CCLS Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Cried and was too anxious to cope with the IV start: It begins with an observation but ends with an interpretation ("too anxious to cope") stated as fact.

Cooperated poorly at first but calmed during the IV start: "Cooperated poorly" is a judgment, and "calmed" gives no observable behavior to support it.

Cried, pulled arm away, and said "stop" during the IV start: Correct. The entry describes observable behaviors and the child's own words without judgment.

Cried, pulled arm away, and seemed angry with the nurse throughout: This is an interpretation stated as fact, without the behaviors that support it.

Child life documentation uses objective, behavior-based language, such as what was seen and what the child said, so the team can interpret it accurately.

Answer: A

Share her assessment and ask rounds for a set schedule: Correct. The CCLS contributes psychosocial assessment to the team and advocates for predictability, which reduces anticipatory anxiety in school-age children.

Enter a new dressing schedule in the electronic order system: Entering or changing orders is outside the CCLS role; scheduling is a team decision.

Help him keep a chart of when past dressing changes happened: Tracking past times does not make future changes predictable; the schedule itself needs a team decision.

Wait for a nurse to request a formal child life consult: The CCLS already has assessment data; waiting delays help the child clearly needs.

Collaboration means bringing the child life assessment to the interdisciplinary team and advocating for changes the team can make together.

Answer: B

Promise to keep it private so the teen will feel safe to open up: The specialist cannot promise secrecy; if the teen then discloses a safety risk, the promise must be broken and trust is lost.

Explain before they share that safety concerns go to the team: Correct. Code of Ethics: confidentiality and its limits. Being honest up front about what must be shared (risk of harm to self or others, or of being harmed) respects the adolescent and keeps trust intact.

Say that anything shared will be passed on to the parents: This overstates what must be shared and is likely to end the conversation and damage trust.

Tell the teen to save it for a talk with the psychologist: This shuts down a teen who is reaching out; referral may follow, but only after listening.

Never promise absolute secrecy; state the limits of confidentiality before the disclosure so the adolescent can choose what to share.

Answer: D

Encourage the team to proceed, since the guardian has consented: Legal consent is in place, but for a nonurgent procedure ignoring the child's dissent skips assent and risks a traumatic, poorly coping experience.

Tell the child it will be over before she even notices it: This is false reassurance; it undermines trust and does nothing to address her fears.

Advise the guardian to cancel the study until the child is ready: Recommending cancellation overrides the guardian and medical team and is outside the child life role.

Ask for a brief pause to explore her fears and plan coping: Correct. Consent vs assent: consent comes from the guardian, but a school-age child's assent is actively sought. Because the procedure is not urgent, the specialist advocates for time to assess her fears, give honest information and offer choices before proceeding.

Guardian consent makes a procedure legally permissible, but the child's developmentally appropriate assent is still sought, especially when the procedure is not urgent.

Answer: A

Explore the parents' worries and what their son already knows: Correct. Assess the family's understanding and beliefs about the illness and the child's current knowledge before acting. That conversation lets the specialist explain how honest, age-appropriate information supports coping and plan the response with the parents and team.

Tell him he has a bad infection that the medicine will fix: Deceptive; false reassurance damages trust when he learns the truth.

Tell him his diagnosis directly because he has asked about it: Overrides the parents without first assessing or collaborating with them; disclosure is planned with the family and team.

Change the subject until the team has decided what to tell him: Ignores his cue and leaves his fear unaddressed; the specialist can acknowledge the question while collaborating with the parents.

When family wishes and a child's questions conflict, first assess the parents' understanding and the child's knowledge, then plan honest communication together.

Answer: A

Explore the family's feeding practices before calling his self-feeding delayed: Correct. Developmental theory is applied through cultural humility: norms vary across families, and his other milestones are on track. Learning the family's practices comes before labeling a skill as delayed.

Document a delay in self-care skills and request an early intervention referral: Judges the child against a single cultural norm without assessing context; his other skills are age-appropriate.

Teach the grandmother to stop feeding him so that he builds independence: Imposes the specialist's own norm and disregards the family's stated practices.

Plan meals around what is assumed to be typical for families of their background: Stereotyping: assumptions about a group replace assessment of this family.

Interpret milestones in light of each family's practices; ask about those practices before labeling a delay.

Answer: D

She is coping well and can be given a lower priority: Quiet compliance can look like coping, but at this age it may hide fear or helplessness.

Her behavior is typical for preschoolers and needs no follow-up: Preschoolers usually show protest; total silence and stillness are not typical and call for follow-up.

She has adjusted to procedures and no longer needs a coping plan: Assuming adjustment without assessment risks missing unmet needs; she should still have a coping plan.

Her passive compliance may mask distress and needs further assessment: Correct. Silent, frozen compliance is unusual for a preschooler during repeated procedures and may signal masked distress or learned helplessness; play and parent input can clarify her coping.

Do not equate "cooperative" with "coping"; unusually passive behavior in a young child warrants closer assessment.

Answer: A

Ask Andre, through talk or drawing, what he recalls of the last scan: Correct. A previous negative experience is a major risk factor; the child's own recollections and feelings must be assessed before building a new coping plan.

Give detailed MRI preparation now, based on the plan from his first visit: Repeating the earlier plan without assessment ignores that it may not have met his needs.

Recommend that the team schedule the scan with sedation this time: Sedation is a medical decision; recommending it before assessing the child is outside the CCLS role.

Accept the mother's report and give routine MRI preparation: The parent's view is valuable, but it is not a substitute for assessing the child after a documented negative experience.

Quiet behavior does not mean a past experience has been resolved; assess the child directly and individualize the plan.

Answer: C

A 15-year-old with cystic fibrosis on his sixth planned admission, who knows the unit staff well: Familiarity and a planned admission lower this adolescent's immediate risk; he can be seen later in the day.

A 9-year-old with asthma who is comfortable and expected to go home this afternoon: An impending discharge with no procedures and a comfortable child signals low current need.

A 4-year-old on her first admission, now scheduled for an emergency appendectomy: Correct. First hospitalization, preschool age, and an unplanned invasive procedure happening soon combine several major psychosocial risk factors, so she is the highest priority.

A 7-year-old sleeping after an uncomplicated fracture repair with both parents at the bedside: Follow-up may be useful, but the procedure is over and the child is resting with parents present; this is lower priority.

Prioritize children whose risk factors stack up: young age, first admission, and unplanned or invasive procedures that are imminent.

Answer: A

Explore barriers with the family and involve social work: Correct. Assessing healthcare disparities means looking past the label to structural barriers such as distance, work schedules and cost, then collaborating on resources.

Ask the child privately why the parent misses visits: Putting the child in the middle of the family's difficulties is inappropriate and can create conflict.

Assume transportation is the only barrier and arrange a ride: Acting on an assumption skips the assessment; there may be several barriers.

Accept the chart label and focus on adherence teaching: Accepting the label risks bias and misses the barriers driving the missed visits.

Healthcare disparities and structural barriers are part of health care data; assess them directly rather than accepting a chart label.

Answer: A

Help her create legacy items she chooses for her brothers: Correct. Legacy-making lets adolescents shape how they are remembered; following her choices, such as letters, recordings or art for her brothers, supports control and meaning, with her family involved as she wishes.

Suggest her parents make a memory box after she dies: A memory box is helpful, but making it later without her takes away her chance to shape her own legacy.

Encourage her to focus on getting stronger for now: Redirecting away from her stated wish dismisses her awareness and her need for meaning and control.

Refer her to the chaplain to talk about life after death: Spiritual care may be welcome, but this referral does not respond to the specific wish she expressed.

Legacy work with a dying adolescent is led by the teen's own wishes and gives control and meaning; involve the family as she chooses.

Answer: D

"Grandpa got very sick, and he passed away.": Euphemisms like "passed away" are abstract for preschoolers and do not tell him that Grandpa cannot come back.

"Grandpa is resting now and is not in pain anymore.": "Resting" suggests sleep or a temporary state and can lead him to expect Grandpa to return.

"You will understand more about what happened when you are older.": Avoids the question; preschoolers need simple honest answers now.

"Grandpa died. His body stopped working, so he cannot come back.": Correct. Concrete, honest language ("died") explains nonfunctionality and irreversibility, concepts preschoolers are still developing.

Use the word "died" and simple, concrete explanations; euphemisms such as sleep or a trip confuse and frighten young children.

Answer: C

Keep him flat but have his father hold his free hand: A parent's hand helps, but supine restraint still increases fear and loss of control; upright positioning is preferred.

Ask the father to wait outside until the IV is placed: Separates the child from his parent at the most stressful moment and ignores the father's wish to help.

Suggest an upright hug hold on his father's lap: Correct. Comfort positioning keeps the child upright in a caregiver's arms, which reduces distress and the need for restraint while giving the parent a supportive role.

Teach him bubble breathing to use while he lies flat: Breathing is a good coping tool, but it leaves the more important problem, being held flat, unaddressed.

Comfort positioning with a caregiver is a core non-pharmacological support that reduces restraint and distress; other coping tools work best on top of it.

Answer: A

Pause, check in, and let him choose what comes next: Correct — individualized preparation: adapting to cues, exploring his reaction and offering choices about pace restores control before continuing.

Continue with the mask so he receives complete information: Ignores his cues of distress and overload.

End the session and ask his mother to finish it at home: Abandons the preparation and shifts it to the parent.

Tell him he will be asleep and will not remember any of it: Dismisses his feelings and skips the sensory preparation he still needs.

Preparation follows the child's cues: pause, check in, offer choices and adjust the pace and content.

Answer: A

Ask which care tasks they want and share that with the team: Correct. PFCC: participation and collaboration. The specialist learns how the parents want to be involved, such as bathing, comforting during procedures or giving medicine by mouth with nursing guidance, and brings that to the team.

Invite them to the next meeting of the parent support group: Peer support is valuable, but it does not address their wish to participate in her care on the unit.

Reassure them that the nurses are trained to handle everything: Reassurance about staff skill misses the point; they are asking for a role in their daughter's care.

Suggest that they take breaks while staff manage her care: Rest matters, but encouraging them to step back is the opposite of what they are asking for.

Families are partners in care; ask how they want to participate and collaborate with the team to make that participation possible.

Answer: D

Redirect him to a calmer activity to reduce his distress: Stops play that may be helping him process the event; meets the adult's need, not the child's.

Remove the toy vehicles from the playroom for now: Takes away the tools he is using to express and master the experience.

Tell him the accident is over and he is safe now: Premature reassurance that dismisses what he is working through in play.

Explain to his mother how this play helps him: Correct — therapeutic play: repetitive re-enactment is a common way children process trauma. Supporting the mother while continuing to observe (and referring if play becomes stuck or escalates) meets both needs.

Repetitive re-enactment in play is a normal way children process frightening events; support it, educate the parent, and watch for signs that a referral is needed.