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Certified Pediatric Nurse Exam

Subjects : certifications, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
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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. Nursing care of the infant with pyloric stenosis
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
from head to toe
A narrowing within the Aorta resulting in collateral circulation

2. Treatment of Meningitis

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3. What has the HIB vaccine been successful in reducing?
the incidence of epiglottis - a life-threatening resp condition involving swelling of the supraglottis
Salicylates
No - it can only be controlled
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

4. What is broncho-pulmonary dysplasia?
E. Coli
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
36 months
inflammation located in the middle ear

5. BMI - underweight
< 5%
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Cool mist therapy - encourage oral intake - s/sx of resp. distress
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

6. Treatment of celiac disease
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
diazepam - lorazapam
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
Delayed puberty - viscous cervical secretions - difficulty getting pregnant

7. What are the S/SX of bleeds in hemophilia?
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
up to 14 days
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Between 6-12 months

8. Asthma
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
< 1
Growth spurt

9. What Pharmalogical measures can be used to treat GERD?
< 1
Maternal infection - premature rupture of membranes
Sterile-caused by blockage of thick mucous at the vas deferens
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

10. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
5ml/dl
School age
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Liver Biopsy

11. Two important assessment rules related to coarctation of the aorta?
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
Assess bilateral upper and lower pulses - assess 4-extremity blood pressures
Repeated involuntary urination in a child who should already by toilet trained at night
fecal soiling

12. treatment of hemolytic disease of the newborn
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
Phototherapy - exchange transfusion
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli

13. 3 symptoms of coarctation of the aorta
6 months
E. Coli
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
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities

14. Pathophysiology of hirschsprung's disease
up to 14 days
absence of ganglionic cells in distal bowel - peristalsis is absent as a result - resulting in inability to move food to be evacuated
gum hypertrophy
Urethral opening is positioned below the glans penis

15. Basic defect in coarctation of the aorta
A narrowing within the Aorta resulting in collateral circulation
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
Maternal infection - premature rupture of membranes
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides

16. Assessment of a patient with suspected epiglottitis
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Length board standiometer

17. Teaching for RSV
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Mechanical Ventalation - high inhaled o2 concentration
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

18. Treatment for mononucleosis
Hydrostatic reduction with a barium enema - using water soluable contrast w/air pressure instead of barium
none
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

19. Cause of bronchiolitis
signs of sepsis - may be only a fever - fever > 101.5 requires IMMEDIATE attention and treatment because risk of death
none
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus

20. What Component of Aspirin cause's Reye's Syndrome?
Salicylates
Abdominal ultrasound - Upper GI
diazepam - lorazapam
Regular diet with low sodium an no added salt

21. Leading cause of acquired heart disease in children
Successful management is based on early diagnosis and aggressive therapy
Mechanical Ventalation - high inhaled o2 concentration
Kawasaki disease - w/o treatment 25% will have permanent heart damage
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

22. signs and symptoms of meningitis in older children
Swelling at bleeding site - joint immobility @ site of hemarthrosis (joint bleeding)
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen

23. Nursing interventions for hemophilia
<25 yrs old
poor feeding - wt loss - fatigue - develop. delays - edema
Phototherapy - exchange transfusion
Factor replacements - joint immobilization - elevation of joints - monitor for bleeds

24. How does pertussis present?
BMI chart
Viral---Varicella or influenza
Time and discription of seizure
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months

25. What should be observed in a case of a seizure?
Barium enema
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
Time and discription of seizure
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant

26. At 6-24 months - head circumference is what size in relationship to chest circumference
Equal to
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
prevention - po antibiotics should be given before and after an invasive procedure
high protien and calorie - multivitamins - extra enzymes for high fat food

27. Pathophysiology of a fever and infection with sickle cell disease
decrease spleen function places the child at risk for infection. This is the #1 cause of death under 5 yrs old
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth
< 5%

28. Rheumatic Fever
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
2 snacks
Contact isolation - gown - gloves and handwashing

29. Nursing care for child with seizure

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30. What are the four main causes of viral croup?
parainfluenza - RSV - Influenza A&B - M. pneumonia
Small bowel biopsy
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
up to 14 days

31. Bronchiolitis
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash
Group B Streptococcus
trunk
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

32. Kawasaki Disease
Dental procedures - gum disease and urinary tract infections
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
Less than 120 f.
O2 status of blood - acid-base balance

33. Head circumference should be assessed until what age
maternal nutrition and genetics
3 years
lethargy - irritability - decrease feedings - fever - seizures
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks

34. 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
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
fever and infection
6 months

35. Viral Meningitis
An Acute inflamation of the meninges and CSF often caused by Enterovirus
chest x-ray following a Positive PPD skin test
pneumonia - encephalitis - secondary bacterial infections (abscess - cellulitis - sepsis)
Triple

36. Viral Croup
Swelling or obstruction of the Larynx
diazepam - lorazapam
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
E. Coli

37. Reyes Syndrome
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
<25 yrs old
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
13 years

38. Diet for Hirschsprung's prior to corrction and treatment
Low fiber - high calorie and protein
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
Regular diet with low sodium an no added salt

39. Average age of menarche
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
drooling
13 years
larger

40. 3 main causes of Bacterial meningitis in children
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
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
Salicylates
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

41. Another name for Hemolytic Disease of the Newborn
Less than 120 f.
A Chronic inflammation of the airway w. reversible episodes of obstruction - caused by an increased reaction of the airways to various stimuli
Erythroblastosis Fetalis
85-95%

42. What should be used for feeding a child during the post operative period following cleft palate surgery?
Milk - Ice cream - Malts - Grains
parainfluenza - RSV - Influenza A&B - M. pneumonia
infants-medicine dropper - bulb w/soft tip - special oral soft nipple - AVOID straws and sharp objects
85-95%

43. Define Proximodistal
from trunk to extremities
A typical lymphocytosis - mono-spot - EBV serology
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
1st-10kg= x 4ml 2nd-10kg= x 2ml each additional kg x 1ml kg over 20kg add 40 ml

44. Etiology of GERD
A narrowing within the Aorta resulting in collateral circulation
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
dysfunction of the lower esophageal sphincter and delayed gastric emptying time

45. Normal Bilirubin
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
< 1
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
measures the largest velocity which occurs during a forced exhale

46. Most cases of Reye's Syndrome follows what type of illness?
maternal nutrition and genetics
Adequate O2 adequatte hydration
Viral---Varicella or influenza
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

47. Pathophysiology of cystic fibrosis
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting
Protein/glutten causes villious atrophy in the small intestines resulting in malabsorption caused by decreased surface area for absorption
up to 14 days
Increased viscosity of mucous gland secretions - elevation of sweat electrolytes - increase in organic and enzymatic constituents of saliva - abnormalities in autonmoic nervous system function

48. difference btwn GER and GERD
Vaso-occulisive crisis - infection and sepsis
>95%
GERD is the complications and symptoms that happen because of GER
BMI chart

49. Age of children at half their adult height
complete physical and psychosocial assessment to rule out underlying disorders
2 years
Sterile-caused by blockage of thick mucous at the vas deferens
fever - chills - headache - stiff neck - irritability - petichial or purpuritic rash

50. Pathophysiology of Acute Asthma
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
Mechanical Ventalation - high inhaled o2 concentration
Appears 1-5 yrs after starting solid foods - failure to thrive - chronic diarrhea - abdominal distention - anorexia and muscle wasting
Swelling of the airways - mucous production - bronchospasms