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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.
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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. Treatment for Hirschsprungs
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver

2. What is Cystic Fibrosis?
A typical lymphocytosis - mono-spot - EBV serology
Contact isolation - gown - gloves and handwashing
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
An inherited autosomal recessive disorder of the exocrine glands - most common genetic disorder in the US

3. What can promote dryness in a child with enuresis?
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
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
Time and discription of seizure

4. Puberty for boys
12 years
increase BP proximal to defect - decrease in BP distal to defect - Absent pulses in lower extremities
maternal nutrition and genetics
5ml/dl

5. Prevention of infection in Sickle Cell Disease
No - it can only be controlled
Upper respiratory infection - after 1-2 weeks barky cough that lasts for several months
Penicillin Prophylaxis (BID)
from trunk to extremities

6. Part of body that grows the fastest in infancy
head
Previous history of life threatening reaction - Mod-severe illness w/wo fever
Mechanical Ventalation - high inhaled o2 concentration
Regular diet with low sodium an no added salt

7. RSV contagious for ...
A narrowing within the Aorta resulting in collateral circulation
Excessive stool fat
20 inches
up to 14 days

8. Celiac Disease
Enteropathy caused by an insensitivity to the gluten found in wheat
9 months
hearing loss - scarring - mastoiditis - meningitis
fever and infection

9. Precaustions needed for pt's with varicella
fever - profound impairment of consciousness caused by cerebral edema - impaired hepatic function caused by fatty changes of the liver
Airborne and contact
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Mid puberty

10. Bronchiolitis
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection
drooling
5ml/dl
Vaso-occulisive crisis - infection and sepsis

11. Sickle Cell Disease
inflammation located in the middle ear
genetic disorder of hemoglobin production characterized by the abnormal hemoglobin
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Maternal infection - premature rupture of membranes

12. Nursing care for Kawasaki Disease
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks
< 5%
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

13. Nursing care of the infant with pyloric stenosis
hearing loss - scarring - mastoiditis - meningitis
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
History - IV fluid therapy - electrolyte balance - npo - po feeds within 24-48 hours post op
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

14. Diet for CF patients
signs-URI - fever - malaise - pruritic rash appears first on trunk - lesion appear at different stages
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
high protien and calorie - multivitamins - extra enzymes for high fat food

15. At what age is a length board required?
Airborne and contact
0-24 months
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Poor suck - decrease tone - weak cry - fever - irritability - vomiting and diarrhea

16. How is mononucleosis diagnosed
Previous history of life threatening reaction - Mod-severe illness w/wo fever
5ml/dl
prevention - po antibiotics should be given before and after an invasive procedure
A typical lymphocytosis - mono-spot - EBV serology

17. What is epiglottitis?
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
GERD is the complications and symptoms that happen because of GER
acute and serious inflammation and obstruction of the supraglottis----LIFE threatening
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping

18. What Component of Aspirin cause's Reye's Syndrome?
Salicylates
E. Coli
decrease anxiety - IV antibiotics and corticosteroids - intubation/tracheotomy - After IV antibiotics then oral antibiotics for 7-10 days
Cardiac monitoring - relief of skin discomfort - mouth care - medicaiton administration - support family because childs irritablity - offer breaks

19. Screening for overweight or underweight child on chart
2 snacks
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
lethargy - irritability - decrease feedings - fever - seizures
BMI chart

20. Signs and Symptoms of Hemolytic Disease of the newborn
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
Jaundice in the first 24 hours of life - a rise in unconjugated bilirubin - anemia lasting 7-21 days
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

21. Viral Meningitis
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes
2.5 inches
An Acute inflamation of the meninges and CSF often caused by Enterovirus
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis

22. Teaching for RSV
Sterile-caused by blockage of thick mucous at the vas deferens
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
Group B Streptococcus
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration

23. Pathophysiology related to Head Trauma
A bacterial infection in the respiratory tract that is characterized by a paroxysmal (barky) cough
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
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
ABC's - suction secretions - provide O2 - turn on side - no restraints or objects in the mouth

24. When does the surgery to correct hypospadias usually occur?
Chronic disease of the pulmonary system in infancy -is common in infants who require supplemental o2 for more than 28 days after birth
Between 6-12 months
RSV (80%) - Parainfluenza - Adenovirus - Rhino Virus
IVIG-reduces the incidence of coronary artery abnormalities if given with 10 days of symptons - Salicylate therapy

25. Diet for Hirschsprung's prior to corrction and treatment
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
dysfunction of the lower esophageal sphincter and delayed gastric emptying time
Low fiber - high calorie and protein
2.5 inches

26. How many days after birth do bilirubin levels return to normal limits?
12-24 days
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
Kawasaki disease - w/o treatment 25% will have permanent heart damage

27. Signs and Symptoms of mononucleosis
Lack of energy (hallmark) - sore throat - fever - increase in atypical lymphocytes - lymphodenopathy - splenomegaly - hepato megaly - Jaundice
from head to toe
12 years
36 months

28. Asthma inhaler - what can be done to decrease risk of thrush
9 months
passage of abdominal contents to the esophagus
Less than 120 f.
Rinse mouth and brush teeth

29. Males Reproductive issues for CF patients
Brain damage - hearing loss and learning disabilities
prevention - po antibiotics should be given before and after an invasive procedure
E. Coli
Sterile-caused by blockage of thick mucous at the vas deferens

30. What is the cause of mononucleosis and its method of transmission?
Low fiber - high calorie and protein
Bulb Suction - Chest PT - Small frequent feedings - signs of dehydration
Epstein Barr Virus - transmitted with intimate contact
passage of abdominal contents to the esophagus

31. BMI - underweight
< 5%
Less than 120 f.
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

32. Define Proximodistal
>95%
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
from trunk to extremities
An obstruction of the small airways (bronchioles) caused by an acute upper resp. infection

33. Viral Croup
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
Swelling or obstruction of the Larynx
inflammatory disease that often occurs following an untreated group a beta-hemolytic streptococci infection
Conditioning traning - which involves a stimulus to waske the child. Retention control-have child drink fluids and delay urination. Waking child to void

34. What should be observed in a case of a seizure?
trunk
Difficulty breathing - hoarseness - hives - dizziness - lethargy - pallor - tachycardia
Enteropathy caused by an insensitivity to the gluten found in wheat
Time and discription of seizure

35. What are the symptoms of pancreatic involvement in Cystic Fibrosis?
Airborne and contact
Adequate O2 adequatte hydration
Blockage of duct results in pancreatic enzymes unabailable in the duodenum - decreased nutrient absorption
measure head circumference - strict I&O - fluid restriction - skin care at incision site - S & Sx of infection or increased ICP

36. Non-pharmalogical measures to treat GER
Pallor - malaise - irritability - fatigue - throbbing bilateral or unilateral headache
Small frequent feeds - thickend feeds - increase caloric density - monitor weight gain - car seat feedings - elevate head of bed - place on stomach for sleeping
drooling
They are people - need a balance of limits and independence

37. Varicella communicable
1 day prior to the appearance of lesions until all scabs are crusted and healed usually 2-4 weeks
Bacteria enter the blood stream from a site of localized infection and grows in the heart
Viral---Varicella or influenza
Strict I&O - watch for increase ICP - Monitor LFT (liver function) educate about avoidance for aspirin for kids < 18 yrs old

38. Reyes Syndrome
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
A disorder of toxic encephalopathy assoc. with other characteristic organ involvement. Assoc. w/Aspirin intake during a fever or viral illness
Acidic Bevarages (Cranberry Juice) -voiding before and after sexual intercourse -avoid bubble baths - avoid tight fitting clothes

39. Nursing care of patient with Meningitis
Isolation - decrease environmental stimuli - neuro checks - observe for complications - strict I&O - IV antibiotics
A thickening of the abdomianal muscle around the circular pylorus muscle causing obstruction of the gastric outlet
Abdominal ultrasound - Upper GI
Small bowel biopsy

40. treatment of hemolytic disease of the newborn
Haemophilus influenza type B--strep pneumoniae--Neisseria Meningitides
Delayed puberty - viscous cervical secretions - difficulty getting pregnant
Phototherapy - exchange transfusion
Milk - Ice cream - Malts - Grains

41. BMI-@ risk for overweight
Frequent emesis - irritability - poor wt. gain - apnea - recurrent pneumonia
85-95%
Erythromycin - droplet precaution - hydration - antipyretics - humidified o2
An Acute inflamation of the meninges and CSF often caused by Enterovirus

42. Normal presentation of cystic fibrosis
Group B Streptococcus
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
RBC's are stiff and non-pliable resulting in RBC trapping - vaso-occlusion and tissue ischemia
antibiotic therapy - mgmt of increased ICP - mgmt of acute shock - control Sz's - mgmt of airway and other complications

43. What confirms a positive TB infection?
5 inches
4 years
Antacids (Ranitidine) decrease gastric acid present - Reglan- increases gastric emptying time by increasing peristalsis
chest x-ray following a Positive PPD skin test

44. Treatment for sickle cell disease
Infant-circumcision - toddler prevent falls - consider helmet - school-age= no contact sports. Discuss limits - educate psychosocial support
supportive - folic acid daily - hydroxyurea for kids with high % HBS and frequent severe manifestations
Adequate O2 adequatte hydration
A narrowing within the Aorta resulting in collateral circulation

45. What is Hemolytic Disease of the Newborn
Avoid smoking - supine sleeping - avoid soft bedding or overheating infant
An abnormally rapid rate of RBC destruction due to RH or ABO incompatibility
birth-36 months
Hallmark--Currant Jelly stools - sudden onset of abdominal pain - inconsolable crying - drawing knees to chest - bilious vominting

46. What promotes unsickling of RBC's?
Rinse mouth and brush teeth
Maternal infection - premature rupture of membranes
Enemas to releave mechanical obstruction or surgical correction if unresponsive to enemas
Adequate O2 adequatte hydration

47. Teaching for Mononucleosis
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
Severe brain damage caused by the deposit of unconjugated bilirubin in the brain
Equal to
Mild analgesic - throat remedies - activity restrictions due to the risk of splenic rupture

48. Where does the adolescent experience rapid growth?
trunk - gonads and associative tissue
IV Factor Replacements - PT for joint damage related to repeated hemarthrosis
fever - malaise - poor appetite - wt loss -cough - night sweats and chills
No manual assessment w/out equip. for rapid intubation--obtain a lateral neck film

49. Focus of adolescent discipline
Steatorrhea - frequent respiratory infections during infancy - failure to thrive
Occurs in the first few weeks of life - increase occurence in males - dehydration and olive-like mass in the abdomen
Equal to
Give freedom and choices - save battles for the important things

50. Pathophysiology of cystic fibrosis
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
Dust - mold - animal dander - viral infections
Steatorrhea - frequent respiratory infections during infancy - failure to thrive

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Certified Pediatric Nurse Exam

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