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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

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Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. Causes of Bronchopulmonary Dysplasia
Mechanical Ventalation - high inhaled o2 concentration
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Erythroblastosis Fetalis
Group B Streptococcus

2. Key nursing intervention for subacute bacterial endocarditis
E. Coli
10 inches
prevention - po antibiotics should be given before and after an invasive procedure
measures the largest velocity which occurs during a forced exhale

3. What level does the bilirubin need to be at in order for jaundice to occur?
5ml/dl
gum hypertrophy
Airborne and contact
Penicillin Prophylaxis (BID)

4. At 6-24 months - head circumference is what size in relationship to chest circumference
6 months
A typical lymphocytosis - mono-spot - EBV serology
Equal to
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis

5. Diagnose Intussusception by
Equal to
4 years
Barium enema
An Acute inflamation of the meninges and CSF often caused by Enterovirus

6. Treatment for mononucleosis
none
Sterile-caused by blockage of thick mucous at the vas deferens
Maternal infection - premature rupture of membranes
5ml/dl

7. Peak flow meter
measures the largest velocity which occurs during a forced exhale
Dental procedures - gum disease and urinary tract infections
Cool mist therapy - encourage oral intake - s/sx of resp. distress
from head to toe

8. Asthma inhaler - what can be done to decrease risk of thrush
Rinse mouth and brush teeth
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

9. Leading cause of head injury
4 years
36 months
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
MVA - bike accidents and falls

10. What is used to diagnose pyloric stenosis?
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Enteropathy caused by an insensitivity to the gluten found in wheat
Abdominal ultrasound - Upper GI

11. Focus of adolescent discipline
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Give freedom and choices - save battles for the important things
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
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

12. Prevention of infection in Sickle Cell Disease
Abdominal ultrasound - Upper GI
Penicillin Prophylaxis (BID)
Foreskin is used during the surgical repair
No - it can only be controlled

13. Hypospadias
used for prolonged sz's
Urethral opening is positioned below the glans penis
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
Previous history of life threatening reaction - Mod-severe illness w/wo fever

14. Viral Croup
Swelling or obstruction of the Larynx
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
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

15. What should a child's wt be at 1 yr compared to birth weight?
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Triple
An Acute inflamation of the meninges and CSF often caused by Enterovirus

16. Clinical signs of infection wilth sickle cell disease
Phototherapy - exchange transfusion
< 1
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death

17. How many meals and snacks should a 1-3 yr old have in a day 3 meals
Time and discription of seizure
Foreskin is used during the surgical repair
2 snacks
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening

18. Can Asthma be cured?
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old
No - it can only be controlled
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
Repeated involuntary urination in a child who should already by toilet trained at night

19. Precaustions needed for pt's with varicella
measures the largest velocity which occurs during a forced exhale
congenital anomaly of lower intestine resulting in mechanical obstruction of intestine
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Airborne and contact

20. Kawasaki Disease
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
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
Oatmeal baths - short nails - mittens - tylenol - fluids - warm baths - Acyclovir (immunocompromised pts)
Enteropathy caused by an insensitivity to the gluten found in wheat

21. How does pertussis present?
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Repeated involuntary urination in a child who should already by toilet trained at night
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

22. S/SX of Hirschsprungs
Chronic constipation - ribbon-like foul smelling stools - chronic abdominal distention
Enteropathy caused by an insensitivity to the gluten found in wheat
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Maternal infection - premature rupture of membranes

23. What is an acute otitis media?
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
inflammation located in the middle ear
double birth weight
lethargy - irritability - decrease feedings - fever - seizures

24. Signs of increased ICP
Salicylates
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
diazepam - lorazapam
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

25. Risk factors of tuberculosis
crowded living conditions - homeless and low income
Family history - EEG - CBC - LP and MRI
6 months
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

26. Complications of meningitis
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
crowded living conditions - homeless and low income
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Brain damage - hearing loss and learning disabilities

27. What should be observed in a case of a seizure?
trunk - gonads and associative tissue
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
Time and discription of seizure

28. What is the treatment for epiglottitis?
Hepatoxicity - pancreatitis
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
20 inches

29. Pathophysiology of celiac disease
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
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
tachypnea - hypoxemia - accessory muscle use - nasal flaring - hypoventilation - apnea - resp failure

30. Childs weight at 6 months compared to birth weight
Hepatoxicity - pancreatitis
double birth weight
Brain damage - hearing loss and learning disabilities
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

31. Lead screening should begin. at ..
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
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
9 months

32. What foods are prohibited for a person with Celiac Disease?
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
gum hypertrophy
Milk - Ice cream - Malts - Grains

33. Teaching for RSV
Length board standiometer
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
3 years
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

34. During an abdominal assessment when should auscultation occur
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Repeated involuntary urination in a child who should already by toilet trained at night
10 inches

35. Treatment of a bleed in hemophilia
poor feeding - wt loss - fatigue - develop. delays - edema
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
GERD is the complications and symptoms that happen because of GER
A narrowing within the Aorta resulting in collateral circulation

36. Leading cause of bacterial meningitis in Neonates
A narrowing within the Aorta resulting in collateral circulation
Group B Streptococcus
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

37. Test to evaluate a Seizure disorder
Family history - EEG - CBC - LP and MRI
inflammation located in the middle ear
4 years
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

38. Pathophysiology related to Head Trauma
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
A typical lymphocytosis - mono-spot - EBV serology
high protien and calorie - multivitamins - extra enzymes for high fat food
Directly related to force - Acceleration-Deceleration= brain striking part of skull - Shearing force= stretching caused by unequal rate of movement of the brain tissue resulting in small tearing of the cerbral vessels

39. 3 symptoms of coarctation of the aorta
Swelling or obstruction of the Larynx
1-6 months
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
Give freedom and choices - save battles for the important things

40. Which growth chart is appropriate for use - Growth for the young child who is measured laying down?
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Foreskin is used during the surgical repair
Auscultation should be preformed after observation and prior to percussion and palpation to avoid altering the true bowel sounds
Length Chart

41. Part of body that grows the fastest in infancy
Rinse mouth and brush teeth
E. Coli
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
head

42. ABG
O2 status of blood - acid-base balance
drooling
They are people - need a balance of limits and independence
No - it can only be controlled

43. GER (gastroesophageal reflux)
passage of abdominal contents to the esophagus
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
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

44. Two important assessment rules related to coarctation of the aorta?
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Swelling or obstruction of the Larynx
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
increase in bilirubin caused by increase in RBC destruction and decrease in bilirubin clearance through the GI system

45. What can promote dryness in a child with enuresis?
School age
Regular diet with low sodium an no added salt
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support

46. What is Cystic Fibrosis?
Barium Swallow Upper GI to rule out abnormalities - PH probe - Apnea monitor
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Rinse mouth and brush teeth

47. Signs and Symptoms of Hemolytic Disease of the newborn
< 5%
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Regular diet with low sodium an no added salt
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

48. Reyes Syndrome
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
9 months
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP
Day 3 of life

49. What should be done to minimize the risks of Sudden infant death syndrome?
3 years
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

50. Characteristics of the RBC's in sickle cell

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