisystem

- Factors Influencing Health Status (risk assessment- prevention and wellness)
- Advanced care planning
- Care transition
- Caregiver burden
- Developmental care
- Genetic counseling
- Growth and development (e.g.- anticipatoryguidance- milestones)
- Immunizations/vaccinations
- Injury prevention (e.g.- shaken baby- helmets-car seats- environmental modification- gunsafety)
- Behavioral health screenings
- Nutrition and weight management
- Pain prevention and management(e.g.- needle stick- chronic pain syndromes)
- Physical health screenings
- Risk-taking behaviors (e.g.- unprotected sex-substance use)
- Safe sleep
- Vulnerable population screenings(e.g.- child abuse- intimate partner violence-human trafficking- bullying)
- Social determinants of health (e.g.- access tocare- socioeconomic factors- health literacy)
- Population health
- Team-based care
- Gender-affirming care
- Patient and family-centered care
- Interventions for health promotion
- Transition to adult care
- Health policy
- Dyslipidemia (early-onset screening)

- Multisystem
- Acid-base imbalances
- Burns
- Neonatal opioid withdrawal syndrome
- Compartment syndrome
- Distributive shock (e.g.- anaphylaxis-neurogenic)
- End-of-life issues
- Failure to thrive
- Hospital-acquired conditions (e.g.- CAUTI-CLABSI- VAP- falls)
- Hypovolemic shock
- Hypoxic ischemic encephalopathy
- Infectious diseases (e.g.- perinatal- viral-bacterial)
- Morbid obesity
- Multisystem trauma
- Near-drowning
- Pain
- Palliative care issues
- Patient safety issues
- Post-resuscitation care
- Sensory impairment (e.g.- hearing- visual-speech- tactile)
- Sepsis/septic shock and MODS
- Toxic exposure (acute and chronic)
- Toxic ingestions and inhalations

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Nursing
ACCNS-P
AACN Clinical Nurse Specialist - Wellness through
Acute Care (Pediatric)
https://killexams.com/pass4sure/exam-detail/ACCNS-P
Question: 1
A 6-year-old child with type 1 diabetes mellitus is experiencing symptoms of
hypoglycemia. Which intervention should the nurse prioritize?
A. Administering a rapid-acting glucagon injection
B. Administering oral glucose gel or tablets
C. Administering a rapid-acting insulin injection
D. Administering an oral hypoglycemic agent
Answer: B
Explanation: Hypoglycemia is characterized by low blood glucose levels and
can lead to neurologic symptoms if untreated. The initial treatment for
hypoglycemia in a conscious child is the administration of oral glucose gel or
tablets. Glucagon injection is used in severe cases of hypoglycemia or when the
child is unconscious and unable to swallow. Rapid-acting insulin injections and
oral hypoglycemic agents are not appropriate interventions for hypoglycemia.
Question: 2
A 16-year-old adolescent with type 1 diabetes mellitus is admitted to the
emergency department with symptoms of diabetic ketoacidosis (DKA). Which
laboratory finding would the nurse expect to see in this patient?
A. Hyperglycemia and metabolic alkalosis
B. Hypoglycemia and metabolic acidosis
C. Hyperglycemia and metabolic acidosis
D. Hypoglycemia and metabolic alkalosis
Answer: C
Explanation: Diabetic ketoacidosis (DKA) is a life-threatening complication of
diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and
ketosis. Hyperglycemia and metabolic acidosis are hallmark findings in DKA)
Hypoglycemia and metabolic alkalosis are not consistent with the
pathophysiology of DKA.
Question: 3
A 14-year-old adolescent presents with symptoms of growth hormone
deficiency. Which assessment finding would be consistent with this condition?
A. Excessive growth of facial and body hair
B. Hypertension and weight gain
C. Rapid growth and increased appetite
D. Delayed puberty and short stature
Answer: D
Explanation: Growth hormone deficiency in adolescents can result in delayed
puberty and short stature. Excessive growth of facial and body hair is more
commonly associated with conditions such as polycystic ovary syndrome in
females or androgen excess disorders in males. Rapid growth and increased
appetite may be seen in conditions like gigantism oracromegaly, which result
from excessive growth hormone production. Hypertension and weight gain are
not typically associated with growth hormone deficiency.
Question: 4
A 12-year-old child is admitted to the pediatric unit with suspected adrenal
insufficiency. Which clinical manifestations would the nurse expect to assess in
this child?
A. Hyperglycemia and polyuria
B. Hypertension and tachycardia
C. Hypotension and weight loss
D. Hypoglycemia and lethargy
Answer: C
Explanation: Adrenal insufficiency is characterized by decreased production of
adrenal hormones, particularly cortisol. Clinical manifestations include
hypotension, weight loss, fatigue, and electrolyte imbalances. Hyperglycemia
and polyuria are more commonly associated with diabetes mellitus, while
hypertension and tachycardia are not typical findings in adrenal insufficiency.
Hypoglycemia and lethargy are more commonly seen in insulin excess or
insulin resistance disorders, such as diabetes mellitus.
Question: 5
A 7-year-old child is diagnosed with hypothyroidism. Which clinical
manifestation would the nurse expect to assess in this child?
A. Heat intolerance and weight loss
B. Tachycardia and hypertension
C. Exophthalmos and goiter
D. Cold intolerance and weight gain
Answer: D
Explanation: Hypothyroidism is characterized by decreased production of
thyroid hormones, resulting in a decreased metabolic rate. Clinical
manifestations include cold intolerance, weight gain, fatigue, constipation, and
slowed growth. Heat intolerance and weight loss are more commonly seen in
hyperthyroidism. Tachycardia and hypertension may be present in
hyperthyroidism but are not typical findings in hypothyroidism. Exophthalmos
and goiter are associated with Graves' disease, an autoimmune disorder causing
hyperthyroidism.
Question: 6
A 9-year-old child is admitted to the pediatric unit with a diagnosis of
syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which
electrolyte imbalance would the nurse expect to assess in this child?
A. Hyponatremia
B. Hypokalemia
C. Hypernatremia
D. Hyperkalemia
Answer: A
Explanation: Syndrome of inappropriate antidiuretic hormone secretion
(SIADH) is characterized by excessive secretion of antidiuretic hormone
(ADH), leading to water retention and dilutional hyponatremia. Hypernatremia
is a condition characterized by high plasma sodium levels. Hypokalemia and
hyperkalemia refer to low and high levels of potassium, respectively, and are
not directly related to SIADH.
Question: 7
A 5-year-old child is diagnosed with hyperthyroidism. Which clinical
manifestation would the nurse expect to assess in this child?
A. Cold intolerance and weight gain
B. Bradycardia and constipation
C. Hypotension and depression
D. Heat intolerance and weight loss
Answer: D
Explanation: Hyperthyroidism is characterized by excessive production of
thyroid hormones, resulting in an increased metabolic rate. Clinical
manifestations include heat intolerance, weight loss, tachycardia, tremors,
hyperactivity, and increased appetite. Cold intolerance and weight gain are
more commonly seen in hypothyroidism. Bradycardia, constipation,
hypotension, and depression are not typical findings in hyperthyroidism.
Question: 8
A 10-year-old child with newly diagnosed type 1 diabetes mellitus is at risk for
developing hyperglycemic hyperosmolar state (HHS). Which clinical
manifestation would the nurse expect to assess in this child?
A. Kussmaul respirations
B. Fruity breath odor
C. Extreme thirst and polyuria
D. Abdominal pain and vomiting
Answer: C
Explanation: Hyperglycemic hyperosmolar state (HHS) is a life-threatening
complication of diabetes mellitus characterized by profound hyperglycemia,
dehydration, and hyperosmolarity without significant ketoacidosis. Clinical
manifestations include extreme thirst (polydipsia) and polyuria due to osmotic
diuresis. Kussmaul respirations and fruity breath odor are more commonly seen
in diabetic ketoacidosis (DKA). Abdominal pain and vomiting may be present
in both DKA and HHS but are more commonly associated with DKA.
Question: 9
A neonate is diagnosed with a rare inborn error of metabolism. The nurse
understands that which of the following is a key characteristic of inborn errors
of metabolism?
A. They are acquired during childhood due to environmental factors
B. They are caused by a deficiency of specific enzymes
C. They are typically resolved by adulthood
D. They are more common in females than in males
Answer: B
Explanation: Inborn errors of metabolism are genetic disorders caused by a
deficiency or dysfunction of specific enzymes involved in metabolic pathways.
They are not acquired during childhood but are present from birth. Inborn
errors of metabolism are chronic conditions that often require lifelong
management. The prevalence of these disorders varies, and they can affect both
males and females.
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Clinical Nurse Specialist - Wellness through Acute Care (Pediatric) Practice Test

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