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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What should be observed in a case of a seizure?
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
none
Time and discription of seizure
Penicillin Prophylaxis (BID)

2. Age group the limbs grow the fastest
36 months
School age
12-24 days
from trunk to extremities

3. Childs weight at 6 months compared to birth weight
# of stools per day - goal=2-3 stools per day
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
double birth weight
0-24 months

4. Nursing care of the infant with pyloric stenosis
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Swelling of the airways - mucous production - bronchospasms
Time and discription of seizure
< 5%

5. Sequence of resp distress
6 months
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Erythroblastosis Fetalis
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

6. Assessment of a patient with suspected epiglottitis
Mid puberty
Maternal infection - premature rupture of membranes
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

7. Signs and symptoms of Reye's Syndrome
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Mid puberty
prevention - po antibiotics should be given before and after an invasive procedure
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

8. Can Asthma be cured?
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Less than 120 f.
No - it can only be controlled
up to 14 days

9. Part of body that grows the fastest in infancy
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml
head
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds

10. Nursing care for Kawasaki Disease
< 5%
Give freedom and choices - save battles for the important things
10 inches
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

11. Non-pharmalogical measures to treat GER
Growth spurt
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
6 months

12. BMI- overweight
Dental procedures - gum disease and urinary tract infections
complete physical and psychosocial assessment to rule out underlying disorders
>95%
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection

13. Prevention of infection in Sickle Cell Disease
Penicillin Prophylaxis (BID)
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
parainfluenza - RSV - Influenza A&B - M. pneumonia
provide airway clearance (CPT - postural drainage - coughing & deep breathing) prevent infection - aggressively treat any infection with IV antibiotics - pt family education - adequate nutrition - psychosocial support

14. Pathophysiology of Chronic Asthma
inflammation and hypersensitivity to triggers
School age
Group B Streptococcus
Barium enema

15. Clinical signs of infection wilth sickle cell disease
4 years
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
13 years
Triple

16. Two important assessment rules related to coarctation of the aorta?
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

17. Reyes Syndrome
Time and discription of seizure
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
36 months
drooling

18. Signs and Symptoms of Hemolytic Disease of the newborn
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
85-95%
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Cough at night or after physical activity lasting >1 week - chest tightness - shortness of breath - wheezing

19. Two examples of benzodiazepines
BMI chart
10 inches
4 years
diazepam - lorazapam

20. What should be done to minimize the risks of Sudden infant death syndrome?
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
# of stools per day - goal=2-3 stools per day
0-24 months
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days

21. What are the side effects of depakote?
Hepatoxicity - pancreatitis
Mid puberty
Repeated involuntary urination in a child who should already by toilet trained at night
Bacteria enter the blood stream from a site of localized infection and grows in the heart

22. Signs and Symptoms of Celiac Disease
Equal to
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting

23. What is used to diagnose pyloric stenosis?
double birth weight
Abdominal ultrasound - Upper GI
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
crowded living conditions - homeless and low income

24. What Component of Aspirin cause's Reye's Syndrome?
Salicylates
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
drooling

25. Etiology of GERD
5ml/dl
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
No - it can only be controlled
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2

26. BMI-@ risk for overweight
Sterile-caused by blockage of thick mucous at the vas deferens
<25 yrs old
85-95%
9 months

27. Where does the adolescent experience rapid growth?
High persistent fever for 5 days - swelling of the conjunctiva w/o drainage - inflammation of the mouth-lips-tongue - swollen red hands & feet - rash - cervical lymphadinopathy
trunk - gonads and associative tissue
>95%
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough

28. What interventions prevent urinary tract infections?
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
Maternal infection - premature rupture of membranes
head

29. What should be used for feeding a child during the post operative period following cleft palate surgery?
Abdominal ultrasound - Upper GI
MVA - bike accidents and falls
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
BMI chart

30. What Pharmalogical measures can be used to treat GERD?
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
<25 yrs old
larger

31. Considerations should be taken when treating a child with cystic fibrosis who has a ___________ tx promptly since bacterial colonization increases destruction of lung tissue----prevention is key
fever and infection
decrease in myocardial contractility - cause congestion of the circulatory system. the heart is unable to pump adequate amounts of bld to meet the bodys needs
Excessive stool fat
inflammation and hypersensitivity to triggers

32. What promotes unsickling of RBC's?
Milk - Ice cream - Malts - Grains
Repeated involuntary urination in a child who should already by toilet trained at night
Adequate O2 adequatte hydration
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention

33. Part of the body that grows the fastest in the toddler-preschool age
trunk - gonads and associative tissue
10 inches
head
trunk

34. Normal presentation of cystic fibrosis
chest x-ray following a Positive PPD skin test
Abdominal ultrasound - Upper GI
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

35. Risk factors of tuberculosis
Dental procedures - gum disease and urinary tract infections
Milk - Ice cream - Malts - Grains
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
crowded living conditions - homeless and low income

36. Varicella communicable
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

37. Treatment of Meningitis

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38. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
3 years
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

39. Clinicla manifestations of sickle cell disease
Day 3 of life
Vaso-occulisive crisis - infection and sepsis
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Contact isolation - gown - gloves and handwashing

40. At 6-24 months - head circumference is what size in relationship to chest circumference
Milk - Ice cream - Malts - Grains
Equal to
glutten free diet - no wheat - rye - barley and oats - may use corn - rice - millet - multivitam - folic acid -iron. Avoid high fiber during periods of bowel inflammation
O2 status of blood - acid-base balance

41. Diagnose Intussusception by
Barium enema
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
birth-36 months
Group B Streptococcus

42. Signs and Symptoms of Bilirubin Kernicterus (encephalopathy)
Triple
lethargy - irritability - decrease feedings - fever - seizures
A mild self limiting condition affecting 50% of newborns because of increin - increase RBC Hemolysis - Decrease in RBC life span - decrease ability to conjugate bilirubrubin - decrease ability to excrete bilirubin in feces
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

43. Treatment for Varicella
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Brain damage - hearing loss and learning disabilities

44. Complications of acute otitis media
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Viral---Varicella or influenza
hearing loss - scarring - mastoiditis - meningitis
1-6 months

45. Normal Bilirubin
maternal nutrition and genetics
< 1
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
one portion of the intestine 'telescopes' into another leading to lymphatic and venous obstruction which causes ischemia - mucous backflow into the intestine and leaking of blood into the intestine

46. Nursing interventions for hemophilia
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds
hearing loss - scarring - mastoiditis - meningitis
drooling

47. What is physiologic Jaundice?
3 years
Rinse mouth and brush teeth
12 years
A mild self limiting condition affecting 50% of newborns because of increin - increase RBC Hemolysis - Decrease in RBC life span - decrease ability to conjugate bilirubrubin - decrease ability to excrete bilirubin in feces

48. Age range that is appropriate to use a length chart
glutten free diet - no wheat - rye - barley and oats - may use corn - rice - millet - multivitam - folic acid -iron. Avoid high fiber during periods of bowel inflammation
birth-36 months
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption

49. Assess the cause of enuresis
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
complete physical and psychosocial assessment to rule out underlying disorders
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor

50. Pancreatic enzyme therapy for cystic fibrosis is adjusted based on what factors growth and development?
crowded living conditions - homeless and low income
chest x-ray following a Positive PPD skin test
# of stools per day - goal=2-3 stools per day
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2